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 |
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Excess skin that hides the
natural fold of the upper eyelids |
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Loose skin that hangs down from the upper
eyelids |
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Puffiness in the upper eyelids (or excess
fat) |
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| Lower Eyelids |
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Excess skin and fine wrinkles of the lower
eyelids |
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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 |
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You can expect: |
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To drive after you are completely off your
pain medications and the swelling is down,
which is usually about 5 days. |
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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. |
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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. |
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To resume normal activities after 5-7
days, depending on how you heal. |
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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.) |
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To visit our office frequently in the first
several months after your surgery. |
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To see your final result after about 3-6
months, after the swelling has subsided. |
| How
quickly can I go back to work? |
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| 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. |
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| When can I return
to using my contact lenses? |
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| 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. |
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| When can I wear
eye makeup? |
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| 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. |
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| When can I expect
the swelling or bruising to go away? |
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| 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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