cOSMETIC PROCEDURES > FACE > EYELID SURGERY

As we age, the soft tissues and supporting structures around our eyes start to sag and lose their strength. This leads to a tired look and a heavy sensation in the upper eyelids. Additionally, decreased volume and thinning of the skin can cause dark circles and a sunken eye appearance. In some cases the normal pockets of fat that were once held back by thicker soft tissues of our youth, may begin to bulge, resulting in noticeable "bags" in the lower eyelids. An upper and lower eyelid surgery or blepharoplasty can help address these changes and restore the youthful and restful appearance of your eyes.

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What is Eyelid Surgery?

Eyelid surgery, called blepharoplasty, is a surgical procedure to improve the appearance of the eyelids. Surgery can be performed on either the upper and lower lids, or both. Whether you want to improve your appearance or are experiencing functional problems with your eyelids, eyelid surgery can rejuvenate the area surrounding your eyes.

Specifically, eyelid surgery can treat:

  • Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision

  • Excess fatty deposits that appear as puffiness in the eyelids

  • Bags under the eyes

  • Drooping lower eyelids that reveal white below the iris

  • Excess skin and fine wrinkles of the lower eyelid

In general, good candidates for eyelid surgery include:

  • Healthy individuals who do not have a life threatening illness or medical conditions that can impair healing

  • Non-smokers

  • Individuals with a positive outlook and specific goals in mind for eyelid surgery

  • Individuals without serious eye conditions

Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to relaxation of the forehead skin and eyebrow. Sometimes a drooping eyelid is caused by stretching of one of the upper eyelid muscles, the levator. Dr. Abedi will evaluate your anatomy thoroughly during the consultation to determine the causes of your eyelid appearance, and what procedures might best remedy them.

Consultation and Preparing for Surgery

    • Your surgical goals

    • Medical conditions, drug allergies, and previous medical treatments and specifically any problems you have had with your eyes

    • Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use

    • Previous surgeries

    • Evaluate your general health status and any pre-existing health conditions or risk factors

    • Take photographs

    • Discuss your eyelid surgery options

    • Recommend a course of treatment

    • Discuss likely outcomes of eyelid surgery and any potential risks

    • Discuss the type of anesthesia that will be used

    • Get lab testing or a medical evaluation

    • Take certain medications or adjust your current medications

    • Stop smoking

    • Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

The Procedure

STEP 1: Anesthesia

Dr. Abedi performs upper eyelid surgery (upper blepharoplasty) under local anesthetic in her accredited office. This allows for a much quicker recovery and is well tolerated by most patients. When the surgery is combined with lower eyelid surgery (lower blepharoplasty) or an eyebrow lift, then intravenous sedation or general anesthesia is required. Dr. Abedi performs all her surgeries that require IV sedation or general anesthesia in accredited private surgical facilities in Vancouver or Surrey. 

Step 2: The Incision

The incision lines for eyelid surgery are designed so the resultant scars will be well concealed within the natural structures of the eyelid region.

The upper eyelid can be corrected through an incision within the natural crease on the eyelid. This  allows for removal or repositioning of fat deposits, tightening of muscles, and removal of excess skin.

STEP 3: Closing the Incisions

Eyelid incisions typically are closed with sutures which need to be removed in 5-7 days post procedure. For lower eyelid incision, the sutures are often dissolvable due to rapid healing of the skin in the area.

Conditions of the lower eyelid may be corrected with an incision just below the lower lash line. Through this incision, excess skin in the lower eyelid is removed.  Again, the excess fat can be repositioned or removed and underlying muscle can be lifted to help with improved contour of mid cheek as well.

A transconjunctival incision, created on the inside of the lower eyelid, is an alternate technique to correct lower eyelid conditions and redistribute or remove excess fat. With this technique, no skin is removed. This technique is ideal for younger patients with lower eyelid “bags”.

STEP 4: See the Results

The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and surrounding region, and an alert and rejuvenated appearance.

risks and safety

The decision to have eyelid surgery is personal, and you'll have to decide if this surgery will achieve your goals, and if the potential risks are acceptable. Be sure you understand the surgery and recuperation completely, and don't hesitate to ask Dr. Abedi all your questions.

The risks include:

  • Anesthesia risks

  • Swelling and bruising

  • Bleeding from the incision lines

  • Dryness to the eyes

  • Sensitivity to sun or other bright light

  • Difficulty closing your eyes

  • Ectropion, an outward rolling of the lower eyelid

  • Infection

  • Lid lag, a pulling down of the lower eyelid may occur and is often temporary

  • Temporary or even permanent change in vision

  • Very rare chance of blindness

  • Changes in skin sensation

  • Pain, which may persist

  • Poor wound healing

  • Possible need for revision surgery

  • Unfavorable scarring

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with Dr. Abedi during your consultation

RECOVERY AFTER SURGERY

After your procedure is completed, lubricating ointment and cold compresses may be applied, and in some cases your eyes may be loosely covered with gauze.

Dr. Abedi will give you specific instructions that may include how to care for your eyes, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your overall health, and when to follow-up with her at her office.

Initial healing may include some swelling, bruising, irritation or dry eyes, and discomfort that can be controlled with medication, cold compresses, and ointment. Irritation at the incision sites is also possible.

For upper eyelid surgery only, you will have visible sutures that are removed 5-7 days after your procedure. You will continue to have residual bruising up to 2 weeks which is easily covered with makeup. Most patients are able to return to work and social life once the sutures are removed. 

Lower eyelid surgery often causes more inflammation and bruising in the eye itself and can cause blurry vision for the first few days after surgery. The swelling and bruising can last a bit longer, but most patients are able to return to work and social life after 2 weeks from the procedure. 

You must practice diligent sun protection and use darkly tinted sunglasses until the healing process is fully complete. Following healing, we highly recommend use of medical grade skin products to help maintain your skin tightness and elasticity.

results

The results of eyelid surgery will be long-lasting. Your final results will appear within several weeks, but it may take up to a year for incision lines to fully refine. While eyelid surgery can be expected to correct certain conditions permanently, you will continue to age naturally. Life-long sun protection will help to maintain your results. Use of medical grade skin products is highly recommended to help slow down the aging process. Our team will be happy to make recommendations to you based on your needs.

Satisfaction with your new image should continue to grow as you recover from surgery. As swelling and bruising subside, the results of eyelid surgery will reveal a smooth, better-defined eyelid and surrounding region and an alert and rejuvenated appearance.

Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Prices for eyelid surgery can vary. Our cost is based on Dr. Abedi’s experience and training, the type of procedure required for your needs, and the geographic location of your surgery. We offer patient financing plans, so be sure to ask.

Cost may include:

  • Anesthesia fees

  • Hospital or surgical facility costs

  • Medical tests

  • Prescriptions for medication

  • Surgeon's fee

Note: Medical Services Plan of BC covers the cost of upper eyelid surgery under very special circumstances. A specialized visual field test is required to see if you are a candidate for non-cosmetic upper eyelid functional surgery. Dr. Abedi can advise you at the time of your consultation if this test should be done. 

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