Blepharoplasty is defined as “any operation which corrects a defect in the
eyelids.” This can be an upper eyelid procedure or a lower eyelid
procedure. While it is important to know about both, lower eyelid
surgery poses a greater challenge. Lower eyelid blepharoplasty
usually aims to get rid of bags under the eyelids and produce a
less tired look. It is important to consult with a qualified
surgeon before undergoing any surgical procedure and this article
poses a few questions to ask the surgeon during a consultation.
What type of incisions will you use?
There are several approaches that can be used to access the lower
eyelid. Some incisions are made on the inside of the lower eyelid
and are not visible. Others are made just below the lash line and
when healed, are nearly imperceptible. The approach used depends
on many factors and the surgeon can discuss these thoroughly.
Is my lower eyelid loose?
When performing lower eyelid surgery, it is important to ensure
that the lower eyelid is tight enough. If the eyelid is not tight
enough, there is a greater risk of pull down of the eyelid after
surgery and resulting dry eyes and eye exposure. To test if the
lower eyelid is loose, the surgeon will pinch the lower eyelid
and pull it out. If it takes a long time to retract or requires
a blink or two to return to a position against the eye, the lower
eyelid is loose. If the lower eyelid is loose, a procedure can be
performed to tighten the lower eyelid. This can be performed at
the same time as lower eyelid surgery and should be discussed
before proceeding with surgery.
Will this surgery take away the bags and lines under my eyes?
Most patients who have bags under the eyes have what is called
pseudoherniation of fat. This means that the fat that normally
exists around the eyeball has pushed out past the edge of the
bone of the eye socket, producing the bags. In some patients, the
bags under the eyes are actually on the cheek and lower eyelid
surgery will not fix this. In addition, if discoloration of the
skin is a concern, it is important to ask the surgeon if just
operating on the lower eyelid will fix the discoloration. Most
of the time, the dark circles under the eyes are due to shadows
from the fat. At times though, this discoloration is due to
pigment in the skin. If pigment is the problem, additional
procedures may be required to address just the discoloration
below the eyes.
What is my recovery time?
While every patient is different, bruising, swelling, and bleeding
are generally the limiting steps for return to normal activities.
Different approaches to the lower eyelid will produce different
amounts of bruising and swelling. Be sure to consult with your
surgeon about expected time away from normal activities.
Above all, research the procedures you are thinking of having and
research the credentials of the surgeon you are considering. While
this is not a complete list of questions you might want to ask, it
is a starting point. It is of utmost importance to discuss your
expectations with your surgeon to ensure that your goals can be
reached.
By D.J. Verret, MDFacial Plastic & Reconstructive Surgery
www.innovationsfps.com
