See the Expert for Functional Eyelid Lift/Blepharoplasty
As an Oculoplastic Surgeon and an Ophthalmologist who has the highest level of training for surgery of the eyelids, Dr. Sherman knows the eye and eyelid anatomy to the highest degree. This level of expertise allows her to use specialized techniques to produce a naturally proportioned result that improves the peripheral vision. This is achieved by meticulous removal of the excess skin in the upper lid that blocks ability to see properly. This is the most common procedure that Dr. Sherman performs; therefore, she knows the details required to achieve the best result. Because she is an Ophthalmologist and Oculoplastic Surgeon, eyes are her first priority. At the Sherman Aesthetic Center, before and after surgery, we will carefully measure your eyelid position and examine your eyes under a special microscope called a slit lamp. This important pre-operative exam will help promote the health and comfort of your eyes during the recovery period.
What is Blepharoplasty/Functional Eyelid Lift?
Eyelid Lift, also called Blepharoplasty, is eyelid surgery to remove excess skin and fat, using incisions along the natural folds of the eyelid. This procedure may be either functional (to improve vision) or cosmetic.
As one ages, the upper and lower eyelid tissues begin to relax. These nonspecific changes may be accelerated by sun exposure, allergies, or recurrent swelling, all of which can result in stretching of the skin. In some individuals, this process may be hereditary. The result is an excess of eyelid tissue referred to as “dermatochalasis.” Stretching and relaxation of the orbital septum (middle layer of the eyelid) allows orbital fat to move forward. As a result, a “fullness” to the eyelid develops and increases over time.
Excess eyelid tissue may create a tired look, a heavy feeling to the lids, and may make patients look and feel older. When the lids become too heavy they can limit our side or peripheral vision, thus affecting our ability to drive and do other activities of daily living comfortably. In these cases surgical treatment can lead to improved peripheral vision and a better quality of life.
Functional Blepharoplasty/Eyelid Lift consists of surgical removal of the excess skin, and fat if needed, leading to an improved and more comfortable field of view which can allow the patient to see better to drive, read, and perform their daily activites. Lower eyelid blepharoplasty is rarely covered by insurance and is considered a cosmetic procedure. Click here for more information about a cosmetic eyelid lift.
Combined with Brow Lift
Blepharoplasty is often performed as a single procedure, but your surgeon may also recommend a brow lift to achieve the best results. Upper eyelids may become heavy due to the development of excess eyelid skin, drooping of the eyebrows, or a combination of these factors. When upper eyelid heaviness is caused by a combination of sagging eyebrows and excess eyelid skin, both the eyelid and the eyebrow must be corrected. Many patients will request to only undergo eyelid surgery, wanting to avoid surgery on the eyebrows. However, the lifting of the brows greatly improves the result of an eyelid lift. You would need a customized facial analysis at the Sherman Aesthetic Center prior to surgery to determine which treatment is right for you.
Frequently Asked Questions
What are the requirements prior to the surgery?
A preoperative comprehensive consultation is necessary before surgery to measure the eyelid and eyebrows and carefully examine you eye under a microscope.
A taped and untaped visual field test is also required by your insurance company to document the level of functional loss of vision. This test is performed by measuring the side vision with the eyelids in a relaxed position and then repeating the test with the eyelid skin taped in an upward position.
Pre-operative photos are required by your insurance company to document the extent of the lid fold that is blocking your vision. Every insurance company has specific guidelines as to whether you qualify as a candidate for a functional eyelid lift or blepharoplasty. It is your responsibility as a patient to check with your insurance carrier for information on the degree of coverage. However, at your pre-operative exam, we can discuss your findings and your specific policy’s requirements as to whether you qualify for insurance coverage of a functional eyelid lift.
What happens during the procedure?
In upper eyelid surgery, the Oculoplastic surgeon first measures the excess skin and marks the incision in the natural creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.
In lower eyelid surgery, the surgeon makes the incision in the natural lower lid fold so that it is inconspicuous along the lashline and hidden in the smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a hidden-incision transconjunctival eyelid lift or blepharoplasty. The incision in this case is made inside, behind the lower eyelid, and excess fatty material is removed and rearranged. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.
What should I do after surgery?
You can usually go home the day of surgery. Before you leave, a doctor or nurse will cover your eyes and eyelids with ointment and a bandage. Your eyelids may feel tight and sore as the numbing medicine wears off. However, the discomfort is easily controlled with pain medication.
Most patients have only mild bruising and swelling, and most can return to work with very little recovery time. Keep your head raised up as much as possible for several days. Place cold packs over the area to reduce swelling and bruising. Swelling and bruising following surgery lasts about two weeks, but complete healing takes a few months. Complications are rare and usually minor and will be discussed in detail with all patients considering blepharoplasty.
Incision lines may remain slightly pink for 6 months or more after surgery but will easily hide with makeup. They will fade eventually to a thin, barely visible white line. These results are often long-lasting for many people as they experience improved peripheral vision that enhances their ability to function on a daily basis.