Eyelid Surgery

The area around the eyes has a significant impact on your overall appearance, so many patients want to improve their droopy upper eyelids or the bags underneath their eyes. When we look at another person, we look into their eyes. If the eyes look tired, they look tired. Often this is the first sign of aging. Loose or excess skin in the eyelid, as well as fat within the eye socket that is bulging forward, can cause a person to look older than they are. To correct these issues we offer upper and lower eyelid surgery, also known as a blepharoplasty.

To see an improvement in the appearance of your eyelids, our surgeons may need to remove the excess fat, skin, and muscle that is causing droopy lids and/or bags. The key in upper and lower lid surgical procedures is to sparingly remove tissue and fat, and to redistribute the fullness to the eye thereby giving a much more youthful overall appearance.

About the Procedure

• Length: 1 to 2 hours
• Anesthesia: Light general anesthesia or local with sedation
• Side Effects: Temporary discomfort, tightness of lids, swelling, and bruising. Temporary dryness, burning, and itching of eyes. Excessive tearing, sensitivity to light for first few weeks.
• Risk: Temporary blurred or double vision. Impaired vision (extremely rare). Infection. Swelling at corners of eyelids. Tiny whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery).
• Bruising: 2 to 4 weeks.
• Swelling: Moderate/Significant for 4 weeks, Subtle/Mild 2 to 3 months, all of which are dependent upon extent of procedures.
• Pain Meds: Ibuprofen or Narcotics as needed.
• Exercise: 1/3 intensity at 3 weeks, 2/3 intensity at 6 weeks, full intensity at 8 weeks.

Before Surgery

During the first consultation, your surgeon will discuss the cosmetic and possible functional benefits and limitations regarding your eyelid surgery. Once we determine what you want from your surgery, we can move forward with the initial consultation by:

• Reviewing your medical history
• Determining the reason behind your droopy or puffy eyelids
• Examining your eyes, brow, face to offer the best recommendations
• Discussing surgical fees (these will depend upon the extent of the procedure)
• Making appointments for routine blood tests, electrocardiogram (if you are 50 years of age or over), and a pregnancy test (if applicable)
• Scheduling surgery well in advanced to coordinate your time at our surgical facility, as well as anesthesia care (we will send out appointment reminders as well)

Who is a good candidate for a blepharoplasty procedure? A patient needs to have overall good health for good results and recovery—this is a requirement for any surgery we offer. Boulder Plastic Surgery surgeons and staff believe that wellness and healthy lifestyle choices prepare patients for surgery and keeps them strong during the recovery phase. To get your body in the best condition before and after surgery, we use a three-phase healing program (which starts a week or so before a procedure) that consists of proper nutrients to promote healing, boost the immune system, and reduce post-procedure inflammation and discomfort.

To achieve better health, you need the necessary vitamins and minerals, a healthy diet, and a regular exercise plan—this is our holistic approach to wellness and less down-time after surgery.

Please let us know of any supplements you are taking before the surgery so we can determine whether or not they will affect the operation in anyway. For recovery purposes, do not take any aspirin for at least two weeks prior to your eyelid surgery. Also, for the effectiveness of anesthesia, do not eat or drink anything 8 hours prior to surgery.

Other pre-surgery tips include:

• Shower or bathe the evening before surgery
• Wear loose fitted clothing, preferably a shirt with buttons
• Plan for someone to drive you home after surgery, as well as monitor your first night of recovery

The Day of Your Surgery

The day of the blepharoplasty, you will meet again with your surgeon to answer any final questions. You will be marked awake and seated in the preop area.  A medication to help you relax will be given through your IV, and you will be taken to the operating room. The rest of the blepharoplasty procedure is as follows:

Small incisions are made in the upper lid’s prominent crease and lower lid just below the eyelashes

• The skin is elevated
• Excess fat and skin is removed
• The remaining skin is re-draped

Surgical techniques must be individualized and modified to achieve a natural, more youthful look.

Risks, Complications, and Limitations

With any surgical procedure, a very small percentage of complications can occur. Normally following the surgery, a small amount of blood-tinged drainage may ooze from the stitch lines for 24-48 hours. Other common side effects of eyelid surgery include:

• Swelling of the eye (should go down in 48-72 hours)
• Lower eyelid rolls outward (due to swelling in the first few days)
• Tearing of the eyes
• Mild eye and skin irritation
• Excessive dryness of the eyes
• Mild feelings of worry and doubt related to new appearance (this is normal for patients to experience at first)

To relieve any irritation, you may need to acquire eye drops or eye ointment to use until symptoms subside.

In rare cases, other complications may arise from a blepharoplasty operation, such as:

• Significant bleeding: This is rare, but if it occurs, the surgeon will remove the stitches to alleviate pressure. Remember to seek medical attention if you notice abnormal bleeding. Leaving it untreated could lead to a swollen and painful eye socket, and too much pressure could affect your vision.
• Adverse reaction to prescribed medication: If a patient has a severe reaction to a medication, such as the anesthetic used during surgery, the surgeon will have access to appropriate medical equipment and assistance. Many cases when patients had bad reactions they were due to the facilities not having the appropriate equipment and personnel to anticipate an adverse effect.
• Loss of contact between eyelid and eyeball: This can be caused by the removal of too much skin. This is a rare occurrence, and treatment involves massage and observation over the course of 3-6 weeks.
• Impairment of vision: This risk is extremely rare.

A conservative approach to periorbital rejuvenation is very important to avoid these risks. We must improve the eyelid periorbital aesthetics, but maintain eyelid function and protect the eyeball and vision.

In terms of the surgery’s limitations, careful examination prior to the operation always reveals slight asymmetry of the eyelids, and although the operation corrects marked differences, slight residual asymmetry may still be present after surgery. It’s important to understand any limitations related to your case.

Post-Operative Care

Post-Operative Care

At the completion of your operation, you will be transferred to the appropriate recovery area where you will remain until you awaken. To make the transition to healing as smooth as possible, here are some helpful tips:

• Fill your prescription for pain medication before surgery and take one immediately on arrival at home (best taken with food, but nothing too heavy).
• Drink a lot of liquids, preferably water.
• Sit in a comfortable upright position.
• Use the pain medication and antibiotics as directed to remain comfortable and reduce the chance of infection.
• Apply cold compresses for the first 48 hours after surgery to reduce swelling and discomfort.
• Avoid bright sunlight, wind, or other irritating factors for the first 48 hours following surgery as much as possible.
• Use eye ointment(s) and eye drops as directed. Refresh® drops to keep your eyes moist during the day and Refresh® gel to keep your eyes protected over night should be used routinely for 6 weeks following eyelid or periorbital surgery.
• Do not soak the incisions with water or any other applied materials for the first 72 hours. Small amounts of water on the incision at a time won’t affect the incisions, so you may shower or bathe as normal following surgery.
• Limit exercise, especially if you have a history of high blood pressure. Light exercise resumed at three weeks and more strenuous exercise at six weeks.

Post-Operative Healing

Your eyes may not close completely for the first 24 to 48 hours due to swelling in the eyelids. The lids themselves may not contact the eyeball in a normal fashion for the same period of time. Usually this effect is minimal, resolves rapidly, and causes minimal irritation to the eyes. Bruising coupled with swelling will usually resolve in 7-14 days, but it can take longer than a week. As swelling goes down, you will notice that the eyes appear larger and different than before—this is normal.

Resume normal tasks of daily living as rapidly as possible. Immobility tends to cause continued discomfort and increased muscle spasms. The only limitation to activity is if you feel significant pain. Discomfort is normal with motion initially, and there is nothing that can be harmed by normal activity. Most patients are back at work in 5-7 days.

Note: All surgical procedures which involve an incision in any area of the body will leave a scar. However, scars near the eyelids are usually inconspicuous and easily camouflaged by makeup or hairstyle.

Eye Lid Surgery Cost

How much does eye lid surgery cost? It depends on your specific situation, but an estimate of eyelid surgery is listed below:

• Upper AND Lower $4,700 to $5,700.
• Upper OR lower: $3,500 to $4,500
• Cost includes surgeon, operating room, and anesthesia

All fees for cosmetic surgeries are payable in advance and include the cost of surgery as well as all postoperative follow-up care. On the day of your preoperative visit, additional fees will be received for the surgical facility and anesthesia care.

Schedule an Appointment Today

How predictable the result of your surgery will be depends on a number of factors, including the skin’s condition, presence or absence of facial fat beneath the skin, skin’s age, bone structure, and present fine lines and wrinkles. To assess your unique situation, we require a consultation. Understanding the relationship between eyelid surgery and your particular case is the best way to making a confident decision.

Please call our office at (303) 578-4193 to schedule an appointment with one of our board certified surgeons at Boulder Plastic Surgery.