Friday, October 25, 2013

Cosmetic Eye Surgery


By Albert Smolyar, M.D.

As you may know, Koby Karp Doctors Eye Institute has long been among Louisville and Kentucky leaders in eye care. I became a part of Doctors Eye Institute in 2006 and have been performing cosmetic eyelid procedures and eye surgery for our patients since. In this article I would like to discuss and share with you some thoughts and information regarding cosmetic eyelid surgery.

Since ancient times it was believed that facial expression often reflects our internal emotional and spiritual state. Cicero, Roman philosopher and orator who lived more than 2000 years ago, said “Forehead in the gate of mind”. Proverbs state:  “Face is the index of mind”, “ Face reflects the brain”.   During human interaction, the face (and particularly the eyes) is the first area of visual attention by others.
 
Cosmetic products designed to enhance eye appearance and remedy effects of aging existed for at least 3000 years. But it was an emergence of oculoplastic and facial surgery which allowed to reverse many effects of aging to a significant extent. In addition, in recent years we witnessed an “explosion”of new nonsurgical techniques for facial  rejuvenation. These include injectable  Botulinum toxin products ( Botox, Dysport, Xeomin) and facial fillers (Juvedevm, Restylane) just to name the few.  Cosmetic eyelid surgery and injectables have gained an increasing acceptance in recent years. As we live longer, both women and men seek ways to look younger and to maintain their sense of self-confidence.

The earliest signs of aging face are wrinkles, redundancy and drooping of skin often involving eyelids. This creates an expression of fatigue, appearance of being “sleepy”. In addition, when severe, droop of upper eyelids (upper eyelid ptosis) or redundancy of upper eyelid skin (upper eyelid dermatochalasis) may lead to visual difficulties.

In this article I will concentrate on one of the most common surgical procedures performed for aging face – upper eyelid blepharoplasy.

What is Upper Eyelid Blepharoplasty?

Upper eyelid blepharoplasty is done to correct excessive wrinkles, skin redundancy of fat prollapse in the upper eyelids area.  Below is step-by-step description of upper blepharoplasty surgery:

  1. Eyelid skin to be removed is determined and marked. Excessive fat is also noted. 
  2. The patient is usually given some pharmacological sedation, often intravenous, to reduce anxiety.
  3. Local anesthetic is injected. Incision is made in the upper eyelid crease . This allows to conceal the scar ( which usually is very fine and is not easily visible postoperatively).
  4. Predetermined amount of skin and fat is removed. Hemorrhaging is controlled with thermal coagulation of “bleeders”.
  5. The incision is closed with several stitches.
  6. The patient is taken to recovery room and usually released with postoperative instructions 20-30 minutes after the surgery.
After the surgery patients use cold  compresses for the first 24 hours while awake. This helps to diminish swelling. However, a degree of bruising (although variable from person to person) is always present after the surgery and should be expected. Significant  decrease in bruising and swelling is expected by 1 week after the surgery. While heavy exertion is to be avoided for several days after surgery, most of  routine daily  activities can be resumed  within hours including  walking, reading, using computer, shopping etc.  Driving is allowed 24 hours after the surgery.

Who is a good candidate for upper eyelid blepharoplasty?

Best candidates are people who have excessive upper eyelid skin and puffiness and who are in generally good health. Medical problems, particularly cardiovascular conditions and high blood pressure, thyroid disease, blood disorders and treatment with blood thinners or aspirin should be discussed with your surgeon. Fortunately, upper eyelid blepharoplasty is a relatively minor aesthetic procedure and does not normally invlove a risk of systemic complications.

Often, age-related descent of eyebrow contributes to the wrinkles and “hooding” in upper eyelid area. In this case, obtaining the optimal cosmetic result without addressing eyebrow droop will not be possible. Therefore a discussion of all present variables, available alternatives and a thorough planning of the procedure is paramount in achieving patient’s satisfaction with upper eyelid blepharoplasty.

Often, results of the surgery can be further improved by using other modalities, for example injections of Botulinum  or hyaluronic acid products to reduce facial wrinkles.

Another factor making a patient a good candidate is maintaining a realistic level of expectations from your surgery. While patients undergoing upper blepharoplasty benefit  greatly from the surgery, bear in mind that it will not always improve your looks to match your ideals.

What are possible complications of upper eyelid blepharoplasty?
 
Complications of upper eyelid blepharoplasty, while rare, may include vision loss, excessive bruising, infection, asymmetric appearance of eyelids and others. Discuss them with your surgeon prior to making up your mind regarding the surgery.

Where is upper eyelid blepharoplasty performed for Koby Karp Doctors Eye Institute  patients?

I perform upper eyelid blepharoplasty, as well as other eye procedures, at Dupont Surgery Center. It is the only facility in Louisville area specializing almost exclusively  in eye surgeries. The center’s  staff, from nurses to anesthesiologists, is very experienced and skilled in eye and eyelid procedures, making surgeries safer and keeping patients very comfortable throughout their experience. Dupont Surgery Center and Koby Karp Doctors Eye Institute share the same building, making it very convenient for our patients.

Conclusion.

In summary, upper eyelid blepharoplasty is a procedure with a high rate of patients’satisfaction. It makes people look and feel younger and allows improve self-confidence. Frank discussion with your surgeon is very important in setting up realistic goals and making the surgery a success.

Should you chose Koby Karp Doctors Eye Institute for your consultation or surgery, our staff, my colleagues and I will make sure that you achieve the best possible visual and cosmetic outcomes. You can schedule an appointment by calling (502) 897-1604

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