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Blepharoplasty

BLEPHAROPLASTY/UPPER AND LOWER EYELID SURGERY

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Blepharoplasty can remove the excess fat, muscle, and skin from both upper and lower eyelids. Upper eyelid blepharoplasty can address the excess skin above the upper eyelid, whereas lower eyelid blepharoplasty can remove or reposition fat deposits which often give the appearance of lower lid puffiness. The results can be a refreshed appearance, with a younger, firmer eye area. Dr. Bakala might recommend planning a simultaneous forehead lift or temple lift to correct a drooping brow and smooth the forehead, or skin resurfacing to improve the fine wrinkling in the eye area.

For upper eyelid blepharoplasty, excess skin is removed and the fat bulges contoured. This procedure is performed by Dr.Bakala in his private accredited surgical suite located in his office. Surgery is approximately 1 hour and the patient is required to have a responsible adult drive them home (and stay with them overnight if sedation is administered). Recovery is approximately 7 to 10 days before being socially acceptable with a little make-up. Patients can generally go back to work after this time period with little bruising or swelling remaining.

For lower eyelid blepharoplasty Dr.Bakala will discuss the best surgical options for you. The lower eyelids usually require removal or repositioning of the fat bulges. There are different surgical techniques used to address specific problems, Dr.Bakala will discuss these with you. You may be a candidate for a transconjunctival blepharoplasty or a standard transcutaneous blepharoplasty. These approaches may be combined with procedures to tighten the lower eyelid. Sometimes lower eyelid blepharoplasty is combined with laser resurfacing to improve wrinkling; Dr. Bakala will review all the options to help you make an informed decision.

All lower eyelid blepharoplasties are performed in Dr. Bakala’s private accredited surgical suite. Surgery is approximately one and half hours long with post-operative recovery of 7 to 10 days. All patients are required to have a designated driver and a responsible adult to stay with them for the first 24 hours.

For both upper and lower eyelid blepharoplasty surgery, it is recommended that patients remain sedentary for the first 24 to 48 hours. This is imperative to help minimize bruising and swelling and expedite recovery. All post-operative care is provided by Dr. Bakala and he will follow your recovery closely.

Dr. Bakala has the expertise to consult with you and provide the information you require to make an informed and realistic decision, trust your face to a specialist.

POST OPERATIVE INSTRUCTIONS (Eyelid)
BLEPHAROPLASTY

1. BLEPHAROPLASTY- Eyelid Surgery
This surgical procedure removes the excessive skin and fat around the eyes making them appear larger, less puffy and youthful.

Discoloration
There may be more discoloration around the eyes the day after surgery. The whites of the eyes may show some redness, but this will disappear quickly. Large sunglasses may be worn to hide the discoloration. Please report any sudden increase in discoloration after the second day.

Swelling
Place an ice pack on the eyelids as frequently and for as long as possible during the first forty-eight hours. This minimizes the swelling. At the time of surgery, you MAY be given some ointment to be applied to the eyelid margin so that they can be readily opened in the morning. Dramatic improvement in the swelling is seen after two weeks. Occasionally the swelling will push the lower lid out, away from the eye. This is temporary and will subside quickly. There may be more swelling in one eye than the other; this usually evens out after two to four weeks.

Bandaging and Sutures
Tape is often applied under your eyes to support the incision lines. The day following surgery start applying polysporin ointment 3 times daily to the steristrips. The steristrips will loosen and come off gradually. Once the steristrips are off continue with the ointment 3 times daily, use 3% Hydrogen peroxide to remove any dry blood that maybe present.
Both Polysporin and hydrogen peroxide can be purchased at your pharmacy without a prescription. This cleaning facilitates removal of the sutures.

Discomfort
There may be some burning of the eyes, but very little pain. The eyelid will often feel tight and be hard to close completely but this disappears within a month. A prescription for Tylenol with Codeine will be given at the time of surgery, to be used if necessary.

Washing your face
You are permitted to wash your face but avoid your incisions. Wash with mild soap and warm water.

Contact Lenses
These can be worn as soon as they feel comfortable, usually in about seven days. Be careful not to put any downward tension on the incision line of the lower eyelid when inserting or removing the lens.

Visual Disturbance
Very slight blurring of vision occasionally occurs for a day or so as a result of the selling or the ointment present in the eye. Please report any other visual problems and gross blurring of vision.

Reading
Because of the swelling, it is advisable to limit your television viewing and reading for the first week or two in order to avoid eyestrain and headaches.

Make-up
Make-up is to be avoided in the first post-operative week. However, in the second week, careful use of make-up to cover the discoloration can be used. Avoid putting make-up on the incision line until forty-eight hours after removal of sutures and until the crusting falls off completely.

White Pimples
Very occasionally white pimples called ‘milia’ may appear along the incision line several weeks after surgery. As these are usually self-limiting, no treatment is necessary. If they cause undue worry, treatment can clear these up quickly.

Smoking
Smoking is not permitted 1 month prior to surgery and 1 month post operative to surgery. Smoke can cause infection and pigmentation in the colour of the skin.

Physical exercise
No physical movements should be done for 24 hours where your head goes below your heart. You must remain sedate and calm. Typical gym work outs or other strenuous exercise which increases your heart rate can usually continue around 21 days. Please discuss this with Dr. C. Bakala first, as each person heals differently.

Considerations
During the recovery period your eyelid area will be swollen and red where the incision was made. As you heal the red incision will slowly return to your normal pigment colour. The incision may remain red and bumpy for approximately 1-6 months post operatively. This redness can be easily camouflaged with make up.

After surgery some patients can suffer bouts of depression. If you feel you are depressed please advise your doctor and family members.

POST OPERATIVE ADVICE AND RESTRICTONS FOR PATIENTS WHO HAVE RECEIVED GENERAL ANEASTHESIA OR INTRAVENOUS SEDATION.

To be read carefully by patient, parent, and/or guardian.

Following general aneasthesia or intravenous sedation, 24 to 36 hours are required for the full effects of the drugs to wear off. During this period, it is essential that you follow these instructions:

1. On leaving the office, you must be accompanied by a responsible adult, who may either drive you home or accompany you home in a taxi. They must stay with you over night.
2. On arrival home, it is common to feel sleepy. You are advised to rest quietly at home for the balance of the day. Sleep in a semi up right position.
3. You are advised to lie flat if you feel dizzy or light headed.
4. You are encouraged to drink lots of non-citric juice or non – diet soft drinks for the first 4-6 hours. Light meals are recommended following your operation (i.e. soup, jellos, and ice cream). Milk is to be avoided for at least 24 hours.
5. Avoid alcohol in any form for 48 hours.
6. Avoid any drugs, which may affect the nervous system for 24 hours.(verify with doctor)
7. You MUST NOT operate motor vehicles, boats, power tools or machinery for 24 hours.
8. You must not operate an aircraft for a least four days following general aneasthesia.
9. You must not sign or enter into a legal contract for 24 hours.
10. You may experience some muscular aches in your back or neck area. As well, you may develop a sore throat or stuffy nose following a general aneasthetic. These symptoms are not serious and will disappear in a short time.
11. You must have a responsible adult with the patient for the rest of the day and night. If you have any questions or problems regarding post-operative signs or symptoms, or any associated concerns please call our office, 250-868-8056 or alternate provided. If this was surgery performed at KGH please call the ENT surgeon on call.
12. If unable to reach the surgeon and it is an emergency please go to the emergency department at KGH.

This information is intended for surgical Patients of Dr. C. Bakala.






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