Eyelid Surgery

Many men and women come to Dr. Mills, complaining that their droopy upper and lower eyelids make them look tired, sad or older than they feel; they desire a more rested and refreshed look that better reflects how they feel on the inside.

Dr. Mills generally suggests blepharoplasty, or eyelid surgery, to help them achieve the appearance that they desire.

With blepharoplasty, Dr. Mills can generally reshape the excess fat and drooping skin of the upper eyelid. Additionally, he can minimize bags under the eyes and tighten the lower eyelid skin. Most of Dr. Mills' eyelid surgery patients remark that the surgery resulted in a more rested, refreshed and happy appearance. Oftentimes, their friends and family never guessed that they had surgery that made their appearance look better.

While most people opt to have eyelid surgery to minimize the signs of aging, even some people in their late 20s and early 30s benefit from the procedure.

You will likely benefit from blepharoplasty if you have any of the following conditions:

Upper Eyelids

Excess skin that hides the natural fold of the upper eyelids
Loose skin that hangs down from the upper eyelids
Puffiness in the upper eyelids (or excess fat)

Lower Eyelids

Excess skin and fine wrinkles of the lower eyelids
Puffy "bags"(or excess fat)

· Learn about the Lower Eyelid Procedure in 3D

· Learn about the Upper Eyelid Procedure in 3D

· Learn about the Outter Eyelid Procedure in 3D

It should be noted that crow's feet, dark circles and/or a sagging brow are not treated with a blepharoplasty, but these conditions may be treated with other procedures. Many patients believe that they only have upper eyelid skin laxity, but oftentimes have a droopy or sagging brow (or a combination of eyelid skin laxity and droopy brow). In this case, Dr. Mills would likely suggest a browlift (with or without blepharoplasty, depending on the case). He may talk to you about the different types of brow lifts, (i.e. coronal, endoscopic or lateral browlift) or even midface suspension, if indicated.

In your consultation, Dr. Mills will assess the amount of excess fat and skin in your eyelid areas, the position of your eyebrows and the condition of the muscles around your eyelids to determine whether you are an ideal candidate for surgery on your upper eyelids (e.g. "upper blepharoplasty"), lower eyelids ("lower blepharoplasty") or both ("quad blepharoplasty").

Many patients opt to have eyelid surgery in conjunction with other facial procedures, such as a browlift to tighten a sagging brow or face lift to smooth out the loose skin of the face and neck. Combined with eyelid surgery, these procedures generally yield a very polished and pulled-together look.

With an upper blepharoplasty, Dr. Mills typically makes the incision in the natural crease of the eyelid, from the inside corner slightly beyond the outside corner into the crow's feet or laugh lines. The incision is typically concealed when healed because it follows the natural contour of the upper eyelid.

With a lower blepharoplasty, Dr. Mills conceals the incision just below the lower lashes. Through this incision, he can remove any excess skin, muscle and fat. Sometimes, Dr. Mills will perform a "transconjunctival blepharoplasty," placing the incision inside the lower eyelid. This technique does not require an external incision, but is mostly beneficial for patients without excess lower eyelid skin.

Within the last few years, the trend in plastic surgery is to blend or rearrange the tissue and fat to give a better contour and more youthful appearance rather than removing fat of the lower eyelids. This creates a more youthful appearance, instead of a hollow or sunken look. This method can also sometimes help a prominent "tear trough." Dr. Mills prefers this technique of lower lid blepharoplasty.

Additionally, there are those who have lost tone in their midface who can use this lower eyelid approach to suspend the midface to the brow, and even lend support to the lower lid. This procedure is, however, much more involved and has a typical recovery period of 4-6 weeks.

About two weeks prior to surgery, you will meet with our pre-operative patient coordinator. She will review all of your pre-operative instructions with you and make sure that you complete all the necessary lab tests and health screenings, including a "tear test" and possible visual field study. If you are a smoker, you will be advised to quit smoking at least two weeks prior to surgery and not to resume for at least two weeks post-operatively. Additionally, there are certain medications, herbs and vitamins that we will ask you to cease taking for two weeks prior to surgery and up until two weeks post-surgery. This appointment will also be a time for you to ask any final questions, so that you are ready for surgery and have an optimal recovery period.

Prior to your surgery, Dr. Mills suggests that you take the herbal supplements, Arnica Montana and Bromelain, which helps to reduce swelling, bruising and inflammation after surgery.

On your day of surgery, you should allow approximately 1-2 ½ hours for your surgery. (The length of your surgery will depend on whether you do upper or lower blepharoplasty or both.) From the moment that you enter our facility, you will be cared for by Dr. Mills' experienced surgical team. This team includes Dr. Mills, a nurse anesthetist, a registered nurse and surgical technician. This group is committed to providing you with the best care possible from the time you are admitted to the moment you are discharged. Dr. Mills has worked with some of these surgical team members since the beginning of his practice and all members share in his core values and patient care standards.

While healing rates vary by patient, Dr. Mills has seen most patients feel pretty good within a couple of days. For the first 72 hours, you will want to elevate your head and keep crushed iced compresses over your eyes non-stop. You will reduce your swelling and bruising around your eyes significantly by following these instructions. The swelling should subside within 7-10 days, if you ice continuous for the first 3 days. You can cover any discoloration with camouflage makeup. Sutures will be removed in 5-7 days post-operatively. Once your sutures are removed and incision lines are healed, Dr. Mills will advise you regarding eye makeup and contact lenses. You need to keep your face out of the sun to avoid permanent bruising for 3-6 months following your surgery. Dr. Mills advises that you not resume any vigorous physical activity for at least 4 weeks post-operatively.

It is important for you to protect your eyes to ensure proper healing. You need to wear darkly tinted sunglasses to protect you eyes from wind and sun irritation. It is normal to have some dryness for the first few weeks, so Dr. Mills will have you use eye drops frequently during the day and ointment at night for the first month. Also, you will want to be careful with any sun exposure to your face for 2 weeks before surgery and for 6 months after surgery. Dr. Mills will recommend that you use a high SPF sun block on your eyelids to protect your delicate skin for the first 6 months after your surgery.

Dr. Mills will schedule frequent follow-up visits in the months following your surgery to closely monitor your healing. If you experience any unusual symptoms between visits, we encourage you to call our office.

With blepharoplasty, the complications are infrequent and usually minor. Complications may include excess skin removal, changes in vision, bleeding, swelling, bruising, dryness of the eyes, ectropian, infection, scar, asymmetry and risks of anesthesia.

We understand that changing any facial feature is a very significant decision and want you to feel comfortable before opting for surgery. We look forward to meeting you in consultation to hear your goals and objectives. In the meantime, feel free to email any questions to our patient coordinator through our contact us page.

Blepharoplasty Post-Operative Information

You can expect:

To drive after you are completely off your pain medications and the swelling is down, which is usually about 5 days.
To keep your head elevated and continuous crushed eye compresses over your eyes for the first 72 hours. This will help to keep your eyes moist and keep the swelling down.
To frequently use eye drops prescribed by Dr. Mills during the day (as often as every hour) and ointment at night for the first month.
To resume normal activities after 5-7 days, depending on how you heal.
To avoid strenuous workouts for the first 4 weeks after surgery. (You may start to get your pulse up to 120 after 2-3 weeks.)
To visit our office frequently in the first several months after your surgery.
To see your final result after about 3-6 months, after the swelling has subsided.

Frequently Asked Questions

How quickly can I go back to work?
When can I return to using my contact lenses?
When can I wear eye makeup?
When can I expect the swelling or bruising to go away?

How quickly can I go back to work?

Most patients can return to work about 5-7 days after their surgery, or after the swelling has subsided and you are no longer on pain medication.

When can I return to using my contact lenses?

You can generally expect to wearing your contact lenses after 2-3 weeks, when the chance of your eyes drying out is diminished. Be careful not to put any pressure or tension on the incisions and not to let your eyes dry out too much. Dr. Mills will evaluate each case individually and will tell you specifically when you can use your contact lenses again.

When can I wear eye makeup?

You may not wear any eye makeup until 2 days after your sutures are removed to make certain that you do not tattoo the skin. Also, be very careful and gentle in removing the eye makeup after your sutures are removed. The incision sites are very tenuous and any tension may widen your scar.

When can I expect the swelling or bruising to go away?

If you ice continuously for the first 3 days, it typically takes 7-10 days for the swelling and bruising to subside. For those who do not ice continuously as indicated, it will take approximately 3 weeks for the swelling and bruising to diminis

	Eyelid Surgery Many men and women come to Dr. Mills, complaining that their droopy upper and lower eyelids make them look tired, sad or older than they feel; they desire a more rested and refreshed look that better reflects how they feel on the inside. Dr. Mills generally suggests blepharoplasty, or eyelid surgery, to help them achieve the appearance that they desire. With blepharoplasty, Dr. Mills can generally reshape the excess fat and drooping skin of the upper eyelid. Additionally, he can minimize bags under the eyes and tighten the lower eyelid skin. Most of Dr. Mills' eyelid surgery patients remark that the surgery resulted in a more rested, refreshed and happy appearance. Oftentimes, their friends and family never guessed that they had surgery that made their appearance look better. While most people opt to have eyelid surgery to minimize the signs of aging, even some people in their late 20s and early 30s benefit from the procedure. You will likely benefit from blepharoplasty if you have any of the following conditions: Upper Eyelids Excess skin that hides the natural fold of the upper eyelids Loose skin that hangs down from the upper eyelids Puffiness in the upper eyelids (or excess fat) Lower Eyelids Excess skin and fine wrinkles of the lower eyelids Puffy "bags"(or excess fat) · Learn about the Lower Eyelid Procedure in 3D · Learn about the Upper Eyelid Procedure in 3D · Learn about the Outter Eyelid Procedure in 3D It should be noted that crow's feet, dark circles and/or a sagging brow are not treated with a blepharoplasty, but these conditions may be treated with other procedures. Many patients believe that they only have upper eyelid skin laxity, but oftentimes have a droopy or sagging brow (or a combination of eyelid skin laxity and droopy brow). In this case, Dr. Mills would likely suggest a browlift (with or without blepharoplasty, depending on the case). He may talk to you about the different types of brow lifts, (i.e. coronal, endoscopic or lateral browlift) or even midface suspension, if indicated. In your consultation, Dr. Mills will assess the amount of excess fat and skin in your eyelid areas, the position of your eyebrows and the condition of the muscles around your eyelids to determine whether you are an ideal candidate for surgery on your upper eyelids (e.g. "upper blepharoplasty"), lower eyelids ("lower blepharoplasty") or both ("quad blepharoplasty"). Many patients opt to have eyelid surgery in conjunction with other facial procedures, such as a browlift to tighten a sagging brow or face lift to smooth out the loose skin of the face and neck. Combined with eyelid surgery, these procedures generally yield a very polished and pulled-together look. With an upper blepharoplasty, Dr. Mills typically makes the incision in the natural crease of the eyelid, from the inside corner slightly beyond the outside corner into the crow's feet or laugh lines. The incision is typically concealed when healed because it follows the natural contour of the upper eyelid. With a lower blepharoplasty, Dr. Mills conceals the incision just below the lower lashes. Through this incision, he can remove any excess skin, muscle and fat. Sometimes, Dr. Mills will perform a "transconjunctival blepharoplasty," placing the incision inside the lower eyelid. This technique does not require an external incision, but is mostly beneficial for patients without excess lower eyelid skin. Within the last few years, the trend in plastic surgery is to blend or rearrange the tissue and fat to give a better contour and more youthful appearance rather than removing fat of the lower eyelids. This creates a more youthful appearance, instead of a hollow or sunken look. This method can also sometimes help a prominent "tear trough." Dr. Mills prefers this technique of lower lid blepharoplasty. Additionally, there are those who have lost tone in their midface who can use this lower eyelid approach to suspend the midface to the brow, and even lend support to the lower lid. This procedure is, however, much more involved and has a typical recovery period of 4-6 weeks. About two weeks prior to surgery, you will meet with our pre-operative patient coordinator. She will review all of your pre-operative instructions with you and make sure that you complete all the necessary lab tests and health screenings, including a "tear test" and possible visual field study. If you are a smoker, you will be advised to quit smoking at least two weeks prior to surgery and not to resume for at least two weeks post-operatively. Additionally, there are certain medications, herbs and vitamins that we will ask you to cease taking for two weeks prior to surgery and up until two weeks post-surgery. This appointment will also be a time for you to ask any final questions, so that you are ready for surgery and have an optimal recovery period. Prior to your surgery, Dr. Mills suggests that you take the herbal supplements, Arnica Montana and Bromelain, which helps to reduce swelling, bruising and inflammation after surgery. On your day of surgery, you should allow approximately 1-2 ½ hours for your surgery. (The length of your surgery will depend on whether you do upper or lower blepharoplasty or both.) From the moment that you enter our facility, you will be cared for by Dr. Mills' experienced surgical team. This team includes Dr. Mills, a nurse anesthetist, a registered nurse and surgical technician. This group is committed to providing you with the best care possible from the time you are admitted to the moment you are discharged. Dr. Mills has worked with some of these surgical team members since the beginning of his practice and all members share in his core values and patient care standards. While healing rates vary by patient, Dr. Mills has seen most patients feel pretty good within a couple of days. For the first 72 hours, you will want to elevate your head and keep crushed iced compresses over your eyes non-stop. You will reduce your swelling and bruising around your eyes significantly by following these instructions. The swelling should subside within 7-10 days, if you ice continuous for the first 3 days. You can cover any discoloration with camouflage makeup. Sutures will be removed in 5-7 days post-operatively. Once your sutures are removed and incision lines are healed, Dr. Mills will advise you regarding eye makeup and contact lenses. You need to keep your face out of the sun to avoid permanent bruising for 3-6 months following your surgery. Dr. Mills advises that you not resume any vigorous physical activity for at least 4 weeks post-operatively. It is important for you to protect your eyes to ensure proper healing. You need to wear darkly tinted sunglasses to protect you eyes from wind and sun irritation. It is normal to have some dryness for the first few weeks, so Dr. Mills will have you use eye drops frequently during the day and ointment at night for the first month. Also, you will want to be careful with any sun exposure to your face for 2 weeks before surgery and for 6 months after surgery. Dr. Mills will recommend that you use a high SPF sun block on your eyelids to protect your delicate skin for the first 6 months after your surgery. Dr. Mills will schedule frequent follow-up visits in the months following your surgery to closely monitor your healing. If you experience any unusual symptoms between visits, we encourage you to call our office. With blepharoplasty, the complications are infrequent and usually minor. Complications may include excess skin removal, changes in vision, bleeding, swelling, bruising, dryness of the eyes, ectropian, infection, scar, asymmetry and risks of anesthesia. We understand that changing any facial feature is a very significant decision and want you to feel comfortable before opting for surgery. We look forward to meeting you in consultation to hear your goals and objectives. In the meantime, feel free to email any questions to our patient coordinator through our contact us page. Blepharoplasty Post-Operative Information You can expect: To drive after you are completely off your pain medications and the swelling is down, which is usually about 5 days. To keep your head elevated and continuous crushed eye compresses over your eyes for the first 72 hours. This will help to keep your eyes moist and keep the swelling down. To frequently use eye drops prescribed by Dr. Mills during the day (as often as every hour) and ointment at night for the first month. To resume normal activities after 5-7 days, depending on how you heal. To avoid strenuous workouts for the first 4 weeks after surgery. (You may start to get your pulse up to 120 after 2-3 weeks.) To visit our office frequently in the first several months after your surgery. To see your final result after about 3-6 months, after the swelling has subsided. Frequently Asked Questions How quickly can I go back to work? When can I return to using my contact lenses? When can I wear eye makeup? When can I expect the swelling or bruising to go away? How quickly can I go back to work? Most patients can return to work about 5-7 days after their surgery, or after the swelling has subsided and you are no longer on pain medication. When can I return to using my contact lenses? You can generally expect to wearing your contact lenses after 2-3 weeks, when the chance of your eyes drying out is diminished. Be careful not to put any pressure or tension on the incisions and not to let your eyes dry out too much. Dr. Mills will evaluate each case individually and will tell you specifically when you can use your contact lenses again. When can I wear eye makeup? You may not wear any eye makeup until 2 days after your sutures are removed to make certain that you do not tattoo the skin. Also, be very careful and gentle in removing the eye makeup after your sutures are removed. The incision sites are very tenuous and any tension may widen your scar. When can I expect the swelling or bruising to go away? If you ice continuously for the first 3 days, it typically takes 7-10 days for the swelling and bruising to subside. For those who do not ice continuously as indicated, it will take approximately 3 weeks for the swelling and bruising to diminis

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