Eyes are the first thing we notice in another person, and the look of our eyes means as much to our interpersonal connections as our smiles. When eyelids droop or become misshapen with age, they not only send out misleading messages about us, but they actually can degrade vision and our outlook on life. Eyelid restoration, or blepharoplasty, by Keller Plastic Surgery in Santa Barbara, CA can restore vision and reinvigorate a youthful appearance.
What Is Blepharoplasty?
Blepharoplasty is the clinical name for a surgical procedure that corrects imperfections or degradations in the eyelids, such as sagging upper or lower lids and bags under the eyes. Performed for both cosmetic enhancement and functional vision improvements, the procedure can produce dramatic effects in both areas.
The Aesthetic Side
When upper or lower eyelids start to sag, they produce an outsized effect on physical appearance. They make us look older, less engaged, and less interested in what we’re seeing and hearing.
When people see bags under our eyes they assume we’re worn out or overtired. When they see eyelids that look half-closed, they think we’re not interested or paying attention. These assumptions aren’t necessarily conscious thoughts, but they’re there, nonetheless.
The Functional Side
When our upper eyelids sag or droop, they cover more of our eye than they’re supposed to. This naturally impairs vision, especially peripheral vision – both side to side and up and down. We simply see less of the world because part of the eye is unnaturally covered.
When our lower eyelids droop, they expose more of the whites of our eye than they’re supposed to. This can cause uncomfortable dryness in the eye or lower eyelid that drops alone can’t solve.
Who Is a Good Candidate?
Most people in good physical condition and who have no vision problems can be appropriate candidates for blepharoplasty. In the U.S., most patients for this treatment are middle-aged or older, though patients as young as 35 often request the procedure. In many Asian countries, the procedure is quite common, even for patients as young as 18.
In general, a good candidate is someone who:
- Has sagging skin causing folds or drooping in the upper or lower eyelid
- Has puffiness in the upper eyelid due to excess fat deposits
- Has bags under the eyes, or droopiness of the lower eyelids.
- Has generally good health
- Does not smoke
- Has realistic goals and expectations
Who Is Not a Good Candidate?
Blepharoplasty is a well-established surgical technique for correcting excess skin and fatty deposits in the upper or lower eyelids. There are many aesthetic procedures that are focused on other aspects of the eye, such as wrinkles and coloration. Different procedures and non-surgical options are available for these other cases.
Some common cases where the procedure is not recommended include:
- Dark circles under the eyes that are caused by reasons other than the eyelids
- Crow’s feet and other wrinkles
- Uneven or drooping eyebrows
- Patients who smoke
- Patients with dry eye or other eye conditions
Why Is It Needed?
As we age, our body’s tissues begin to lose their original firmness and integrity. Our skin is the largest organ in our body, with no less than seven layers of tissue. Skin that has lost its suppleness through the aging process is clearly apparent to the outside world.
In the facial area, the evidence for this “laxity” can be seen as sagging cheeks and jowls, wrinkles around the mouth, and notably, drooping of the upper and/or lower eyelids. When the main muscle in the eyelid, called the levator, loses its original strength, the upper eyelid sags. This condition is called ptosis, and it is prevalent in older adults.
While many eyelid surgeries are undertaken purely for aesthetic reasons, this condition can impair vision by covering too much of the eye’s pupil. Similarly, a drooping lower eyelid can expose too much of the “white” of the eye, causing dryness and discomfort. Blepharoplasty solves these issues.
How Is It Performed?
The procedure is performed on an outpatient basis. The patient is put under general anesthesia for the duration of the operation. Once the surgery has been completed and the patient has awakened in the recovery area, they go home the same day.
During the surgery, our expert plastic surgeon will make tiny incisions in the natural folds of the eyelids. This keeps the visible evidence of the procedure at a minimum while the patient undergoes the recovery process.
Working within the incisions, the excess skin and/or fat that’s causing the eyelid problem is drawn away. Skin and muscle tissue that has been sagging is strengthened and made taut again. When the results are complete, the eyelids are naturally youthful once more.
How Long Does It Take?
Each case is different and the extent of the work determines the length of the procedure. However, a blepharoplasty typically lasts from 45 minutes to 2 hours, depending upon whether another procedure is being performed during the same session.
Because the work is done on an outpatient basis, patients can come in in the morning and be seeing the world with new eyes by lunchtime.
How Long Is the Recovery?
Our advanced techniques and longstanding expertise with this procedure are such that there’s no need for the eyes to be bandaged when leaving our center after surgery. As mentioned, it is imperative that patients have someone available to drive them home after the procedure.
The patient’s immediate vision will be blurry after the procedure, and in general, patients who have just had general anesthesia are advised to not drive. Once the patient is home, vision may still be blurry because there are small stitches in the eyelids.
These symptoms usually resolve themselves in about a week. Rest is recommended for about a week until the stitches are removed in a next visit with the doctor. After about two weeks, you can go back to your usual daily activity and begin wearing contact lenses again, if you wear them already.
How Can I Prepare?
Most of the “work” of the procedure is actually in the recovery period. The surgery itself is only a matter of hours, but full recovery is days and weeks of resting and restoration while following your post-op instructions. To best prepare for the surgery, the patient is really preparing for the recovery.
Before undergoing eyelid surgery it’s a good idea to have the following items handy for when you return home:
- A comfortable ice pack and an ample supply of ice cubes
- Sterile gauze pads for any stray fluid
- Soothing eye drops for dry eyes; confirm your choice with Dr. Keller
- Over-the-counter acetaminophen (Tylenol or generic); not aspirin or Ibuprofen.
What Can I Expect After the Procedure?
Dr. Keller will provide you with detailed post-operative care instructions. You can usually find relief from any swelling by using a cold compress such as the ice pack for the first day or two after the procedure. You may also be given an eye lubricant, which may also temporarily blur your vision.
Neither of these instructions should interfere with your primary recovery strategy, which is to rest as much as possible. Avoid strenuous physical activity such as sports until you’re given the ok. Patients won’t have their full, best vision for several days, so it’s a good idea to plan ahead and have others to help with vision-critical jobs like driving or kitchen work.
How Can I Help Myself Recover?
It is important to follow the post-operative instructions for the smoothest, quickest recovery. The patient can help assist their recovery by acknowledging the temporary physical limitations that they should expect and coping with them accordingly.
It is natural that your eyes will get tired more quickly than is usual for you during the first few weeks. Again, rest is critical. If you need to be on the computer, consider moving the work to shorter sessions and longer breaks.
Also, it’s important to protect the eyes from wind and sun. Remember to wear dark sunglasses that provide adequate coverage when you go outdoors. Be sure to follow the post-op instructions for any questions about sunscreen or cosmetics.
Which Post-Op Activities Should I Avoid?
While the procedure itself is effective and low-risk, eyes are delicate organs and they should be pampered during the recovery period. Obviously, you should avoid rubbing the eyes, even though they may feel dry or grainy. Also, smoking is out of the question both before and after the procedure, as it constricts blood flow and inhibits healing.
Other activities that you should avoid during your recovery include:
- Strenuous physical activity such as sports, running or workouts
- Contact lens usage for about two weeks following the surgery
- Unprotected sun exposure – use sunglasses and plenty of sunblock
Will My Insurance Cover It?
Most health insurance plans do not cover cosmetic procedures. However, in the case of fallen eyelids that are affecting vision, a case can be made for medical need and potential insurance coverage. An examination and vision check from the doctor will confirm if this is the case. The insurer may cover the procedure in such instances.
How Can I Pick the Right Surgeon?
The surgeon is the most important factor in the success of any surgery. Finding the right one is a matter of trust and personal rapport. Both patients and surgeons should have a common vision of what needs to be done and to what degree. The patient should feel absolute confidence in the surgeon’s credentials, experience, and manner.
This is a procedure that will likely last a lifetime, so it’s a decision where both parties need to feel complete trust. You should be honest about your medical history during your pre-procedure examinations. The doctor should be completely explicit about the surgical plan, the recovery regimen, and the target outcome.
How Can I Get Started?
Finding an eyelid surgeon that embodies this combination of medical, aesthetic, and interpersonal skills is easy for those in the areas around Santa Barbara, Los Angeles, Beverly Hills, and adjacent areas in Southern California.
Dr. Gregory Keller is an award-winning, double-certified facial plastic surgeon with over 25 years of experience in the most demanding market in the U.S. Dr. Keller recently received a lifetime service award from the UCLA, where he is also a Clinical Professor and the co-director of the university’s facial plastic surgery fellowship. A celebrated practitioner and educator, Dr. Keller is world-renowned for his expertise in facial plastic surgery, including blepharoplasty.
Get Help Today
Sagging eyes are not just a cosmetic problem. They are often a physically debilitating issue and for many, certainly an emotional one. Looking your best goes a long way toward feeling your best, and a simple procedure will take years off your look and your outlook. Call today to schedule an appointment with Keller Plastic Surgery in Santa Barbara, CA.