Lower Eyelid Blepharoplasty (Lower Eyelid
“Lift”)
The lower eyelids are a common source of dissatisfaction
with one’s looks. The graceful, rounded, unbroked contours
of youth give way to the bags and deep valleys (“dark
circles”) that characterize middle age. Related areas,
such as the skin of the lower eyelid and the apples of the
cheek, often age similarly.
The Consultation
During your consultation for lower eyelid surgery, Dr. Nayak
will ask you what about your lower eyelids bothers you, and
may also ask you to talk about other, related areas of your
face, such as your upper eyelids, cheeks, and lower eyelid
muscle strength. Dr. Nayak will likely ask you to point out,
very specifically, what you’d like to see changed. Identifying
exactly what needs to be addressed is the cornerstone of good
results!
Dr. Nayak will then review your medical history form, and
may ask for some additional information from you. Previous
eyelid surgery, LASIK surgery, and tendencies toward dry or
runny eyes are important to mention to Dr. Nayak during this
part of the consultation. Dr. Nayak will also pay special
attention to parts of your medical history that need to be
considered carefully when undertaking eyelid surgery, such
as uncontrolled high blood pressure, or any medications or
supplements you may take that thin the blood. In general,
all over-the-counter pain/fever reducers (except Tylenol)
are off-limits for 2 weeks before and after eyelid surgery,
as are ginkgo biloba, St. John’s Wort, or high doses
of fish oil, flax seed oil, or vitamin E.
The Physical Examination
Dr. Nayak will then examine your eyelids to determine exactly
what must be corrected to achieve optimum results. Almost
all patients require removal of some excess fat from the lower
eyelids. In addition, most require replacement of missing
fat to the valley, or tear trough, that creates the “dark
circle”. Some patients, with excessive skin wrinkling,
may require laser skin tightening of the lower eyelid or conservative
skin removal. Dr. Nayak will take a few moments to discuss
these options with you to make sure they meet your personal
esthetic goals.
The Preoperative Visit
Once you have decided to undergo lower eyelid blepharoplasty,
Dr. Nayak’s staff will help you schedule your surgical
date, and, about 2 weeks preceding that, a preoperative visit.
Expect to spend about 90 minutes in the office on the day
of your preoperative visit. During this visit, you will be
educated on before instructions, after instructions, and prescriptions.
Written copies of all of these will be given to you at this
visit, as well, and you will be able to fill your prescriptions
ahead of time. You will also be reminded at this time to avoid
for 2 weeks before and after surgery any medications and supplements
that thin the blood.
Also at the preoperative visit, your private preoperative
photographs will be taken, the surgical consent form will
be read to you, and you will have an opportunity to discuss
with Dr. Nayak any questions you still have remaining. Finally,
at the conclusion of this visit, the balance of your surgical,
facility, and anesthesia fees will be due.
The Surgical Visit
In general, you will be asked to arrive at 7:30 AM the morning
of your planned surgery. You should have nothing to eat or
drink (not even water, candy, or gum) after midnight the night
before your procedure. If Dr. Nayak prescribed antibiotics,
oral sedatives, or if you take blood pressure medication in
the mornings, you may take these with a small sip of clear
water.
You will need an adult driver on the day of your surgery
to bring you and to take you home. Your companion may wait
in our comfortable reception area, watching TV, reading, and
enjoying coffee, soda, and snacks. Alternatively, if your
companion wishes to leave a cellular telephone number, we
can call him or her with updates and also at the conclusion
of the procedure.
Upon your arrival, Dr. Nayak’s staff will greet you
and review your medical history, looking for any new changes
since your initial consultation. Dr. Nayak and his staff will
also confirm that they and you are in agreement about which
procedures are to be performed, and those areas will be marked
with you sitting upright in a chair. If you are a woman under
50 and have not been surgically sterilized, a urine pregnancy
test may be performed. In any case, you will have one last
opportunity to have last-minute questions answered and use
the restroom, and will be escorted to our AAAHC-accredited
surgical suite.
Once there, you will be positioned comfortably on your back,
with pillows behind your knees and under your neck. Blankets
are also available if needed. You may also bring your own
iPod or CD’s, or listen to our choice of soothing music.
Painless blood pressure and oxygen monitors will be placed
on your arm and finger, and massaging air-filled stockings
will be placed on your legs and thighs to encourage excellent
circulation while you are lying down. Most patients truly
enjoy these stockings and find them very soothing.
Dr. Nayak and his staff will then perform one final “time-out”
aloud to ensure they are about to embark on the appropriate
procedure on the appropriate patient. Your eyelids will then
be slowly, gently numbed with local anesthesia, and sterile
towels will be placed around your face and neck.
By this time, most patients feel very relaxed. Once numb,
the majority of patients actually fall asleep intermittently.
Those who do not remain relaxed but awake, and Dr. Nayak and
his staff get the welcome opportunity to talk with you during
the procedure.
Your Recovery – Day 1
At the conclusion of your procedure, Dr. Nayak will tell
your companion how everything went, and he or she will have
the opportunity to see you. You will be mildly bruised and
swollen at this point. There are no bandages for lower eyelid
surgery, and most patients will have no sutures or visible
incisions. If laser resurfacing is performed, a thin layer
of Vaseline will be applied to the lower eyelid skin.
You will be asked to spend 1 hour with us prior to being
discharged. Dr. Nayak will call you the evening of the procedure
to check on your progress, and you will also be given Dr.
Nayak’s personal cellular phone number in case questions
should arise after hours or on the weekends.
Your Recovery – Week 1
You should be up and about and feeling well the same day
as lower eyelid blepharoplasty. Many patients find they nap
intermittently the first afternoon, and are back to their
regular energy the next day. You may shower and wash your
face, getting the stitches wet, the day after the procedure.
Pain is generally mild or absent with eyelid surgery. The
vast majority of patients take Tylenol or nothing, but stronger
medications are prescribed just in case, as all other over-the-counter
pain relievers will be off-limits for 2 weeks. A mild to moderate
sunburn sensation may be felt on the lower eyelid skin if
laser resurfacing was peformed, but this is easily treated
with pain medication. You will be asked to use intermittent
cold compresses and keep your head elevated for the first
few days.
By the 7th day after surgery, you will return to the office
for a checkup visit. By this point, almost everyone may wear
makeup, and is “presentable” to run errands or
go back to work. By 2-3 weeks, most people are “undetectable”.
If you are not self conscious about being seen with bruising,
redness, or swelling, or if you work from home, expect to
be back to work within 3-4 days!
Your Recovery – Long Term
Over the ensuing weeks and months, you will find your eyelids
look better and better. Any lasered skin is generally mildly
pink for a few weeks, but easily covered with regular makeup.
By 3-4 months, the pinkness is generally gone.
While duration of results depends on lifestyle, genetics,
and ongoing skin care and sun protection, lower eyelid surgery
is one of the most durable facial cosmetic procedures. It
is not uncommon for results to last well over 10 years before
touchups are required.
For detailed information about eyelid surgery, please visit:
Eye Lid Surgery St. Louis
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