Bags under the eyes and drooping skin over the eyelids may cause patient to look tired, uninterested, sad and worn out, despite how they may feel. Many patients seek rejuvenation of the eyes to appear refreshed, bright and cheerful.
Drooping skin in the eyelids are caused by several factors; progressive loss of elastic tissue and collagen in the skin, changes of the orbicularis muscle that surrounds the eye, and the downward pull by gravitational forces as we age. Additionally, many patients have a hereditary predisposition to loose skin around the eyes.
Bags or puffiness under the eyes is caused by orbital fat being pulled out by gravity with a weakening orbital septum. This causes a bulge or pseudogenization of fat, which results in puffy lids. Blepharoplasty is the gold standard for eyelid rejuvenation.
What to Expect
It all starts with a consultation.
At your consultation Dr. Rodman will need to know your full medical and surgical history as well as any medications that you take. She will review any medical history related to your eyes including problems with vision, if you wear glasses or contacts, irritation or tearing, dry eyes. You’ll have a thorough exam which will evaluate how much extra skin you have on the upper and lower lids, tightness of the lower lid, as well as tear production. Some patients who have lower lid laxity may need a lid tightening procedure at the same time they undergo a lower blepharoplasty, and Dr. Rodman will check for this at your visit. The physical exam is very important to differentiate excessive skin of the upper eyelid versus a drooping eyebrow. A drooping eyebrow can push down the eyelid skin and make it appear loose, but the brow should be corrected before the eyelid. The position of the eyebrow in relation to the orbital rim is important in determining which procedure should be done to make the patient look more refreshed. It women the eyebrow should sit right above the orbital rim. In men, the brow should sit right at the orbital rim. Any symmetry between the eyebrows and eyelids is also very important to note before undergoing surgery.
It is important to be evaluated by a board-certified physician such as Dr. Rodman to rule out any medical conditions that may be responsible for the appearance of the eyes such as allergic rhinitis, thyroid disease, and ptosis. These may need treatment before proceeding with a blepharoplasty.
The surgery is performed under general anesthesia or IV sedation depending on the patient preference. Patients are able to go home the same day after surgery. The upper blepharoplasty is performed through it in incision in the crease of the upper eyelid. This heals extremely well and is barely visible soon after surgery. The lower blepharoplasty can be performed two ways. The first is through a small incision right under the lower eyelashes, which leaves a barely visible scar hidden by the lashes. The second is an incision inside the lower eyelid, which leaves no scar. The each option has risks and benefits, and Dr. Rodman will discuss which option is best for you.
After surgery patients should expect swelling and bruising that can be dramatic the first week, but will subside the second week after surgery. Patient may have increased tearing, and some may have a burning sensation which will resolve after 1 to 2 weeks. Patients should not wear contact lenses for several weeks after surgery.