Peter Galpin, M.D., FACS

Kahului, HI (96732)

200 Kalepa Pl # 203

(XXX) XXX-XX00 phone

(808) 877-7480 fax

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Eyelid: Frequently Asked Questions

These FAQ's are designed to help you with general information about a given procedure. They are not designed to give full detail, or take the place of informational consults with a Plastic Surgeon certified by the American Board of Plastic Surgery.

What can eyelid surgery do?

As we age there are three major changes which take place and become apparent; Gravitational change, fatty deposition, and actinic (sun) damage. How much any one of these contributes to an aged look, differs from patient to patient, and body area to body area. Eyelid surgery is designed to deal with the effects of aging around the eyes. It is an excellent way to deal with fatty deposition (bags), and excess skin (gravitational change). It can also improve a sun damaged look, but to a lesser extent.

What can’t eyelid surgery do?

The most common area not affected by eyelid surgery is the "crow’s feet" area. "Crow’s feet" are lines of facial expression caused by underlying muscle action, not skin changes per se. In almost all cases, they exist mostly on the skin outside the eyelid itself and therefore are not usually helped by eyelid surgery. They may be helped by brow lifts, or "Botox" injections (which weaken the muscle action).

How is the surgery performed?

Upper eyelid surgery is performed through an incision placed in the crease of the upper lid. Fat is removed from the upper lid, and excess skin is removed through the incision. This leaves a scar, which is hidden when the eye is open (when you blink, the eye is typically not closed long enough for the scar to be seen). The scar may be visible if the eye is closed for a time (sleeping), and someone looks closely.

Lower lids can be done in one of two ways.

1. If skin needs to be removed, an incision in the skin, just below the lash line (where eyeliner would be placed) is used. This is called a Subcilliary (or "Outside") approach.

2. The other approach is from the inside of the eyelid, if only fat needs to be removed. This procedure is called "Transconjunctival/Inside Approach."

The outside approach allows for removal of skin and fat, the inside approach avoids a potentially visible scar, but limits what can be done (no skin can be removed). Which approach is appropriate for you should be discussed with your surgeon.

Will I Be Asleep When The Surgery Is Performed?

The surgery is done under "Conscious Sedation and Local Anesthesia". In general this means that patients sleep throughout the procedure, but are conscious. They may feel a little discomfort when the local anesthesia is put in, but most patients don not remember it. This is usually the safest way to perform the surgery.

How Long Does The Surgery Take?

Surgery usually takes about two hours for upper and lower lids when done together and is usually performed in the office operating room. However, surgery can be done at the hospital depending on your preference. You go home the same day.

How Long Does It Take To Recover?

Recovery from eyelid surgery usually takes a few days. It is important during the first two to three days after surgery, that you keep ice packs on your eyes as much as is comfortable. This will dramatically cut down on the amount of bruising and swelling, and therefore shorten the recovery time. You can shower and wash your face normally the day following surgery.

Sutures come out around day four. At this time any bruising that remains can usually be easily covered by a little light make up and people usually return to work at this time. It may take several more days for all the bruising to resolve. The scars themselves may stay a little pink for several weeks, but can be covered by make up.

What Limitations Are There?

I recommend avoiding aerobic exercise or strenuous activity for at least three weeks. You can shower the next day and wash your face normally. No make up should be used on the eyes until after the sutures come out. The first few days are very important and can really speed up the recovery time. Ice packs applied as often as comfortable will speed up the early recovery.

How Long Does The Result Last?

Fat removal should be almost permanent. Excess skin (gravitational change) may re-accumulate, but the result should last for several years.

What Are The Risks Of Surgery?

The most common and concerning risk is "over resection," or taking out too much skin. This can either prevent the eye from closing completely (if it happens in the upper lid), or pull down the lower lid exposing the conjunctiva (if it happens in the lower lid). These problems can usually be fixed, but will most likely require a further surgery.

Eyelid surgery may make the eye dryer. If you have symptoms of dry eyes, you need to let your surgeon know.

Infection is very unlikely, but can occur.

There are other much less frequent complications, which can be discussed with your surgeon.

Does It Hurt?

Other than the few seconds it takes to put in the local anesthetic, there is usually no pain. Postoperatively there will be some discomfort, but with some pain medication and ice packs this is usually minimal. After about two days most patients do not require pain medication.

See Eyelid Procedural Photos