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EYELID REJUVENATION OR BLEPHAROPLASTY
Surgery to reduce the excess tissue around the eyes (blepharoplasty) may be performed in conjunction with a facelift operation, or more commonly, as a separate procedure. When a patient wants both a face-lift and a blepharoplasty, the operations may be performed together or in stages, according to the patients personal preferences or financial considerations. In most cases the right and left eyelids are operated on at the same time. However, it is not uncommon to do only the upper eyelids or the lower eyelids, as the patient wishes. To remove excess skin and other tissue form the upper eyelids, incisions are made in the eyelid fold and extended laterally toward the smile lines. Fatty tissue from the lower eyelids may be removed either through an incision in the skin (just below the eyelashes) or through an incision in the back surface of the eyelid (the transconjunctival approach). Some patients have droopy eyelids from a weak eyelid muscle (with or without excess eyelid skin and fat). If this problem, which is called blepharoptosis, is diagnosed, it is often amenable to surgical correction. The operation takes from 30 minutes to two hours and usually is performed using local anesthesia. Intravenous sedation may be given if the patient wishes. General anesthesia often is used if blepharoplasty is performed as the same time as a face-lift. Sutures typically are removed four to seven days after surgery. Although discoloration around the eye usually resolves in about one to three weeks, swelling may persist for several weeks. The skin scars heal as inconspicuous thin lines in nearly all patients within a few weeks to months. Some patients may experience dryness of the eyes after surgery. This symptom may be caused by incomplete closure of the eyelids during the healing phase and usually resolves within a few weeks. In the interim, the eyes may be soothed by using artificial tear drops and ointments. Because people who have dry eyes before surgery have a greater chance of experiencing this problem postoperatively, we recommend an examination by an ophthalmologist before blepharoplasty is performed. Rarely, there may be other problems after surgery such as persistent drooping or retraction of the eyelids or darkening of the lids because of permanent retention of blood pigments in the skin. These undesirable effects frequently can be treated satisfactorily. Complete loss of vision in an eye is an extremely rare complication of blepharoplasty. Temporary visual blurriness occasionally may occur after surgery because of alterations of the tears, but the problem is typically short lived. Most patients indicate that their eyes look and feel more rested and youthful after blepharoplasty. In general, it is a relatively safe procedure.
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