Blepharoplasty

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Dr.Ghorabi

غلامحسین غرابی دکتر زیبایی

Specialist in plastic and cosmetic surgery
Member of the American Society of Plastic Surgeons
Member of the Iranian Plastic Surgeons Association

Survices

جراحی پلک

Eyelid surgery

Aging, prolonged exposure to sunlight, genetics, metabolic diseases, and gravity are among the factors that contribute to aging, skin wrinkles, drooping, and puffy eyelids, which creates a tired and aged look for the eyes.

 Eyelid surgery can restore youth to all 4 eyelids and give your eyes a beautiful appearance.

Eyelid surgery is a type of surgery that removes excess skin from the eyelids.

History

The first references to eyelid surgery were given by the first century Roman physician Celsus in his book Mericina about making an incision in the skin to release the eyelids.

 The term eyelid surgery or blepharoplasty was coined by German surgeon Carl Ferdinand in 1818, when the technique was used to correct cancerous abnormalities of the eyelids.

 

The lexical root of blepharoplasty is derived from the Greek words Blepharon meaning eyelid and Plazin meaning shaping.

What is blepharoplasty?

Eyelid surgery is called blepharoplasty.

Blepharoplasty is the removal of excess skin and protruding fat from around the eyes.

The eyes and the area around them are especially important in making the first impression when meeting people. In fact, the eyelids and the area around them are the area that shows the first signs of aging.

With age and small changes in the appearance of the eyelids, it has a greater effect on the appearance and beauty of people because the eyelids can make a big change in the overall appearance of the face.

 The amount of excess skin removal is very important.

Because if it is removed more than the allowed limit, it may cause problems in closing the eyelids, and if the eyelids are not closed properly, it will lead to dryness of the eye surface and cornea, and other dangerous complications.

 

 Different types of surgical procedures are performed for the upper and lower eyelids. Sometimes this involves removing or redistributing fat near the nose or in the corner of the upper eyelid, or just below the eye in the lower eyelid.

Upper blepharoplasty is a relatively simple surgery with few complications. However, lower eyelid blepharoplasty surgery, if performed by inexperienced and untrained people, may have higher complications and a much longer recovery time.

 

Blepharoplasty can be performed as a single procedure or often in combination with other facial cosmetic surgeries such as a brow lift or face lift.

 

 The information you are reading is a general guide for patients who undergo eyelid surgery

What is the cause of eyelid bag?

In the lower eyelid, some people have a family history of excessive swelling.

Lower eyelid bags in the young age of some people, their swelling first appears only in the morning, but with age and aging, it tends to continue throughout the day.

 Most of the time, as the skin and ligaments of the lower eyelid stretch and loosen and age increasing, the layers of fat around the eyeball often move forward, giving the appearance of bags.

In the upper eyelids, the first signs of aging appear with skin laxity and wrinkling. As age progresses, there is a downward displacement of the eyebrow and widening at the inner corners of the eyes.

Also, with age, the fat of the upper eyelids protrudes forward and creates an upper eyelid bag.

Will the cost of surgery be covered by my health insurance?

In cases where the skin of the upper eyelid loses its youthful consistency and becomes loose and hanging, it can disturb the field of vision. In cases where your field of vision is impaired, private health insurance may cover the cost of surgery.

In such a situation, insurance companies will need evidence that there is a report of examination and impairment of the field of vision.

 If blepharoplasty is performed for cosmetic reasons, it is usually not covered by health or private insurance

Blepharoplasty methods

Similar to other plastic and cosmetic surgeries, eyelid surgery is done with different techniques. After analyzing the person’s face, we will make the necessary decision regarding the surgical technique.

a – Conventional method

In the conventional blepharoplasty method, excess skin, tissue and fat are removed or moved to create a more beautiful and fresh appearance for the person.

 The incisions are made with a surgical knife and the location of the incision depends on the type of problem.

Incisions are made along the natural lines of the eye to remove excess eyelid skin.

There are three different types of eyelid surgery, and the procedure you need can vary depending on your eye shape and other health conditions.

 One of these three types is recommended by your specialist:

Upper eyelid surgery:

 This type of blepharoplasty is mainly used to improve vision and eye appearance due to aging or genetics. As the name suggests, it focuses on the upper eyelid. This type of surgery can restore eye function or create a more beautiful and youthful appearance.

Lower eyelid surgery:

This procedure is performed around the lower eyelid and eyes with a focus on removing skin wrinkles, correcting puffiness of the eyes or improving the appearance.

Double eyelid surgery:

In double eyelid surgery, a crease is created in the upper eyelid, creating a wider and larger eye. This is a procedure that has gained popularity in East Asia and is often referred to in relation to blepharoplasty in general.

The lower eye area is treated in two different ways.

 If there is a need to treat puffy eyes, the incision may be made inside the lower eyelid and the excess fat underneath is removed.

In another case, if it is necessary to remove excess skin along with fat, an incision is made on the lower eyelid about one to two millimeters below the eyelash line.

Cosmetic surgery of the upper eyelid or blepharoplasty takes about 1 hour and the lower eyelid takes about two hours, and their recovery time is also short.

b – Use of lasers

The great advantage of laser is its flexibility. With a laser, it is possible to cut, burn and remove excess skin and fat from the eyelids.

 In laser surgery, because the incisions are without bleeding or with very little bleeding, it is suitable for patients with coagulation disorder problems.

 This type of operation is effective in the front areas of the eye.

Although laser surgery has a lower risk of bleeding and bruising, it irreversibly burns the tissues around the cut site and the recovery period and healing process are longer.

c – Plasma jet

Plasma jet is a non-surgical alternative method and does not require surgery or stitches. In this method, plasma is used to create a small arc of electricity that can target the surface cells of the skin.

In fact, the skin or fat of the eyelid is not removed, but the surface layer of the skin is sublimated using plasma.

 This causes the lower layers of the skin to shrink.

The plasma jet method is not a suitable option for the elderly or clients who have loose and hanging skin and the fat around the eyes is puffy and does not have good results.

Why blepharoplasty?

If the drooping or puffiness of the eyelids is such that it causes:

  • a feeling of heaviness and impaired vision
  • You have difficulty opening your eyes in the afternoon and at night.
  • you get early fatigue and heavy eyelids while reading.

 You are probably a good candidate for blepharoplasty.

 Removing excess tissue from the upper eyelid can improve vision.

Upper and lower eyelid blepharoplasty makes the eyes younger and more open and solves the problems mentioned above.

If you have the following conditions, you will be a good candidate for blepharoplasty:

  • Puffiness or drooping of the upper eyelid
  • The excess skin of the upper eyelid affects the peripheral vision
  • Excess skin in the lower eyelid
  • Puffiness under the eyes

 

Blepharoplasty can be performed together with another beauty procedure such as eyebrow lift, face lift, fat injection or skin rejuvenation.

Consultation before blepharoplasty

During the consultation and meeting with the surgeon, you will discuss the following issues:

  • Medical history: The surgeon will ask questions about any surgeries you’ve had before. including your vision condition in the morning, afternoon, while reading and driving, dry eyes, glaucoma, allergies, blood circulation problems, thyroid problems and diabetes.
  • In addition, the doctor will ask questions about the medicines and herbal supplements you take, the amount of possible alcohol, tobacco and drug use.
  • One’s expectations from the surgery: An honest conversation about the hopes and motivations for the surgery can ensure your level of satisfaction after the surgery.

The plastic surgeon will discuss whether or not this surgical procedure will work for you.

Procedures before blepharoplasty

  • Physical examination: a complete examination will be performed, including checking eye tear production and measuring different parts of the eyelids.
  • Vision examination: the eyes are examined and the peripheral vision is measured.
  • Imaging of the eyes: photographs of the eyes are taken from different angles, and these images help in planning the surgery, and with their help, the immediate and long-term effects will be evaluated.
  • Requesting necessary tests before surgery based on your history and chronological age.
  • If your age is more than 50 years old, it is necessary to have an initial examination of your heart and blood vessels and blood pressure.

What measures should I take before the operation?

  • Aspirin or aspirin-containing medications should not be taken for a week before surgery because it interferes with normal blood clotting during surgery.
  • At least three weeks before surgery, smokers should reduce smoking as much as possible and stop smoking at least three days before surgery.
  • If you have had problems with your eyes in the past, especially dry eyes tell your surgeon about frequent pain, infection, or excessive watery eyes so he can evaluate your tear production.
  • Do not eat or drink anything at least 6 hours before surgery.
  • Bathe at least the night before surgery.
  • On the day of surgery, you should not put makeup or cream on your face.
  • Do not take any medicine without consulting the plastic surgeon.
  • Bring sunglasses for discharge.
  • One of your relatives must accompany you for admission and discharge from the hospital and preferably stay at home with you the first night after surgery.

Operation technique

What happens during the operation?

Eyelid cosmetic surgery or blepharoplasty is usually performed under local anesthesia simultaneously with the induction of superficial drowsiness.

 In general, during the eyelid cosmetic surgery process, small incisions are made along the natural lines of the face on the upper and lower eyelids, and these lines disappear after healing.

 The surgeon usually removes the excess skin of the eyelids, places the fat in its anatomical position, and restores the muscles that shape the eyes.

Removing the excess skin of the upper and lower eyelids along with the restoration and reconstruction of the muscles that shape the eyes, creates a fresh look and a beautiful appearance for your eyes.

Upper eyelid surgery is sometimes combined with eyebrow lift, based on the procedures required to perform eyebrow lift surgery, it can be performed by endoscopic surgery.

Inpatient status

Blepharoplasty surgery does not require admission to a clinic or hospital, and you can be discharged and go home within the first hours after surgery.

Side effects of surgery include

  • swelling and bruising in the surgical area.
  • A feeling of stretching the skin in the surgical area.
  •  
  • Itching and burning in the eyelid area.
  • After eyelid cosmetic surgery or blepharoplasty, the side effects disappear within the first few days after the operation.
  • There will be some swelling and bruising of the periorbital and eyelids, which will usually resolve within 2 weeks.

Care after eyelid surgery (blepharoplasty)

  1. During 48 hours after the operation, it is good to keep the head about 30 degrees above the level of the heart (semi-sitting position) because it reduces the swelling of the area around the eyes and face.
  2. In order to reduce the swelling and bruising of the surgical site, it is necessary to use an ice bag wrapped in 2 layers of gauze for 10 minutes every hour for the first 12 hours on the forehead and around the eyes.

The next day, use an ice pack on your eyes 4 to 5 times throughout the day.

  1. Avoid heavy activities for 7 to 10 days.
  2. According to the doctor’s order, you can take a light shower for 7-10 minutes from the second or third day. Avoid pulling on the operation area and use a neutral shampoo (baby shampoo).
  3. Be sure to wear sunglasses to avoid direct sunlight.
  4. Avoid eye makeup for at least 7 to10 days.
  5. Avoid scratching and manipulating the operation area.
  6. Be sure to use prescribed medicines and eye drops.
  7. If non-absorbable sutures were used, the sutures in the operation area are removed 5-7 days after the operation.
  1. Swelling and bruising of the operation area will improve within 2-3 weeks after the operation.
  2. Avoid driving and doing things that require attention for a week.
  3. Take only prescribed medicines exactly as prescribed by the doctor and on time.
  4. Get more rest than usual. In the first seven days after the operation, avoid bending and putting pressure on the operation area.
  1. In case of inflammation, redness, and fever, inform or refer to your plastic surgeon.
  2. Do not worry if you have swelling and bruising around the eyes after the operation, it will heal in up to three weeks.
  3. For 2 months, avoid doing sports activities that cause accidents such as skating and skiing.
  4. Use a diet rich in protein and vitamins, especially fresh fruit juice and plenty of fluids.
  5. Refrain from drinking alcohol for five days.

See a doctor immediately if you notice any of the following symptoms:

  • Shortness of breath
  • Chest pain
  • Abnormal heartbeat
  • New severe eye pain
  • Bleeding
  • vision problems

Complications and possible risks

  • Although very rare, post-operative bleeding may occur, so it is important to stay in the hospital or clinic for at least 4 hours after surgery.
  • Asymmetry in the eyelids
  • Dry and irritated eyes
  • Inability to close the eyes completely
  • Visible scar line
  • Eye muscle damage
  • Change in skin color
  • The need for more surgeries
  • Blurred vision and in very rare cases loss of vision

It is very important to have the experience and proficiency of a surgeon and to undergo the training courses of the cosmetic specialist.

The precision and expertise of the plastic surgeon will minimize these complications.

Consult your surgeon about possible risks.

 Understanding what is done during blepharoplasty and comparing the risks and benefits can help you make a decision.

recovery

Eyelid cosmetic surgery or blepharoplasty does not have much pain or discomfort, and only a little swelling and sometimes a slight bruise appears after the operation, which disappears within 2 weeks.

The patient’s sutures are removed within 4 to 7 days after the surgery, and after the sutures are removed, the patient can have his eye make-up.

 It is safe to use contact lenses 2 weeks after the operation. You can study after 2 days and return to work after 5 days.

Results

Many people who have blepharoplasty say they feel more confident and feel younger and more relaxed.

Bruising and swelling generally subsides slowly in about 10 to 14 days.

 Scars from surgical incisions may take months to fade.

Be careful to protect the delicate skin of your eyelids from the sun.

Based on the skin type, genetics and living environment, skill and experience of the plastic surgeon, the result of eyelid cosmetic surgery or blepharoplasty lasts for several years for some people and is permanent for others.

Ten golden tips about eyelid surgery

1- What should I expect after the operation?

  • After the operation, your eyelid incision will be covered with a special tape and you will have no problem opening your eyes.
  • A special lubricating eye ointment is placed inside your eyes, which may blur your vision at first, which is nothing to worry about and resolves after a few hours.
  • In order to reduce the swelling and bruising of the surgical site, it is recommended to use an ice pack wrapped in 2 layers of gauze on the forehead and around the eyes at home during the first 24 hours.
  • Moderate swelling, black and blue discoloration of the eyelids may occur, which will disappear within 2-3 weeks after surgery.
  • 48 hours after the surgery, applying cold compresses every few hours helps to absorb the bruise quickly and it can be started.
  • Your eyes may feel gritty, dry, or watery, which can be removed by covering your eyes at night or using ointments and eye drops.
  • You may need mild analgesic to relieve the discomfort.
  • However, if you have significant eye pain, then you should inform your doctor immediately.
  • You will feel stiffness, especially in the upper eyelids, and numbness for the next few weeks
  • You can use eye make-up on the seventh day after removing the stitches.

2- Does blepharoplasty damage vision?

Although very rare, bleeding may occur after blepharoplasty.

 This can cause pressure on the blood supply to the eyeball and put pressure on the optic nerve and cause permanent vision damage.

This is why it is important that you stay in the hospital for at least 4 hours after surgery and that your eyes are checked for possible bleeding before you leave.

3- Are there any other long-term complications?

 

  • Bruising and excessive swelling are rare but can occur with any surgery.
  • Scars usually do not cause a major problem and are easily hidden with a little makeup in the first few weeks.
  • Occasionally, small millimeter cysts may develop at the surgical incision line.
  • Sometimes, the lining of the eyeball becomes swollen (called subconjunctival edema), which always resolves without specific treatment.
  • If too much skin is removed from the lower eyelid, the white of the eye can appear larger (scleral show).
  • Sometimes, patients report blurred vision immediately after surgery, but this usually resolves on its own.

4- Why does eyelid drooping occur?

As you age, the skin along your eyelid loses its firmness and the muscles that lift the eyelid weaken over time.

 For some, droopy eyelids can be caused by an injury or disease, such as diabetes, myasthenia gravis, or a tumor.

A drooping upper eyelid can occur on one or both of your eyelids.

5What are the symptoms of drooping eyelid?

  • A common symptom of drooping eye is loss of normal field of vision, especially the upper and outer parts of your field of vision, usually this change happens gradually.
  • You may have trouble driving.
  • Blurred vision while watching TV.
  • Other symptoms can be very dry or watery eyes.
  • It can make your eyelids look tired due to puffiness or drooping.
  • An optometrist can test your field of vision and determine if you have vision impairment due to the shape or position of your eyelids.

6How is eyelid surgery performed?

 

Blepharoplasty is a type of surgery that repairs drooping eyelids. A plastic and reconstructive surgeon or oculoplastic surgeon can perform this surgery.

During surgery, the surgeon will make an incision in the natural crease of your eye and remove excess skin, muscle, and possibly fat along your upper eyelid. This incision is hidden in the natural crease of the eyelid.

The procedure is performed as an outpatient surgery, which means your recovery can be done conveniently at home.

Blepharoplasty can reduce or eliminate visual field problems, in addition to making the eyes look younger and more alert.

 

7Can young children have droopy eyelids?

Babies can be born with drooping eyelids, also known as congenital ptosis. The child may raise his eyebrows or tilt his head back to see.

A droopy eyelid that completely or partially blocks a child’s vision can lead to permanent vision loss. An ophthalmologist should evaluate this.

Surgery on young children to correct droopy eyelids is usually performed at preschool age.

8How do I know if I need an upper eyelid surgery or an eyebrow lift?

The diagnosis of this issue depends on the position of the eyebrow.

 During the initial consultation and examination, the plastic surgeon pulls the forehead skin to a certain extent.

If most of the skin of the upper eyelid disappears after the forehead skin is stretched, it is more beneficial for the patient to perform forehead skin retraction surgery.

If the stretching of the forehead skin has little or no effect on the upper eyelid, blepharoplasty is the best solution.

To have a younger appearance, it is recommended to use eyebrow lift and upper eyelid surgery at the same time if you are over 45 years old.

9- When should you expect results?

After surgery, you may experience blurred vision from the lubricating ointment used on the eye, watery eyes, sensitivity to light, double vision, or some pain or discomfort.

 Bruising and swelling will occur, this generally subsides in 10 to 14 days.

Scars from surgical incisions may take months to fade. During this time, it is important to protect the delicate skin of your eyelids from excessive sun exposure.

Most people are satisfied with the results and see improvement in their vision.

Results may last a lifetime for some people.

10- Is eyelid surgery covered by insurance?

  If you have surgery just to improve your appearance, insurance will not cover the cost.

If your field of vision is disturbed due to a drooping eyelid, some private insurance companies will cover its cost.

Frequenty ask qustion about eyelid surgery 

  1. What happens in the preoperative visit?

The doctor will meet you and review your health and medical history and examine you closely. They answer your possible questions exactly. The required tests and investigations are requested, the photograph is taken from the face to the more detailed analysis.

Finally, you will have to sign the Informed Consent form.

  1. What is informed consent?

It means that you have obtained comprehensive information about all aspects of surgery, including benefits and possible risks, benefits before and after the operation, and you have decided to perform the operation with full confidence and knowledge.

  1. What are the risks of eyelid surgery?

 

Discuss the risks of surgery with your surgeon and weigh the benefits and risks to help you decide if the procedure is right for you.

Like any other surgery, there are possible risks, but note that the risks increases if the surgery is performed by untrained people.

The risks are:

  • Infection and bleeding
  • Dry and irritated eyes
  • Difficulty closing the eyes or other eyelid problems
  • A noticeable scar
  • Damage to eye muscles
  • Change in skin color
  • The need for a subsequent surgery
  • Temporary blurred vision or, rarely, loss of vision
  • Reaction to anesthesia and blood clotting
  1. Will I keep my true shape after the procedure?

Most patients say that when they return to the group of people around them after the operation, they are faced with the following statements:

Oh my God! You are amazing!

Did you change your hairstyle?

were you on vacation?

Maintaining your uniqueness is a sign of successful surgery. Although the change of appearance may be important to you and may be very noticeable.

But if these changes are not felt by those around you, don’t be too surprised.

  1. Can I significantly change the appearance of my eyes using this surgery?

It is not easy to answer such questions. Only an experienced and honest surgeon can inform the patient about realistic and unrealistic expectations.

  This answer will be different for different people. To get a better answer, it is suggested to evaluate the percentage of people’s satisfaction with the result of the operation by referring to the people for whom this procedure was performed.

6.Will I have cuts on my skin?

Removing excess skin and fat in the upper and lower eyelid area is inevitable. These cuts usually heal quickly.

Lower eyelid surgery through intra conjunctival incision is a very successful procedure in blepharoplasty, which has been successfully implemented in the last 10 years.

 In this method, the incision is made only in the inner part of the eyelid and there is no need to cut the outer part of the eyelid. Through this incision, annoying fat (fat that causes bags or under-eye circles) can be removed or repositioned.

Sometimes, blepharoplasty is combined with some skin rejuvenation methods such as laser or peel, so that all facial tissue lines in the skin can be removed.

 

  1. What are the risks of this procedure?

In part of the consultation session, the doctor will evaluate your expectations from the operation and will tell you which of your expectations are feasible and which are impossible.

According to the type of operation, a list of possible risks due to the surgery you are considering is presented.

 Although the risks of plastic surgery are rare, every patient needs to be fully aware of the possible risks.

  1. What should be done if you have previous ugly scars?

If you have pierced your ears before, you can better understand how to heal wounds and injuries caused by plastic surgery.

 Wounds in other areas of the body can be a good model for understanding how to heal wounds caused by plastic surgery.

 During the pre-operative consultation and meeting, be sure to show the location of your previous wounds to the attending physician so that he can provide you with proper information on how to treat surgical wounds.

 

  1. Can blepharoplasty correct all wrinkles and lines and facial expressions?

In addition to the bag-shaped skin around their eyelids, some patients have tissue or surface abnormalities on the skin around their eyes.

By combining blepharoplasty and skin smoothing methods (such as laser and chemical peels), it is possible to correct all the recent cases.

  1.  I’ve already had eyelid surgery but I’m not happy with the results, can you correct it?

While we are looking for solutions to improve traditional blepharoplasty, we need to talk a little about the term eyelid surgery revision.

Patients who request revision blepharoplasty need to take certain measures.

In revision blepharoplasty, the surgeon must work on the point that was previously affected by the changes.

Correcting the previous surgery is a complex task, so it may take more time than the initial surgery.

Also, the swellings resulting from blepharoplasty revision are more severe and their treatment takes more time.

 These types of patients should also take the same steps as other blepharoplasty applicants.

11.Can I stay awake during the procedure?

Applicants are put to sleep by injecting analgesic intravenously and at the same time get local anesthesia and are completely comfortable during the operation.

Beauties immediately regain consciousness after the operation.

It is better for the patient not to be alone the night after the operation and to have someone with him as a companion.

Also, it is forbidden to drive for at least 24 hours after the operation.

  1.  Is blepharoplasty painful?

Most patients are surprised that they had little pain after the operation.

Of course, after any type of surgery, we should expect some discomfort and pain.

 Although performing this procedure does not cause any uncontrollable pain, all applicants are provided with a prescription for analgesic.

Sometimes patients take painkiller 4-5 days after the operation. People who have undergone facial surgery feel pain when chewing food for up to 48 hours

  1.  How long does the surgery take?

The duration of surgery depends on various factors such as the complexity of each person’s eyelids.

 Revision blepharoplasty usually takes a little longer because it requires more precision.

  1.  Can I return home after the operation?

Most of the time, this operation is done on an outpatient basis and you can go home after you are fully awake and able to tolerate the liquid diet.

 It is necessary for a reliable person to take you home and stay with you at night, and two days later, he will accompany you to the office or clinic for a post-operative visit.

  1.  When can I go back to work?

Most patients take 2 weeks off, but usually a week later the patient can return to work. After a week, all bruises and swelling can be easily camouflaged using normal cosmetics.

 

  1.  How many days after surgery is physical activity allowed?

Aerobic activities should be avoided for 2 weeks.

Avoid lifting heavy objects or heavy physical activities for 3 weeks after the operation.

Bending, lifting heavy objects and putting pressure on the body will increase the swelling and delay the healing process.

  1.  How long does it take to heal bruises and swelling caused by the operation?

By the end of the first week, post-operative bruising and swelling will begin to heal.

 The complete disappearance of these symptoms takes 2-3 weeks.

7-10 days after the operation, you can completely camouflage them with the help of cosmetics.

  1.  I am not ready to do a cosmetic procedure. Is there another way to change the beauty of the eyes?

Skin smoothing methods such as Botox, collagen and peel can be an opportunity for people who are not ready for cosmetic surgery.

  1.  I really want to have cosmetic surgery, but I’m nervous. What should I do if I am stressed?

Getting nervous is normal. Frankly, if you take this step as a joke, we will be angry.

If you have any problems, let us know.

 One of the best things to deal with nervousness is to observe and evaluate the satisfaction of the people who have had this procedure done.

  1.  What are the necessary preparations to prepare for surgery?

Your medical history and health will be thoroughly examined.

 Since the use of tobacco, including cigarettes, hookah delays wound healing, it is recommended to avoid using these substances at least two weeks before and after the operation.

Needless to say, medical findings emphasize not to use these substances and it is recommended to avoid using them altogether.

  1.  What advice do you have about taken my medications?

In the pre-operative consultation, the doctor will check all the medications you are taking.

If you are taking anticoagulation, you should stop taking them about a week before the procedure.

They will also provide you with a list of medications and supplements that should not be taken before the procedure.

 

  1. I take vitamins and supplements. Should I avoid eating them before the operation?

Most of these substances have side effects. Some of them, such as fish oil and vitamin E, affect the blood flow during the operation. However, they will give you a list of drugs and supplements that you should not take.

  1. Do you recommend any special medication before surgery?

Most patients do not need to take any special medication before the operation.

 Avoid eating and drinking from midnight before the procedure.

 There is no contraindication to taking vitamins A and C before surgery.

  1. Why should I avoid eating and drinking before the operation?

Anesthetic drugs cause irritation of the stomach and abdomen.

If your stomach contains food or liquids, the possibility of irritation and nausea and vomiting increases.

  It is better to stop eating and drinking from midnight before the operation to prevent these side effects from worsening.

 The medical staff will consider special care for patients with certain diseases such as diabetes.

  1.  What is done to check before the operation?

The nurse will prepare you for surgery and try to ask all possible questions so that you can enter the operating room with full confidence and without worries.

 

  1.  What will I look like when I wake up?

After the operation, your eyes will be bandaged with a special adhesive tape at the surgical incision line, but you will be able to open your eyes.

 Your eyelids are swollen. There may be some bruising under your eyes, which will intensify within 24 to 48 hours after the operation, but will decrease within a week after that.

  1.  How do I feel when I wake up?

Due to the effect of anesthesia and the swelling of the eyes and the use of antibiotic eye ointment, you are hardly able to see for one or two hours, and they will ask you about nausea. Nurses will be by your side to take care of you carefully.

 

  1.  When I am wake up enough, will I be allowed to drive?

NO.

Due to the effects of anesthesia, you are not allowed to drive and someone else must drive you home after the operation and stay with you at night.

 

  1.  Is it necessary to have a companion at night after surgery?

Yes.

 On the first night after the operation, it is advisable to take him with you so that he can be with you at home and take care of you.

  1.  Is it necessary to follow a special diet after the operation?

NO.

 Patients can start eating and drinking. It is recommended to start your diet with liquids and gradually increase to soft and solid foods.

  1.  Do I need a special prescription after surgery?
  • Taking some kind of oral antibiotic
  • Anti-inflammatory medicine to reduce swelling
  • Analgesics to minimize any possible discomfort and pain
  • Ointment to rub on stitches
  • Taking Arnica to reduce the amount of bruising
  • Do not take aspirin, ibuprofen, vitamin E until one week after surgery to speed up recovery.
  1.  When should these medicines be taken?

After being fully awake and tolerating the diet of liquids and food, you will be able to take your medicines according to the doctor’s order.

  1.  How long does bruising and swelling last?

These complications can be seen in most patients for about a week.

If you bruise easily, this period will probably be two weeks for you, which happens very rarely.

  1.  Do you have any suggestions to prevent the aggravation of bruises?

After the operation, most patients will have bruises.

 Bruising can be reduced with Arnica and frozen saline eye pads.

 

  1.  When can I take a shower?

48 hours after surgery, you have no restrictions on bathing.

 Use a lukewarm water shower. Remove the adhesive tape of your eyelid dressing under the lukewarm water shower and wash the surgical site with neutral shampoo.

  1.  Do I have to do anything during my daily activities?

When sleeping, your head should be 30 degrees above the heart level.

During the first 2-3 days after the operation, avoid bending, lifting heavy objects and hugging the child.

37.When will I look normal?

You will look normal in 2-3 weeks.

 After 6 weeks you will look amazing and after 3 months you will look better than you expected.

 You will still have some swelling and the final result you want will be achieved within 3-6 months.

  1.  What age is required to perform eyelid surgery?

Although most of the eyelid surgery is performed on middle-aged people, some people may undergo surgery at a younger age due to family history.

  1.  What are the general conditions required for eyelid surgery?

Having perfect physical and mental health is one of the basic conditions.

  • Complete knowledge of eye disease records
  • Information about being allergic to medicines
  1. Is anesthesia necessary for blepharoplasty?

NO.

 Eyelid surgery can be performed under local anesthesia according to the patient’s condition. At the discretion of the doctor, you can use sleep induction.

  1.  Can eyelid surgery cause vision impairment?

NO.

 Basically, if the eyelid surgery is performed by an experienced and trained plastic surgeon, it does not affect vision.

  1.  Can lower eyelid puffiness be due to kidney or liver diseases?

Yes.

Sometimes, cardiovascular diseases, liver, kidney and thyroid diseases can cause puffiness in the lower eyelid.

  1.  Does the scar remain after eyelid surgery?

The place where the eyelid is cut should be usually 8 to 9 mm above the place where the eyelashes grow and right where the stitches disappear if the person opens his eyes.

 And within 2-3 months after the operation, almost the patient’s scar is not visible.

  1.  Can lower eyelid puffiness be corrected without cutting the skin?

Yes.

In cases where the patient’s only problem is eye puffiness, it can be corrected through the inner mucous membrane of the eye without the need for external incision.

  1.  Can eyelid surgery change the size or shape of the eyes?

Yes.

 If the eyelid surgery is not performed by inexperienced persons correctly and in principle with accurate calculations, it may cause the stretching of the eyelids and, as a result, change the state of the eyes.

 

  1.  ​​My child has droopy eyelid since birth. Can it be corrected by eyelid surgery?

Your child has drooping eyelids or ptosis.

How to correct it is different from the usual eyelid methods. But it can be fixed anyway.

 

  1.  I am a middle-aged person with vision in only one eye, can I have eyelid surgery?

It is better not to perform the operation or to do it with full caution and by an experienced plastic surgeon.

References

Mayo clinic

ASPS

NHS

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Phone Call

+982122040382

Hours

Saturday, Monday, Wednesday
16:00 - 20:00

Location

No.2713, Jam Building, Valiasr Ave, Tehran, Iran

Dr. Gholamhossein Ghorabi

Dr. Gholamhossein Ghorabi, a subspeciality in Aesthetic, plastic and reconstructive surgery, an active member of the International Society of Aesthetic Plastic Surgery (ISAPS) and Iranian Society of Plastic and Aesthetic Surgeons (ISPAS).