Eyelid Surgery (Blepharoplasty)

THE BLEPHAROPLASTY PROCEDURE STEPS

WHAT TYPE OF ANESTHESIA IS USED FOR EYELID SURGERY?

A majority of patients will choose to have their eyelid lift surgery in an outpatient setting, such as the office, a surgi-center or the outpatient wing of the hospital. Medications will be administered for your comfort during the procedure. The choices include local anesthesia, oral sedation medications, intravenous sedation and general anesthesia.

Dr. Ridenour will help you choose which anesthesia option is best for your eyelid surgery based on the extent of your procedure as well as your personal preferences.

WHERE ARE THE INCISIONS MADE FOR UPPER EYELID SURGERY?

Eyelid surgery incisions are designed to be naturally concealed within the contours of the eyelids. Signs of aging in the upper eyelid can be treated using an incision placed in the natural fold or crease of the upper lid. This placement means the resulting scar will be invisible while your eyes are open and blend with the crease for a natural appearance when your eyes are closed.

WHERE ARE THE INCISIONS MADE FOR LOWER EYELID SURGERY?

Lower blepharoplasty incisions can be made in one of the following two locations:

EYELASH LINE INCISION (TRANSCUTANEOUS)

If you need excess skin removed as well as fat deposits and muscles addressed, your surgeon will create an incision just beneath your lower eyelash line. This is called a transcutaneous incision because it is created along the external skin.

INTERNAL EYELID INCISION (TRANSCONJUNCTIVAL)

If you need only fat and muscles adjusted without skin removal, an incision can be made on the backside of the lower eyelid. The resulting scar is inside your eyelid, avoiding a visible external scar. This technique is called transconjunctival blepharoplasty because the incision is created along the conjunctiva, which is the mucous membrane inside your eyelid.

HOW ARE THE EYELID TISSUES CORRECTED?

Once these incisions are made, your plastic surgeon will strategically reposition or remove displaced fat and tighten loose eyelid muscles using sutures. Your skin will then be smoothed over your new eyelid contours before any excess skin is removed.

WHAT TO EXPECT AFTER EYELID SURGERY

WILL I BE ABLE TO SEE AFTER BLEPHAROPLASTY?

Your eyes will be covered in ointment after your surgery, and your vision will probably be blurry for a couple of days. Since you won’t be able to see well, make arrangements for someone to drive you home after surgery and help you around the house for at least the first 24 hours.

HOW LONG DOES EYELID SURGERY RECOVERY TAKE?

The initial recovery period after eyelid lift surgery is two to four weeks. Most blepharoplasty patients feel comfortable returning to work within two weeks. However, the time it takes you to be ready will depend on what your job entails and how comfortable you are with your colleagues knowing you underwent eyelid lift surgery.

HOW CAN I PROTECT MY EYELIDS AND HELP THEM HEAL?

Lubricating ointment and cold compresses can help reduce irritation, bruising and swelling. Be gentle when cleansing your eyes and do not rub them, even if they feel itchy. Eating a nutritious diet will also help your body heal faster after blepharoplasty.

You must be careful to avoid exposing your eyelids to direct sunlight. Even while inside the house, it’s essential to be cautious of indirect sunlight. If you go outside, use mineral sunscreen and wear dark sunglasses to protect your delicate eyelid skin as it heals. To preserve the health of your eyelids, we recommend wearing sunscreen daily even after you’ve completely healed.

HOW LONG AFTER BLEPHAROPLASTY DO YOU SEE RESULTS?

Your results will develop gradually as bruising and swelling resolve over the coming weeks. Most patients see improved eyelid contours and definition that makes them look more youthful and alert after four to six weeks. Your final blepharoplasty results will continue to develop as residual swelling resolves and your eyelid tissues settle into place.

HOW LONG DO EYELID SURGERY RESULTS LAST?

The results of eyelid surgery are designed to be long lasting for years to come, and the excess skin and fat removed will be gone permanently. Fat that was redistributed will generally maintain its new position for years to come.

This procedure cannot stop the aging process, so your eyelids will continue to age naturally as time passes. Fortunately, you will always continue to look more youthful than if you hadn’t undergone blepharoplasty.

WILL I HAVE SCARS AFTER BLEPHAROPLASTY?

Upper eyelid surgery incisions will result in a scar that blends with the natural crease of the eyelid. Lower blepharoplasty may result in a scar that is camouflaged by the lower lash line, or the scar may be inside the lower eyelid and not visible at all.

While scarring is inevitable when incisions are made, patients say the scarring is worth it for eyelid lift surgery because of the results. The scars are hardly noticeable, and they will fade more and more with each passing year.

FREQUENTLY ASKED QUESTIONS ABOUT BLEPHAROPLASTY

WHAT IS THE TYPICAL COST OF EYELID SURGERY?

The average cost of blepharoplasty varies based on whether patients undergo upper eyelid surgery, lower eyelid surgery or both. The techniques used for the procedure, anesthesia fees and facility costs will also affect the price.

After a blepharoplasty consultation at Ridenour Plastic Surgery, we will be able to provide you with specific pricing details.

DOES INSURANCE COVER BLEPHAROPLASTY?

If your upper eyelid sagging is extensive enough to block your full range of vision, your insurance company may consider this a reconstructive procedure needed to restore your vision. In these cases, insurance may cover all or a portion of your procedure. Please note: Ridenour Plastic Surgery is a cosmetic-only practice and we do not accept insurance. If you have visual impairment that may qualify you for insurance, we are happy to make a referral. If you are having this procedure for purely cosmetic concerns, your insurance company will not cover the cost of eyelid surgery.

WHAT IS A GOOD AGE FOR EYELID SURGERY?

Most eyelid surgery patients are over the age of 35. However, if you are under 35 and suffer from excessive sagging and puffiness in your eyelids, you may qualify for this procedure. Everyone ages at different rates, and one person may see signs of aging around their eyes first while others develop them in their neck.

During your blepharoplasty consultation, we can determine if this procedure is right for you no matter your age.

HOW SHOULD I PREPARE FOR MY BLEPHAROPLASTY?

Once your procedure is scheduled, make arrangements for transportation to and from your surgery, help around the house during the first day and childcare if needed. We also recommend grocery shopping for nutritious and easy meals you can prepare ahead of time and freeze, such as casseroles and soups, and meals that will be easy to make during your recovery, such as frozen fruit smoothies, sandwiches and salads.

Do not take any medications or herbal supplements that can thin your blood for at least two weeks before your surgery. If you smoke, stop several weeks ahead of time since smoking increases your risk of infections and other complications. Quitting weeks beforehand will give your body time to adjust so you don’t have withdrawal symptoms at the time of your surgery.

IS EYELID SURGERY PAINFUL?

Anesthesia is used during surgery, so the procedure itself will not be painful. Once the anesthesia wears off during your initial recovery period, you will likely experience some mild to moderate discomfort for a few days. The first day after surgery is typically the worst, and discomfort gradually reduces after that. If you experience extreme discomfort or pain, you can take over-the-counter pain medicine for relief. Some patients experience dry eyes that can be more irritating than painful, but they can be relieved with eye drops.

We will provide specific recommendations on how to increase your comfort as you recover, such as using cold compresses and sleeping with your head elevated to reduce swelling and pressure.

ARE THERE ANY RISKS WITH GETTING AN EYELID LIFT?

As with all surgical procedures, eyelid lift surgery carries some risks and potential side effects. While rare, potential complications include but are not limited to:

• Infection
• Bleeding
• Injured eye muscles
• Discolored eyelid skin
• Anesthesia risks
• The need for a subsequent eyelid surgery
• Eyelid retraction, entropion or ectropion
• Scarring of the eyelid skin or conjunctiva

Choosing a qualified facial plastic surgeon such as Dr. Ridenour can help mitigate these risks.

DO I NEED AN EYELID LIFT OR A BROW LIFT?

If you suffer from hooded eyelids, where tissues hang over the crease of your upper eyelid, you may be wondering whether an eyelid lift or brow lift will correct them. Excess tissue in the upper eyelids may be causing this condition, but drooping eyebrows can also hang over the eyes and produce a similar result.

One way to see if you might benefit from an eyebrow lift is to look in the mirror and lift your eyebrows to just above your brow bone. If your brows were sagging below the bone and lifting them eliminates hooding, you may want to consider brow lift surgery. A brow lift can also correct frown lines between the eyebrows and wrinkles on the forehead.

In some cases, patients may have excessive sagging in the eyelids and drooping brows. They can generally benefit from combining both procedures into one surgery.

A qualified plastic surgeon can evaluate your concerns and discuss the best procedure(s) to achieve optimal results.

CAN I COMBINE OTHER PROCEDURES WITH BLEPHAROPLASTY?

If you’d like to address signs of aging in other areas of your face, you may be able to combine multiple procedures into a single surgery. This is an economical approach that provides comprehensive results and saves time and money.

Facial plastic surgery procedures commonly combined with eyelid lift surgery include facelift surgery, brow lift surgery, neck lift surgery and facial implants. Be sure to ask your St. Louis plastic surgeon about additional procedures you may be interested in to see if they can be combined.

WHY SHOULD I GET EYELID SURGERY AT RIDENOUR PLASTIC SURGERY IN ST. LOUIS?

As a double board-certified physician, Dr. Ridenour has the skills, training and experience to produce optimal eyelid surgery results. He received board certifications from the American Board of Facial Plastic and Reconstructive Surgery as well as the American Board of Otolaryngology. Dr. Ridenour is also a member of prestigious organizations, such as being a Fellow of the American Academy of Facial Plastic and Reconstructive Surgery (FAAFPRS) and a Fellow of the American College of Surgeons (FACS).

DOES RIDENOUR PLASTIC SURGERY ACCEPT OUT-OF-TOWN PATIENTS?

Yes, we welcome patients from any geographical location. Whether you’re coming from a St. Louis County city like Chesterfield, a city outside of Missouri or even somewhere out of the country, Dr. Ridenour looks forward to providing you with the best possible blepharoplasty results.