Eyelid Surgery (Blepharoplasty)

Blepharoplasty Eyelid surgery MontrealThe eyes are usually the most attractive facial feature. As the principal component of expression, the eyes communicate our mood and attitude to others. The eyes have a great deal to do with how people perceive us as they glance at our facial features because the eyes are what they first noticed. In the same fashion, when aging changes occur they are first seen around the eyes. These are related to the structures surrounding the eyes, including the eyelids and brows.

The signs of aging around the eyes are slightly different for the upper and lower eyelids. The upper eyelids can show skin wrinkling and sagging as well as some bulging of fat pockets, particularly visible in the eyelid near the nose. The lower eyelids are usually associated with similar changes of skin wrinkling and drooping, but the fat pockets can be more pronounced. These changes to the upper and lower eyelids not only confer an aged appearance but often display a tired or saddened impression. Many of these changes occur as part of the normal aging process as the skin loses some of its firmness and gravity prevails. In some cases, however, these changes occur in younger people as a result of heredity.

Blepharoplasty aims to reverse some of the unfavorable features of the eyelids to provide a more refreshed and youthful appearance. Blepharoplasty may address the upper eyelids, the lower eyelids, or both. Regardless of which eyelids are rejuvenated, Dr. Samaha's goal is a natural, "unoperated" look which enhances the youthful glow of the eyes and the entire face. Dr. Samaha's technique emphasizes a minimally invasive approach which minimizes bruising to allow a faster recovery. When performed meticulously, blepharoplasty is a painless procedure. Dr. Samaha favors local anesthesia with sedation for the procedure (see anesthesia).

Dr. Samaha's considerable experience in facial surgery also allows him to avoid two potential "traps" that surgeons inexperienced with rejuvenation surgery can fall into, leading to a poor result. The first is to fail to recognize that the drooping of the upper eyelid is not due to the eyelid itself but to a droopy brow. In such a case, the patient needs a brow lift to have a great esthetic result, whereas a blepharoplasty would not provide an improvement and may even worsen the droopiness. The second is to fail to recognize some instances where the lower lid may appear puffy but it is not due to excessive fat pockets. Rather it because the normal cheek fat under the eyelid has dropped as a result of age or heredity. This creates a hollowness along the bony edge below the eye, which in turn gives the illusion that the normal fat pocket above this hollowed bone is bulging. In such a case, this hollowed area over the bone needs to be filled in with either fat or injectable fillers to provide the desired result.

Dr. Samaha performs blepharoplasty alone or in conjunction with a facelift or browlift as part of an overall facial rejuvenation. In his experience, blepharoplasty carries a high success rate and the improvement can be significant and long lasting. Certainly, the aging process continues, but problems such as bags under the eyes or sagging skin of the upper eyelid are unlikely to return following the procedure, even with advancing age. In Dr. Samaha's practice, it is associated with a very high degree of satisfaction.

The day of the surgery

Blepharoplasty is performed as an outpatient surgery. It is painless and patients are able to return home within 30 minutes to an hour after surgery. A small tape is placed on the upper lids if these have been operated. This tape does not affect opening and closing the eyelids. The lower lids simply have a lubricant placed under the eyelashes.

Following surgery

The eyelids and areas around the eyes are slightly swollen and discolored for about 5-7 days following surgery. Cold compresses, eye drops and gels are also prescribed to sooth the eyes and keep them moist. Water-based make-up can be applied at 4-5 days after surgery to conceal any residual discoloration.

Accessory procedures

For some patients, a blepharoplasty alone will provide an excellent esthetic result and help the patient achieve the rejuvenation they are seeking. However, as mentioned above, some patients may require other procedures either as an alternative to blepharoplasty or as an adjunct to it. Most frequently, these consist of a brow lift or fat injections. In addition, the wrinkles in the skin at the corner of the eye (frequently referred to as "crow's feet") may be improved but not necessarily eliminated with blepharoplasty alone. Botox injections are usually quite effective to treat these lines, for that extra enhancement.

Frequently Asked Questions

At what age can I have blepharoplasty?
There is no specific age. While blepharoplasty can be performed with the goal of rejuvenating an aged appearance around the eyes, it is also performed on younger people who, because of hereditary factors, have puffy lower lids due to fat bags or droopy or excessive upper lid skin. These are often hereditary "family traits".

What are the restrictions after surgery?
The main restriction is the avoidance of vigorous exercise and heavy lifting for about 10 days. Other maneuvers that require straining, such as bending forward are also to be avoided. Otherwise, patients may carry out usual activities.

How long is the recovery?
Recovery time varies depending on whether blepharoplasty is performed alone or in conjunction with another procedure. When performed alone, recovery time is usually about one week. Patients are quite presentable at that time and can plan work or social activities accordingly. If it is done in conjunction with a facelift, 4-5 additional days may be required.

Is it a painful procedure?
No. Blepharoplasty is no a painful procedure. Although Dr. Samaha prescribes pain medications for his patients, they usually do not use them.

What about bruising?
Blepharoplasty is usually associated with some bruising. The location of the bruising is usually in the eyelids operated and surrounding the eyes. The degree of bruising depends on the surgical technique and the patient's own tendency to bruise. The discoloration from bruising will gradually diminish and migrate down the face in the first few days following surgery. Dr. Samaha uses advanced, minimally invasive techniques to minimize bruising and swelling after surgery. Patients who have a natural tendency to bruise easily will experience slightly more bruising in the initial recovery period.

How long does it take to see the result?
After the initial swelling subsides in the first 1 week, the result is apparent, but some subtle minimal swelling remains. Further "setting" continues in the weeks to months following surgery. Usually, within 2-3 months, the final result is apparent.

Will I need another procedure in a few years as I continue to age?
A second procedure is seldom needed because the problems addressed with blepharoplasty do not frequently return.

For more information on blepharoplasty, please contact Dr. Samaha.