During the initial consultation, you?ll be able to talk with your doctor about the changes you would like to make in your appearance. He/she will explain the different options available to you, the procedure itself, and its risks and limitations. He/she will also explain the kind of anesthesia required, surgical facility where it is performed, and costs involved.

Your doctor will begin by recording your complete medical history, and then examine the skin and fat around your eyes. He/she may also examine your eyesight, peripheral vision, and tear ducts. You should tell him/her about any related symptoms you may have, including any dryness of the eyes, changes in vision or eye pain.

Take this opportunity to ask all the questions you have about the surgery, and ask to see photos of the doctor?s recent patients, before and after surgery. Also ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision. See Questions to ask your doctor below.

Blepharoplasty is performed with very fine electrocauterization instruments to control bleeding. In lower eyelid blepharoplasty, the doctor makes tiny incisions under the eye, removes excess skin and fatty tissue, and closes the incisions with tiny sutures to reduce scarring. Another common method, the transconjuctival approach, involves making an incision from inside the eye pocket in order to remove fat. The benefit of this method is that there is no scarring on the outside of the skin, but success depends on the contraction of the excess skin as a result from internal tightening.

In upper eyelid surgery, the incisions are made in the eyelid itself, where it would be found naturally. Excess tissue is removed, a natural skin fold is created, and the incisions are carefully closed with fine sutures. Any scars are hidden by the crease created during the procedure.

For a week after surgery, you should avoid strenuous activities and sports, as well as activities that dry the eyes, including reading, watching television, wearing contacts and using a computer. Your doctor may also recommend that you cut down on alcohol consumption and avoid excessive blinking, which can lead to increased swelling. Wearing dark sunglasses will protect your eyes from wind and sun. Most patients are able to return to work within 7-10 days.

Your sutures will be removed within a week of surgery. At first, the incisions will probably be red and somewhat bumpy. Slight scars may remain pink for six months or so, but can easily be concealed with makeup. Any scars will eventually fade to thin, nearly invisible white lines or be concealed beneath the folds of your eyelid.

• 18 years of age or older
• In good physical health
• Psychologically stable
• Informed about the procedure
• Free of ophthalmic conditions such as glaucoma or detached retina
• Without medical conditions such as high blood pressure, circulatory problems, hypothyroidism or other thyroid related conditions.
• Realistic about the outcome of surgery

The above is only a partial list of the criteria that your surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your surgeon if he / she considers you an ideal candidate for upper eyelid blepharoplasty.

Significant complications from upper eyelid blepharoplasty are infrequent. As with any surgical procedure, however, there is always a possibility of infection, or reaction to the anesthesia.

Other potential complications include:

1. Are the desired results I described realistic?
2. Where is the surgery performed? How long will the procedure take?
3. Are there other procedures that I should consider to enhance the effects of this procedure?
4. What kind of anesthesia is used?
5. What is the recovery period like? How soon can I return to work following the procedure?
6. How much does the procedure cost?
7. What is your experience in performing this procedure? (How long has he/she performed this procedure, and how many he/she has performed in the past year?)
8. (If the patient is Asian) Are you experienced with performing this procedure on the unique structure of the Asian eye?
9. What percentage of patients have had significant complications? (The physician should disclose this information to you.)
10. Will you repeat or correct procedures if it does not meet agreed upon goals? And if the procedure must be repeated / corrected, will I be charged again? (The physician should provide you with his/her policy on this issue.)
11. May I see "before and after" photos of recent patients? (The physician should provide many photos of recent patients).
12. May I have the names and contact information for several recent blepharoplasty patients? (Follow up to get first-hand information on the procedure and the surgeon.)
13. Could I observe the exact procedure I am considering before I decide to have the surgery? (Either on videotape or ask to view one in real life.)
14. What should I expect post-operatively, in terms of soreness, what to watch for, medication, bathing, and level of activity?
15. Who will be assisting during the surgery? What are their qualifications? (Does the facial surgeon perform the entire surgery?)
16. Have you ever had your malpractice insurance coverage denied, revoked, suspended?
17. Do you offer patient financing?

• Tell your doctor if you have any of the following pre-existing conditions:
  • thyroid problems such as hypothyroidism
  • insufficient tear production or dryness of the eye
  • elevated blood pressure or other circulatory disorders
  • cardiovascular disease
  • diabetes
  • ophthalmic problems
  • any other serious medical condition(s)
• Tell your doctor about any allergies you have (to foods, drugs, environmental elements)
• Tell your doctor about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription).
• Be sure to tell your doctor if you smoke. Smoking can lead to complications and poor healing.
• Carefully follow any instructions your doctor gives you regarding eating and drinking.
• Avoid aspirin and aspirin-containing medicines, as well as anti-inflammatory medicines such as Nuprin, Motrin, and Advil for two weeks prior to surgery. Also avoid herbal remedies such as St. John?s Wort, gingko biloba, some types of Chinese black mushrooms and other natural medicines and foods that may thin the blood.
• Arrange for someone to drive you home after surgery and help you for a few days afterward, if needed.

The information on this web site is only intended as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.

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