Blepharoplasty (Eyelid Surgery)
- Blepharoplasty Overview
- Am I a Candidate for Blepharoplasty?
- Your Welcoming Visit
- Preparing for Surgery
- The Location of Your Surgery
Blepharoplasty is the procedure that rejuvenates the upper and lower eyelids, restoring a younger, refreshed look. There a number of blepharoplasty procedures; Dr. Zemmel at Richmond Aesthetic Surgery will carefully select the correct one for your special needs.
Blepharoplasty can remove fat along with extra skin from the upper and lower eyelids. Blepharoplasty can also correct drooping upper lids and puffy bags below your eyes–features that make you look older and more tired than you feel. They may even interfere with your vision. Dr. Zemmel at Richmond Aesthetic Surgery uses cutting edge techniques during blepharoplasty. He always puts the incisions in areas that will be hidden: the crease of the upper eyelid or along the eyelash margin in the lower eyelid. Importantly, he sometimes uses an “incisionless” technique where he performs the lower blepharoplasty through the inside of the eyelid. That means that he can rejuvenate your lower eyelid without any external scar! Also, he may use a state-of-the art method of repositioning the fat in your eyelid to eliminate those unwanted “tear troughs”.
Blepharoplasty can be done alone or in conjunction with other facial surgery procedures, such as a facelift, neck lift, or brow lift. Dr. Zemmel may recommend additional procedures to give you an overall balanced rejuvenation. For example, Dr. Zemmel at Richmond Aesthetic Surgery sometimes combines lower blepharoplasty with a midface lift. This combination can restore the lower lid and cheek together as one unit, providing you with a smooth transition between the eyelid and cheek to recreate the youthful face you desire.
Blepharoplasty will not eliminate dark circles under your eyes or lift sagging eyebrows. If you have these concerns, please discuss them with the doctor at Richmond Aesthetic Surgery during your initial consult.
If you’re considering Blepharoplasty, or surgery to rejuvenate the upper facial area, this page will give you a basic understanding of the procedure: when it can help, how it’s performed, and what results you can expect. Dr. Zemmel at Richmond Aesthetic Surgery will review the entire procedure in detail during your consultation.
Am I a Candidate for Blepharoplasty?
Blepharoplasty can enhance your appearance and your self-confidence and possibly improve your visual field. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Zemmel at Richmond Aesthetic Surgery.
The best candidates for blepharoplasty are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have Blepharoplasty at a younger age.
A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution. You will need a complete ophthalmological exam before surgery.
Your Welcoming Visit
The initial consultation with Dr. Zemmel at Richmond Aesthetic Surgery is very important. Dr. Zemmel will need your complete medical history, so check your own records ahead of time and be ready to provide this information. Be sure to inform him if you have any allergies; if you are taking any vitamins, herbal supplements, medications (prescription or over-the-counter-especially aspirin or blood thinning products), or other drugs.
In this consultation, Dr. Zemmel at Richmond Aesthetic Surgery will test your vision, your eye movements, and assess your tear production. You should also provide any relevant information from your ophthalmologist or optometrist or the records of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along. Please let Dr. Zemmel know if you have had previous eye surgery, such as LASIK.
You should carefully discuss your cosmetic goals and expectations with Dr. Zemmel at Richmond Aesthetic Surgery. Think carefully about what bothers you most about your appearance and discuss these concerns with Dr. Zemmel. You will also need to discuss whether to do all four eyelids or just the upper or lower ones.
Dr. Zemmel at Richmond Aesthetic Surgery will then examine your entire face, focusing on the area around the eyes. He will evaluate:
- The position of your eyebrows
- The function, movement, and resting position of your eyelids
- The skin tone of the upper and lower eyelids
- The amount of excess skin of the eyelids
- The amount of excess fat around the eyelids
- The position of the cheek
- The tilt of the eyelids
Dr. Zemmel at Richmond Aesthetic Surgery will discuss his finding in detail and the possible surgical indications and plan. Dr. Zemmel will explain the techniques, anesthesia, and the type of facility where the surgery will be performed.
Most insurance policies don’t cover blepharoplasty, unless you can prove that drooping upper lids interfere with your vision. Do not hesitate to ask Dr. Zemmel at Richmond Aesthetic Surgery any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing for Surgery
Dr. Zemmel will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.
While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
The Location of Your Surgery
Dr. Zemmel at Richmond Aesthetic Surgery performs blepharoplasty at St. Francis Hospital’s Ambulatory Surgical Center. Blepharoplasty is done on an outpatient basis; rarely does it require an inpatient stay. When combined with other procedures such as a full facelift, Dr. Zemmel may admit you overnight to the hospital for observation.
Blepharoplasty is usually performed under local anesthesia with mild intravenous sedation. Occasionally a general anesthetic is used. You will be asleep during the surgery and unaware of the procedure. You will be completely pain free during the entire surgery.
When blepharoplasty is performed by a trained plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following Dr. Zemmel’s instructions both before and after surgery.
Minor complications are very rare after blepharoplasty, but include: double or blurred vision for a few days, temporary swelling at the corner of the eyelids, and a slight asymmetry in healing.
Following surgery, some patients may have difficulty closing their eyes when they sleep. This is caused by temporary swelling and tightness of the upper eyelid skin and resolves in a few days to a couple of weeks. In very rare cases this condition may be permanent and may require corrective surgery. Another very rare complication is ectropion, or pulling down of the lower lids. In this case, further surgery may be required. Dr. Zemmel at Richmond Aesthetic Surgery will monitor your progress very closely after surgery and will be there every step of the way. If a problem occurs after surgery, he will address it immediately.
Blepharoplasty usually takes one to two hours, depending on the extent of the surgery. If you are having a brow lift with upper and lower lids performed, Dr. Zemmel at Richmond Aesthetic Surgery will perform the brow lift first, then the upper lid procedure, followed by the lower lid procedure. The brow lift often changes the amount of skin removal of the upper lids and therefore must be performed first.
In a typical procedure, Dr. Zemmel makes incisions following the natural lines of your eyelids which will always be hidden: in the creases of your upper lids and just below the eyelash margin in the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, Dr. Zemmel at Richmond Aesthetic Surgery separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin. The incisions are then closed with very fine sutures.
After surgery, Dr. Zemmel at Richmond Aesthetic Surgery will lubricate your eyes with ointment and apply a cold silicone eye care product. Your eyelids may feel tight and sore as the anesthesia wears off, but you will have excellent pain medicine to control the discomfort. Dr. Zemmel will give you a prescription before surgery so you may get it filled and have it ready. If you feel any severe pain, call Dr. Zemmel immediately.
Dr. Zemmel at Richmond Aesthetic Surgery will instruct you to keep your head elevated for several days and to use cold compresses to reduce swelling and bruising. Bruising and swelling varies from person to person: it reaches its peak during the first week and generally lasts 2 weeks. You’ll be shown how to clean your eyes, which may be gummy for a few days. Dr. Zemmel will recommend antibiotic eye drops, since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.
Dr. Zemmel will follow your progress very closely for the 2 weeks. The stitches will be removed 5 days after surgery. Once they are out, the swelling and discoloration around your eyes will gradually subside, and you will start to look and feel much better.
Feeling Normal Again
You should be able to get back to your normal daily activities in 2 or 3 days, but you may not be socially presentable for 7 to 10 days. Many patients will wear sunglasses outside of the house to cover the bruising.
You will not be able to wear contact lenses for two weeks, and even then they may feel uncomfortable for a while until your tear production returns to normal. At that time, depending on your rate of healing and Dr. Zemmel’s instructions, you will probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.
Dr. Zemmel at Richmond Aesthetic Surgery will tell you to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about two weeks. It’s especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports.
Your New Appearance
Healing is a gradual process, and your scars may remain slightly pink for a few months after surgery. Blepharoplasty scars heal extremely well, and eventually they will fade to a thin, nearly invisible white line.
Contact Richmond Aesthetic Surgery
If you would like more information on eyelid surgery, or if you would like to schedule a consultation to talk more about this procedure, please contact Richmond Aesthetic Surgery.
Directions to Our Office
Dr. Zemmel is proud to provide his plastic surgery services to patients traveling from nearby cities. For your convenience, we have provided driving directions to our practice from the following locations:
- Directions from Charlottesville
- Directions from Chesterfield
- Directions from Colonial Heights
- Directions from Glen Allen
- Directions from Henrico County