General Information

Every year, over 100,000 women and men choose eyelid surgery (blepharoplasty) to enhance and improve the way they look. Droopy upper eyelids can make you look older and can also encroach on your field of vision. Blepharoplasty improves or corrects these problems and also removes bags and puffiness from under the eyes that make you look tired or weary. This procedure does not alter dark circles under the eyes, nor can it change eyebrows that sag.

If you are wondering how blepharoplasty, or eyelid surgery, can improve your appearance or the appearance of someone you know, then you’ll be interested in knowing how this procedure is performed and what you can be expect as a result from having it done. This information page, brought to you courtesy of Dr. Richard C. Parfitt, can address many of your concerns and questions.

Good rapport between patient and surgeon is important in achieving successful results in facial cosmetic surgery. Trust develops in the consulting stages prior to surgery. This trust is based on realistic expectations and exacting medical proficiency. If you have specific questions or specific needs, please ask Dr. Parfitt, as he should be able to accommodate your needs and answer these questions.

Insurance usually doesn’t cover surgery that is done solely for cosmetic reasons. Surgery to improve or correct vision, or surgery for eye injury or deformity may be reimbursable in part or in whole. It is the patient's responsibility to check with their insurance carrier for information regarding degree of coverage.

Is it for You?

As with all cosmetic facial surgery, realistic expectations and good health are prerequisites. Blepharoplasty will remove excess fat, muscle, and skin from both upper and lower eyelids. The result is a refreshed appearance, with a firmer and younger eye appearance.

People with any serious medical or ophthalmologic conditions must rely on the diagnostic skills of their own personal specialists to help decide whether blepharoplasty is an option to be considered. Consultation with Dr. Parfitt can help you decide whether any complementary or additional surgery would increase the success of the eyelid surgery. He might suggest considering a simultaneous forehead or brow lift to correct a low or drooping brow and smooth the forehead and crow’s feet area, or he may suggest skin resurfacing to help improve the fine line wrinkling on the lower eyelid skin.

Making the Decision

Whether the surgery is desired for cosmetic or functional reasons, your choice of a board-certified facial plastic surgeon is of paramount importance. The patient must also understand the importance of following Dr. Parfitt’s pre-surgical and post-operative instructions.

At the pre-surgical consultation, you will be asked to answer questions concerning your vision, use of lenses, tear production, and your desires for surgery. Dr. Parfitt will examine your eyes and explain what you can expect from blepharoplasty. He will also take a more complete medical history. Factors to be weighed include skin type, age, degree of vision obstruction, and ethnic background. You can also expect an honest and open exchange between you and Dr. Parfitt, which will establish the basis for a successful outcome and result.

As you and Dr. Parfitt make a mutual decision, he will discuss the technique indicated for your individual surgery. The surgical facility, type of anesthesia, any additional surgery, and the risks and costs of the procedure will be detailed.

Procedure Details

In surgery of the upper eyelid, Dr. Parfitt first measures and marks along natural lines, folds, and creases of the lids in order to keep the scars as invisible as possible. Through this incision, excess loose skin, muscle, and fat are removed. Very fine sutures are used to close the incisions, thereby minimizing any scar visibility.

In lower eyelid surgery, Dr. Parfitt makes the incision in an inconspicuous line that is located right next to the lash line of the lower lid. Excess skin is then precisely measured and removed before the incision is closed with fine clear sutures that dissolve on their own in about a week. Puffiness under the eye, caused by excess fat, is then corrected by a procedure called transconjunctival blepharoplasty. In this procedure, an incision is made just inside the lower eyelid, and the excess fat is located, measured and trimmed away. A single suture is then used to close this incision, which is also self-dissolving.  This incision, therefore, leaves no visible scar. Blepharoplasty, under usual conditions, takes from 45 minutes to two hours.

Recovery

Immediately following the completion of the surgery, Dr. Parfitt applies antibiotic ointment and will apply tiny sterile bandages near each end of the upper eyelid incision to keep the suture in place. Only ointment is applied to the lower eyelid incision.  To minimize any bruising or swelling, the eyes are covered with cold compresses during the first 2 days. An ointment to prevent dryness of the eye area may be used for a while following eyelid surgery. A certain amount of bruising or swelling is normal, but this is often minimal. Head elevation when lying down, as well as the cold compresses, help enhance healing and relieve discomfort. Dr. Parfitt will prescribe medication for discomfort, although it is rarely needed.

For about 10 days following blepharoplasty, you will clean the eye area (the eyes may feel heavy, dry, and perhaps a little itchy). Eye drops might be prescribed. Dr. Parfitt will identify environments and activities during the healing period that you should avoid . Upper eyelid stitches will be removed 6 days following surgery. Self-absorbing sutures will dissolve on their own.

Cosmetic surgery of the face makes it possible to enhance and correct many problems with facial appearance and the signs of premature aging that can undermine self-confidence and self-esteem. By changing how you see yourself and how people see you, facial plastic surgery can help improve how you feel about yourself.