Skin Approach Lower Blepharoplasty

The skin approach lower blepharoplasty is also know as transcutaneous lower blepharoplasty and anterior approach lower blepharoplasty. The main target of this surgery is to remove excess skin, orbicularis muscle, and fat from lower eyelids. Transcutaneous lower blepharoplasty may be performed with adjunctive procedures like lateral canthal reinforcement. This surgery can be performed under local anesthesia with oral sedation or intravenous sedation.
In skin approach lower blepharoplasty, the skin is incised along its complete length just below the eyelid margin. The skin is slightly incised beyond the lateral canthus. After that in a similar manner, exposed orbicularis muscle is incised along its full length. Skin muscle is then taken off from underlying orbital spectrum using cotton tip and sharp dissection with scissors. The dissection of skin muscle flap extends to the down side over the full lower eyelid to approximately orbital bony rim. Incision is made to the orbital spectrum to bring out fat pockets from lower eyelids. Excess fat is teased apart and clamped in transcutaneous lower blepharoplasty. Fat is lifted off with scissors. The surgeon asks patient to look upward towards forehead and drapes the skin muscle flap over initial incision to confirm the excess tissue. The blepharoplasty surgeon trimmed any excess tissue. After that surgeon closes the skin edges using sutures.

Benefits of Skin Resurfacing

Skin resurfacing is required to remove the fine lines on the face. Skin resurfacing doesn’t mean to tighten of skin, but it is required to forehead lifting, eyelid tightening and face lifting. Generally skin resurfacing is a medical procedure to improve the texture, clarity and appearance of skin. Skin resurfacing can also be done in conjunction with blepharoplasty.
Advantages: Blepharoplasty is performed to strengthen weakened structure and removal of extra tissue. Skin resurfacing procedures are performed to create a controlled injury in the dermis of the skin. This process leads to reduction of wrinkles in the lower eyelids during the healing from blepharoplasty. Nearly 50-80% of deep wrinkles is reduced by skin resurfacing and is reasonable to expect. The “cutting surgery” damages the skin due to skin creasing and may blunt the appearance of wrinkles in lower eyelids. Skin resurfacing improves the clarity and appearance of skin by reduction of wrinkles.

Skin Resurfacing After Blepharoplasty

There are ablative procedures in blepharoplasty which include chemical peel and laser surfacing in variety of forms. The wrinkles are blunt by tightening within dermal layer of skin. New collagen is generating in skin surfacing and skin texture is altered. The outermost layer of eyelid skin is know as “Epidermis” and below epidermis is the “Dermis”. A mild oral sedation for anesthesia is required. Skin resurfacing is a destructive technique and performed just after blepharoplasty. Skin resurfacing is a non-surgical and stand alone procedure. After blepharoplasty, chemical is applied using Q-tips on the eyelids. Typically, tricholoacetic acid (TCA) is used for apply on the eyelids. 35% TCA solution is used for skin preparation and cleansing. Alpha- hydroxy acid is used for destructive resurfacing and deeper level of wounding. Chemical peeling must be repeated once a month for 5-6 months for better effect. Generally a single treatment is required for medium-depth peel. This can be accomplished by increasing the concentration of trichloroacetic acid (35-50%). Depth of chemical peeling with more potent chemicals is not predictable. Some surgeons use laser for resurfacing because energy is more controlled.
In laser skin resurfacing beam is directed over the tissue of skin. For stronger effect carbon dioxide laser (CO2) and for weaker erbium YAG laser is used. Sometime both the lasers are used in combination. The blepharoplasty surgeon checks the amount of energy required with the depth of penetration. Most of the surgeons prefer laser skin resurfacing because it is less destructive.

New York City Blepharoplasty

Blepharoplasty in new york city is very famous. People are undergoing for blepharoplasty over the full face lift, because this surgery is easy, less discomfort and early recovery. You can experience the expected results and feel satisfaction after blepharoplasty. People under going blepharoplasty in new york city have good benefits. The surgical techniques used in new york city are the latest and totally modernize in the world. In most of the surgical centers laser treatment is used. This reduces your cost of blepharoplasty and recovers time and also you feel just little discomfort. If we talk about cost, then in new york city cost of blepharoplasty is quite low as compare to other places. For the full blepharoplasty (Upper and Lower), the cost will be around $2500-$3000 and it is very cheap as compare to full face lift or other cosmetic surgery. Sometime people called it as new york city blepharoplasty. You can easily find expert blepharoplasty surgeons in new york city. Here are some references that can help you a lot.

• Dr. Philip Miller, MD, FACS, New York plastic surgeon
60 East 56th, Third Floor, New York City, NY 10022

• NYU Medical Center, Department of Otolaryngology
530 First Avenue Suite 7U, New York City, New York 10016

• Scott J. Zevon MD, FACS
Central Park Plastic Surgery
75 Central Park West, New York City, NY 10023

• Z. Paul Lorenc, MD, FACS
983 Park Avenue, New York City, NY 10028

• Robert A. Guida, MD, FACS
8 East 75th Street, New York City, NY 10021

Blepharoplasty for Repositioning of Eyelid Fat

Blepharoplasty can be performed for fat transfer, fat redraping, fat transportation, arcus marginalis release and septal reset. Fat injection and free fat grafting can also be performed under blepharoplasty. Some people have depression at the junction of lower eyelid and the cheek. This depression is caused by heredity or aging factor. The depression is appears as dark circle near lower eyelid.

Generally blepharoplasty is used to remove the depression or dark circle. In blepharoplasty, bulging orbital fat is used to camouflage the depression at the junction between lower eyelid and the cheek. Local anesthesia is acceptable for manipulation of wider area of tissue. Eyelid Fat Repositioning is not so much different procedure during blepharoplasty. It is just a different method to handle the bulging fat during blepharoplasty. Transconjunctival Lower Blepharoplasty is preferred to approach fat pockets. After that they are dissected out from thin capsules but not removed. Extra fat is then changed to uniform layer but remains connected to blood supply. This uniform layer of fat is reflected over the rim of bone into the area of depression. Sometimes this procedure is called as arcus marginalis release. This procedure comes under blepharoplasty. During the procedure, the fat is tucked under periosteum. Fat is usually elevated from the bone and anchored with removable sutures and tied on the cheek. After the completion of the blepharoplasty procedure, eyelids appear normal without extra fat.

Blepharoplasty Removes Dark Circles Under Eyes

Dark circles under eyes give tired and older looks. People have confusion about the cause of dark circles. Dark circles are nothing but the thick skin under your eyes. There are few reasons for the cause of dark skin under eyes or dark circles under eyes.
Dark Purple skin under Lower Eyelid Skin: Some people have purplish or dark color of the lower eyelid skin, they think they have dark circles under their eyes. But this is not only with these people. Everyone have dark skin of lower eyelids as compare to rest of the face. The lower eyelids skin is the thinnest skin on the face and this is so thin that everyone can see through it. Even you can see the eyelid muscles of purple color through thin eyelid skin. Eyelid skin appears more bluish when skin is thick. This appears dark due to the eyelid muscles beneath the thin skin. This not a problem but a racial and familial difference in the eyelid skin thickness and muscle color. This makes a variation in the darkness under eyes. You can use cove make-up to hide the dark circle, this is the only solution.
Appearance of Hollowed Eyes Due to Eyelids Sunken in: Some people have hollow eyes appearance due to eyelids sunken in. This thing caused by the deficiency of normal fat under eyelids which surrounds the eyeball. The fat normally plumps the lower eyelid skin. The deficiency of the fat caused due to racial factors, malnutrition, dehydration or general disease. This deficiency can be solved by performing Tranconjunctival Blepharoplasty. During the blepharoplasty, a thin incision is made on the inside pink potion of the lower eyelid. After that some fat transplant under lower eyelid. This blepharoplasty plumps the lower eyelids and makes a good appearance.
Dark Circles due to Naso-jugal Fold or Tear Trough Deformity: Naso-jugal fold is a depression or deep dark line along the lower eyelids just above the cheek. This called true dark circles under eyes. This depression attached to the underlying bone of rim of the eye socket. The depression is free to move due to unattached skin of lower eyelid just above the depression and drops shadow which make crease the dark color. The Naso-jugal fold or dark circle becomes darker with the age because eyelids and cheeks begin to sag with age but dark circles can not sag. Dark circles attached to bone and cannot sag with the face skin. So, with the age eyelids and cheeks sagging and dark circles become darker.
Tranconjunctival blepharoplasty can be performed to correct the Naso-jugal fold or dark circle. During the blepharoplasty, arcus marginalis ligament is released and free the dark circle. After that dark circle skin frees up and starts moving with the lower eyelid skin and rest of the skin. This procedure of blepharoplasty lessens the shadow of dark circle. Some fat is implant under dark circle to prevent the re-attachment of arcus marginalis. This is called tear tough implant under dark circle. Removal of true dark circle requires the blepharoplasty surgery.

Signs and Symptoms for Blepharoplasty

It is very simple to determine if you need to consider Blepharoplasty. You can check the signs just to look in mirror. Now the thing is, what do you see?
# Is any tiredness appear on your face, even though you are not tired?
# Is your upper eyelid skin overhanging your normal eyelid crease and effecting the eyelashes?
# Are the eyelids appear baggy and saggy with excess fat pockets?
# Notice the fat bags and bulges where they shouldn’t be.
# Look at your eyes. Do eyes appear smaller than as they did appear before?

Sign and symptoms for blepharoplasty generally depend upon your age. If you are in late forties, chances of drooping eyelids and puffy bags under your eyes become more. In thirties, elasticity of the eyelid skin remains perfect. But during late forties, elasticity of thin and delicate eyelid skin starts loosing, though rest of your face appears perfect. This makes you look tired and older.

Main thing is that whether these points should be considered as symptoms or not for blepharoplasty. In some cases, upper eyelids becomes too heavy and its skin resting upon eyelashes. These things affect your eyesight vision. In late forties, almost all people suffering from baggy eyelids and they can have benefit from blepharoplasty. In year 2006, about 23000 people underwent blepharoplasty. Blepharoplasty is preferred over the full facial surgery.

Transconjunctival Lower Blepharoplasty

Variations: The lower blepharoplasty may be accomplished with the use of laser or simple scalpel for the incision. A skin pinch excision may be used if your surgeon indicates and the muscles tightened through the same eyelid skin incision. Fat repositioning may be used in lower blepharoplasty to fill in slight depressions on upper cheek.

Advantages: The transconjunctival lower blepharoplasty has several advantage over transcutaneous lower eyelid blepharoplasty. Advantages of Lower blepharoplasty include:
# There will be no external scar after surgery.
# Chance of lower eyelid ectropion will be less and lower eyelids remain near to eye.
# Less incision to middle layers of eyelid.
# Fat is precisely sculpting from lower eyelids.
# Swelling and bruising will be less in lower blepharoplasty.
#Lower blepharoplasty is safer for patients who had previous blepharoplasty.

Limitations: In lower blepharoplasty, the excess fat is more address than the skin. The eyelids with less or minimal excess skin returns to a normal position after the surgery with no evidence of wrinkling or redundancy. The patients have excess skin can be excise with canthoplasty over lower eyelids. the excess skin can be tightened using laser surfacing or chemical peel over lower eyelid and upper cheek. You can get 70-80% improvement from lower blepharoplasty.

Lower Blepharoplasty Surgery

Lower Blepharoplasty is performed to remove bulging fat from eyelids. Local anesthesia is used for the lower blepharoplasty. Local anesthesia with intravenous sedation or oral sedation may be used. In lower blepharoplasty, the lower eyelid is pulled away from eyeball with the use of blunt retractor. The eyeball is then protected using a plastic plate. The electrocautery is used in lower blepharoplasty to seep across the back side of eyelid along its junction with eyeball. Incision is made across the eyelid to remove fat pockets. Size of incision depends upon the quantity of fat pockets presents in the lower eyelids. The incision may be enlarged in lower blepharoplasty using scalpel. After that 3-4 fat pockets teased out from their capsules into the surgical field. The excess fat from each of the fat pocket is clamped and then excised in a conservative fashion. Blepharoplasty surgeon places the eyelid to its normal position and evaluates the lower blepharoplasty results. Surgeon may stop at any time for excellent precision of the surgery. At the end of lower blepharoplasty procedure, surgeon may close the wound with one or two dissolving sutures. Normally surgeon does not use stitches. Lower blepharoplasty can be accomplished with the use of laser or any other cutting tool like scalpel.

How to judge a Blepharoplasty Surgeon?

Once you have decided for the blepharoplasty, the major issue is to judge the good blepharoplasty surgeon for treatment. You may hear about some people who got disappointed after blepharoplasty, because the surgery performed by non-specialty surgeon. You should go for a blepharoplasty surgeon who has good experience in blepharoplasty and performs the surgery on regular basis. Now the question is how to get such surgeon for blepharoplasty. One way to get information about blepharoplasty surgeon is the phone book. Pick the number of all surgeons and call for most specialized surgeon. But this may not be a fruitful way. The phone book will list you most practitioners having specialized in different surgery from face lift to liposuction with “blepharoplasty” among them. You need a specialized blepharoplasty surgeon who’s experience in blepharoplasty only and perform blepharoplasty surgery 3-4 times a day.

You can ask to your regular physician for a good blepharoplasty surgeon. Your family physician can give you the personal contacts of some reputed surgeons. Now you can contact them through phone and have a personal meeting with them. Don’t hesitate while asking questions to blepharoplasty surgeon, be direct with him. Don’t ask question which have answers in yes/no. Rather ask questions to blepharoplasty surgeon, how many blepharoplasty operations the surgeon does in a month on average basis. What percentage of his practice devoted to the blepharoplasty? How long the blepharoplasty takes? Ask cost of blepharoplasty and the preference for the type of blepharoplasty (lower and upper blepharoplasty). After a discussion with blepharoplasty surgeon, you can ask with some of his patients. It will give you a very good picture.

Benefits of Laser Blepharoplasty

Laser blepharoplasty is more efficient in soft tissue surgery and in some case use of laser is more effective than some standard techniques. The laser acts as three instruments when used properly, a cutting tool used for incision, cautery and a dissection device. Due to this the total operating time reduced. In laser blepharoplasty, the intraoperative is further increased near the absolute hemostasis which is often achieved when working in pre-orbital regions. Co2 laser has greatest incisional application in pre-orbital regions. The dissection with CO2 laser for eyelids in laser blepharoplasty performed on delicate vascular structures with a low risk of tissue distortion, functional impairment and hematoma formation. Laser blepharoplasty allows surgery in pre-orbital regions with low risk on vascular structures. Use of laser in some certain incisional procedures like blepharoplasty Ptosis repair and correction of eyelid retraction gives better precision.

There is an issue which is unclear whether incision procedure in laser blepharoplasty benefits the blepharoplasty surgeon, patient or both. Some study about laser blepharoplasty reported that benefit of CO2 laser over scalpel for incision includes quicker recovery time. The surgeons preferred blepharoplasty with laser due to improved intraoperative hemostasis. This has been noticed by the surgeons and patients that laser blepharoplasty reduce recovery time as well as operating time.

Laser Blepharoplasty

Laser is used by ophthalmologists for past thirty years for the treatment of diseases related to retina. Laser has been used frequently for medicine and surgery in recent years. In laser blepharoplasty, laser is used for incision and removal of skin, muscle, fat, tumors and almost any imaginable tissue. The laser incision tends to bleed less in laser blepharoplasty and thus the surgery takes less time as compare to general blepharoplasty. With laser blepharoplasty, extra fat from eyelid removed without first clamping and it also prevent bleeding. Laser blepharoplasty may eliminate slight discomfort.

The first laser used in laser blepharoplasty was neo-dymium- YAG (ND-YAG) laser in 1980. In this laser instrument, laser is transmitted through fiber optic coil with a power that can be directly applied to the skin. Laser power cuts the tissue and coagulates blood vessels. Laser blepharoplasty reduces the surgery time, but the saved time lost in the pre-surgery set-up. There was no demonstrable advantage from the laser blepharoplasty. Also there was an obvious scar on the operated side due to thermal injury.

The laser blepharoplasty then renewed in 1990s with some good features. Laser blepharoplasty was then introduced with high-energy pulsed CO2 laser. This laser devise is know by its trade name Ultra Pulse. The CO2 laser device produces pulse beam with high frequency that made skin incision with a smaller zone of thermal injury. The pulsed beam frequency and energy can be independently vary to achieve the ideal blend of cutting and coagulation of tissues. The CO2 laser in laser blepharoplasty also produces a small diameter beam approx 0.2mm which is also useful in pre-orbital region. When used properly, laser blepharoplasty could be performed quickly and thermal incision region reduced. After the healing from laser blepharoplasty, the scars become indistinguishable in appearance in very short period compare to steel wound blepharoplasty. After the satisfactory results from laser blepharoplasty, it become more popular in many clinical settings. In 1998, Er: YAG laser used to produce soft tissue incision. Unfortunately this laser was not able to produce enough hemostasis for soft tissue incision surgery.

Variations in Eyelid Ptosis Surgery

Eyelid Ptosis can also be repaired with several different procedures like muller’s muscle-conjunctival resection and Fasanella servat procedure. These procedures are less common and rarely used by surgeon. The operation is performed by the surgeon from back side of eyelid in conjunction with blepharoplasty from normal skin. These posterior procedures work well for eyelid Ptosis repair performed as an isolated approach. These less precise operations have advantage instead of direct levator tuck because once the eyelid is open it is hard to operate.
Advantage: Repair of eyelid Ptosis may give expected results of blepharoplasty surgery. If a patient suffering from both baggy eyelids and eyelid Ptosis (drooping eyelids) and only the baggy eyelids are operated then final result will not be appreciable. For expected results from blepharoplasty you have to go through with both the operations.
Disadvantage: Eyelid Ptosis surgery does not interfere with the blepharoplasty surgery, but recovery can take long time. The operation is performed on defective tissues and this is the cause for long time recovery. Re-operation rate of eyelid Ptosis surgery is higher than cosmetic blepharoplasty.

Repair of Droopy Eyelid-Eyelid Ptosis Surgery

Eyelid Ptosis is the drooping of the upper eyelid caused by muscle paralysis and weakness. Eyelid Ptosis surgery includes the elevation of drooping upper eyelid. This surgery is not related to the baggy eyelids. This surgery may be performed with blepharoplasty. The levator muscle starts in the back of eye and as it enters the eyelid turns into the aponeurosis (tendon). The thinning and tearing of the levator aponeurosis are the cause of adult-onset Ptosis. Very rare muscle diseases like myasthenia gravis cause the muscle paralysis which requires major operation.

During the eyelid Ptosis surgery, patient cooperation is required. So, local anesthesia is allowed with minimal sedation. The Ptosis surgery can be performed through upper blepharoplasty with a skin incision in the upper eyelid. During the upper blepharoplasty the levator aponeurosis is inspected by the blepharoplasty surgeon. After examination, the levator aponeurosis is tucked by the non-dissolving sutures. The blepharoplasty surgeon must be careful for smooth lift of droopy eyelid. The surgeon should have in mind to restore the normal curve of eyelid margin which becomes flattened with eyelid Ptosis. After the blepharoplasty your one upper eyelid should match with other upper eyelid with a smooth curve to the lid margin.

Instructions After Asian Blepharoplasty

# After several days of Asian blepharoplasty, some of sutures may untie or break but it is normal. There is no cause of harm until or unless your incision remains closed.

# Excess salt intake may increase swelling over eyelids, so limit the amount of salt in your food.

# Stitches from eyelids are removed in 5 to 6 days after Asian blepharoplasty surgery.

# When your surgeon remove your sutures, use antibiotic on that evening only. You should use warm compresses at least once a day after sutures are removed. Do this thing for 3 or 4 days.

# After Asian blepharoplasty you may not be able to open your eyelids fully for first three weeks. You can use artificial tear preparation during the day. It may feel comfortable with that.

# You can apply light concealer make-up on upper cheek area after 5 days. This may help you to camouflage any bruising. You can use regular eyelid cosmetics after 10 days. Application of Vitamin E oil can harm you, so do not apply it. In Asian blepharoplasty, special scar reducing creams or gels are of no use. Instead of this you can use eyelid moisturizing cream.

# After three day of Asian blepharoplasty, the improvement in your eyelids begin slowly. Most of swelling and bruising gone after 2 to 3 weeks. Although 20% of swelling remains for long period. You have to be more patient because your crease will improve day by day and may take 4 months to reach at final position.

# You can reuse your contact lens after 8- 10 days of Asian blepharoplasty.

# Initially your incision turns to red and becomes slightly bumpy and elevated. Its scar will continue to fade by the time.

# Do not expect success of Asian blepharoplasty with early recovery. There may be some imbalance between the two eyelids due their healing rate and variation in swelling. Final healing may be expected in 12 to 14 months and your eyelids will look alike.

Asian Blepharoplasty Procedure

Asian blepharoplasty is also known as double eyelid operation. The goal of Asian blepharoplasty surgery is the creation of upper eyelid crease and removal of excess skin. Sedation is kept normal during the surgery so that blepharoplasty surgeon can examine position of new crease through patient.

In Asian blepharoplasty surgery, incision is made across the upper eyelid. Skin of Asians is more reactive, for best incision scalpel is used instead of laser. A small strip of skin is excised using scissors just above the initial incision. Small strips of orbital septum and orbicularis muscle are excised. Height, shape and depth of new crease depend upon the amount of orbital fat removed. Skin and fat are removed from eyelids in a similar manner as in the normal upper blepharoplasty. Amount of tissues removed from eyelids are more conservative. Deep fixation is done for Asian blepharoplasty to create an attachment between the aponeurosis and the dermal layer of skin. Selective tissue removal and precise internal tissue rearrangement result in height and shape of the final crease. The Asian blepharoplasty is done to correct incomplete or multiple creases.

Asian Blepharoplasty/ Double Eyelid Surgery

Asian blepharoplasty is also known as double eyelid surgery and double blepharoplasty. Man and woman of Asian ethnicity seek blepharoplasty to feel better about their appearance. The enhancing of eyelid structure through Asian blepharoplasty, its better conforms aesthetics and feel happier and more confident. Nearly half of the Asians have upper eyelid crease, which makes a difference with occidental crease in its way. The Asian upper eyelid crease notably differs in height, shape and depth as compare to the occidental crease. Some Asian people are born with low/weak crease or without crease, later seek double blepharoplasty. Through Asian blepharoplasty some patients want only defined and stable platform for their upper eyelashes. Besides this some patients want removal of excess skin and fat rather than full Asian blepharoplasty.

The first Asian blepharoplasty description was published in 1800s in Japan and it is widely appreciated by Asian people. The Asian blepharoplasty has become popular in the last fifty years. Asian blepharoplasty is the most requested cosmetic surgery and reason behind this is the population on Asian people in both Asia and United States. Although Asian people undergo Asian Blepharoplasty at a younger age compare to occidentals.

Functional Blepharoplasty

Functional blepharoplasty is related to the vision of eyesight. The primary goal of functional blepharoplasty is to improve the vision of eyesight. At an older age, the eyelid skin becomes overhanging and narrows the field of eyesight vision. So, in functional blepharoplasty only the overhanging eyelid skin in removed. During functional blepharoplasty, surgeon will not remove fat pockets and deep fixation. Because this results in hollow space in eyelids and give ugly looks.

Results of functional blepharoplasty are not comparable with the full blepharoplasty surgery. Your insurance company will pay for functional blepharoplasty if it is really necessary and recommended by your blepharoplasty surgeon. Otherwise it is considered as a cosmetic surgery and no insurance company pay for that.

Advantages and Disadvantages of Upper Blepharoplasty

Advantage: Upper blepharoplasty is a proven and safe procedure to improve your appearance. Upper blepharoplasty may give a dramatic improvement depending upon the preferences of the patient. Eyes are the attractive and most focal part of the face. Such operation can be performed at a modest cost with quicker recovery. Most of the people preferred blepharoplasty than the full face lift. At a very modest cost, you can get 75-90% improvement in your looks. Upper blepharoplasty gives you expected results as compare to full face lift.
Disadvantage: If eyebrows are already droopy and weak, then you should require brow stabilization to prevent the further ancestry. For eyebrow stabilization browpexy is the only suitable procedure that can be performed with the same incision of upper blepharoplasty. Wrinkles at the lateral canthus also known as “Crow’s Feet” are minimally removed. Blepharoplasty alone is not the sufficient procedure to remove the droopiness of the eyelid due to defective aponeurosis or levator muscle “True Ptosis”. None of the patient have perfect eye anatomy. Every patient have some pre-existing anatomical limitations and why healing is not perfect. There may be some slight asymmetry after upper blepharoplasty.

Variations in Upper Blepharoplasty

1- “Tissue Sparing Upper Blepharoplasty” is used to avoid high creases and eyelid hollowing. In this surgery orbicularis muscles are not thinned and orbital spectrum are left integral. Very little orbital fat is removed if necessary.
2- In recent years, Laser Blepharoplasty has received much attention. During upper blepharoplasty a laser is used with traditional scalpel and scissors. Laser blepharoplasty reduces the operating time and has benefits for the surgeon. There are other techniques which used for incising and excising like electrocautery, heated scalpels, heat cautery and radiofrequency energy.
3- “Deep Fixation” in upper blepharoplasty may be used for some selected patients to deepen the eyelid creases. This will give a better support for drooping eyelashes and stable platform of skin to apply cosmetics.
4- To close the upper eyelids incision, “Tissue Adhesive” may be used resembling super-glue. In this process few sutures are placed. This technique is seldom used in upper blepharoplasty.
5- If tear gland dropped down inside orbital rim of the bone from its normal position. This may creates a bulge at the lateral side of upper eyelid that mimics eyelid fats. The tear gland may need resuspension, if severe.
6- In upper blepharoplasty, “Transconjunctival Incision” may be considered. If there is no excess skin and only nasal fat pocket bulging. Fat removal may be undertaken from the inside surface of upper eyelid without making any external scar.

Upper Blepharoplasty Procedure

For upper blepharoplasty technique, an outline is made across excess skin on the upper eyelids using a marking pen. This amount of excess skin is removed from the eyelids. Initial incision made about 7-10mm above the eyelashes along the normal eyelid creases. Incision made across entire eyelid and slightly outward and upward in the lateral canthus. The second incision depends upon the amount of skin on eyelids that need to be removed. It is made just above the first incision. Orbicularis muscles can be tiny strip trimmed in blepharoplasty surgery depending upon its thickness.
After incision, the orbital septum opened and showing the fat pockets overlying the eyelid opening muscles (levator aponeurosis). The fat pockets are inspected. First fat pocket is trimmed using the process of dissection, excision, cauterization and clamping. After that nasal fat pockets inspected and trimmed. For Nasal fat pockets slightly deeper dissection is done. In this same fashion, excess skin and fat removed from the upper eyelids. Usually fat removal is avoided in upper blepharoplasty surgery. It gives a hollow look on eyelids and can remain for a long time.
Now skin edges of eyelids are closed by sutures. The eyelids reform and reposition with deepen the eyelid creases.

Upper Blepharoplasty Surgery

Upper Blepharoplasty is also known as upper eyelid lift and cosmetic eyelid surgery. The upper blepharoplasty can be require when upper eyelids becomes baggy and eyelashes start dropping. Primary goal of surgery is to remove excess fat and skin from upper eyelids. By removing orbicularis muscle from upper eyelids you can restore a more youthful appearance. The secondary goal of upper blepharoplasty surgery is to uplift the dropping eyelashes due to excess fat. Dropping of eyelashes can weaken eyesight vision. This surgery includes restoration of eyelid crease and increase in eyesight vision.
There is no special anesthesia for upper blepharoplasty. It can be performed under local anesthesia. The anesthesia used may be oral sedation which can last for a few hours without any side effect.

Insurance Coverage for Blepharoplasty

Generally blepharoplasty is taken as a cosmetic eyelid surgery, which is done to improve your appearance. No insurance company going to pay for such reasons. Cosmetic surgery is excluded from insurance coverage. Some patients complain to their surgeons for excess baggy eyelids that interfere with their eyesight. Heavy baggy eyelids make them feel tired. In such cases, medical insurance company happy to pay for their blepharoplasty surgeon fees. Medical insurance company gives a vague provision of your insurance policy. They stated the significant changes in the eyesight vision or health of your eyes will be considered. These changes generally occur at an age of eighty. There is no advance advantage for this because if you are eighty years old and your baggy eyelids interfering with your eyesight, the blepharoplasty has more limitation to consider. Insurance company covers a minimum amount for the surgery which is functional blepharoplasty related to treatment of your eyesight vision. Functional blepharoplasty differ with the complete eyelid blepharoplasty.

Blepharoplasty Operating Room

Blepharoplasty is a very tedious and delicate operation. The operating room for blepharoplasty should be well equipped with all the required surgical instruments and monitoring systems. Generally a good surgeon maintains all these facility for blepharoplasty, because it gives a comfort level to you and also to your surgeon. surgical systems for monitoring blood pressure and pulse rate required throughtout whole blepharoplasty.The surgery can be performed under normal anesthesia and moderate oral sedation. Some blepharoplasty surgeon prefer deep intravenous sleep or inhalation anesthesia. This include high risk of drug side-effects and anesthesia recovery can take long time.

How Do I Select Blepharoplasty Surgeon?

The best criteria for selecting a blepharoplasty surgeon is the experience that surgeon has. Performing blepharoplasty surgery three or four times a month between tummy tucks, is not an experience. If a surgeon perfoms blepharoplasty seven to eight times a week this is called experience. The surgeon you are going to select for the surgery should be more concern about blepharoplasty and this can only be judge by his experience. There are some other factors also:
1- The Blepharoplasty surgeon should have sterling reputation for good results of blepharoplasty among other doctors.Because it takes practice and years of hard work to maintain and earn reputation.
2- There are many online message boards where you can find informations about blepharoplasty surgeon- whatever good or bad- but it should be taken as a big grain.
3- The office location of blpharoplasty surgeon should be in consideration. A surgeon in Beverly Hills definitly better than a surgeon in Fresno.If you are visiting a surgeon at an exclusive place then that blepharoplasty surgeon should be equally skilled.
4- Blepharoplasty surgeon should be "University Affiliated" like a clinical professor.

Post Blepharoplasty Guidelines

After the blepharoplasty surgery, bandages are used to lubricate and cover the scar. Oral medication is used to heal pain. Sometimes antibiotics are also prescribed to get rid of infection. Also care needs to be taken in cleaning eyes, during makeup, when watching television and contact lenses should not be used at all for some time. Alcohol intake should also be reduced for some reasons.

Blepharoplasty Cost

Estimating the exact Blepharoplasty cost for surgery is quite difficult as it may be performed to reduce fatty tissue, skin, and muscle, and the extent of the blepharoplasty surgery can vary. Also the blepharoplasty cost varies from person to person. The costs that come in picture are anesthesia fees, surgeon's fees and hospital fees.
The basic cost for upper or lower blepharoplasty is about $3,500 to $4,000. This cost includes blepharoplasty procedure and other facility fees. Blepharoplasty cost gets increase up to 50% more in case of all four upper and lower eyelids at the same time. Total surgery fees for regular Blepharoplasty procedure can range from $2,000 to $5,000 or more. Blepharoplasty cost can increase, in case of some addition in surgery like brow lift, chemical peel and canthopexy.

Word of Caution

Complications can arise during blepharoplasty procedure due to some factors which are preexisting dry eyes, loosness of the lower lid margin and loosness of the lower lid margin. Temporary complications may include temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after stitches are taken out.
A few medical conditions make blepharoplasty procedure more risky. These conditions 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 considered a risky situation.

Process of Blepharoplasty

Blepharoplasty procedure involves external incisions, under local anesthesia, after the surgeon has marked the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds, carried into the eyelid skin, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid. Sometimes swelling and bruising takes place but it takes not more than one to two weeks to get rid of it. Most people feel ready to go out in public (and back to work) in a week to 10 days. The final results of Blepharoplasty procedure are visible in few months time. The duration of the procedure is one to three hours but it entirely depends upon the scope of the procedure.

Scope of Blepharoplasty

Blepharoplasty procedure carried out for Lower eyelid is almost always carried out for cosmetic reasons. This can correct drooping upper lids and puffy bags below ones eyes. These features are ones that make people look older and more tired than they actually are and may even interfere with vision. However, Blepharoplasty procedure won't remove crow's feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. Also evidence of your ethnic or racial heritage cannot be erased by this procedure.

Purpose of Blepharoplasty

Blepharoplasty surgery for many, is the procedure for looking younger and more alert. For others, it is a welcome option for restoring vision that has become obscured.
In simpler words, it is a functional or cosmetic surgical procedure aiming to reshape the upper or lower eyelid by the removal and/or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons. Sometimes, in case excessive skin in there, the skin may hang over the eyelashes and cause of loss of peripheral vision causing difficulty in activities such as driving or reading.

Curing After Blepharoplasty

Most of the patients undergoing blepharoplasty surgery have mild aching or burning that is normally controlled with Tylenol and cold compresses.

• After blepharoplasty surgery swelling on eyes remain for next ten days. A small puffiness may persist for few months.
• Most of the patients feel moderate bruising that begins to fade with in few days after blepharoplasty and is gone by two weeks.
• Regular day-to-day activities of patient may be resumed within two days of blepharoplasty surgery. Arduous activities should be avoided for about two weeks.
• Most patients prefer rest for about ten days after blepharoplasty surgery. They start their normal work with in two weeks.

What should be suitable age for Blepharoplasty?

Most of the people undergo blepharoplasty just above the age of 35 years. The eyelid skin is the much thinner skin as compare to rest of the face. After the age of 35, eyelid skin starts loosing its elasticity and become wrinkled. Eyelids appear saggy and scars of depression visible over there. Age is not only the factor for saggy eyelids, some more reasons are there like swelling under lower eyelids Skin and excess fat packets in eye socket. In this situation a person can go for blepharoplasty.
Blepharoplasty surgery is less modest in scope, cost, risk and recovery time as compare to other sugery like face-lifting, neck lifting or forehead lifting. People may elect blepharoplasty before going for full facial treatment. Most of patients undergo blepharoplasty once in lifetime. Because rest of your face doesn't need any surgery for ten to twenty years after blepharoplasty. you have chance to enjoy the improvement by blepharoplasty during your relative youth and vigor.

Reasons Behind Baggy Eyelids

• In your forties or late thirties, elasticity of your extremely thin skin of eyelids start loosing and getting stretch. This causes wrinkles in the upper eyelids and become daped by overhang. Epidermis becomes in relative excess on the eyelids as the collagen in the dermis starts to lost and crow's feet and wrinkles appear on the eyelids. The underlying orbital fat unveils as the skin of eyelids thinning.
Blepharoplasty will be suitable for those who has droopy and baggy eyelids.
• Facial fat begins to imbued, making to volume loss. The resulting reduction not only emphasizes the appearance of baggy skin, but may be its primary cause.
• The orbicularis muscle stretches, thins out and becomes wrinkled, leading to sagging of the overlying skin of eyelids.
• The eyelid skin starts to thin and get stretched by the influence of the wear-and-tear of blinking, gravitational forces, excessive smoking and sun exposure.
• Deeper fat pockets in the eyelid socket become visible. these packets appear forward due to a weakening of an eyelid restraining layer known as the "orbital septum". Blepharoplasty can make your facial appearance better and enrich your self-confidence.
• The orbital fat packets inside the eyelid socket may absorb rather than bulge out and gives a hollowed appearance in both upper and lower eyelids.
• In later forties, the frontals muscle may baggy and lowering the brow, and the excess eyelid skin becomes more noticeable.
• The tissues of cheek and midface starts loosing their tone and lowers, making a small area of depression under the lower eyelids, emphasizing lower eyelid imperfections, and allowing the corners of the orbital rim to show through the skin.
• In some patients, a triangular fluid filed under the bone of lower corner of lower eyelids. this swelling becomes purplish and appears more on excess salt intake.
Blepharoplasty is a procedure that can make your eyes and aging face fresh.

Facts About Blepharoplasty

Blepharoplasty is very popular now these days. Around 240000 people in united states got eyelid surgery. After cosmetic surgeries like facial plastic surgery, face lift, surpassing rhinoplasty, forehead lift and facial implants, Blepharoplasty has become the most sought. Eyes are the most expressive part of the face. If the eyelids are sagging or bulging, the face gives tired look and lack of strenght despite good health and enough rest. Blepharoplasty (Eyelid surgery) is a procedure that can make your eyes and aging face fresh. Blepharoplasty makes eyes look bright and alert that reduce the effect sagging jaw line or neck.Thus most of the people considering blepharoplasty instead of a full face lift.

Blepharoplasty gives a long lasting improvement in looks with a low cost, less discomfort, low risk, less pain, and less inconvenience.

About The Blepharoplasty

Surgeon usually takes one to three hours for blepharoplasty. It depends upon the extent of the eyelid surgery. If you want surgery over all four eyelids, then your surgeon will first work on upper eyelids and after that the lower ones.you're having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.
In the procedure of blepharoplasty, the surgeon will make incisions in the upper eyelid's creases, just below the lashes of the lower eyelids and on the natural lines of your eyes. This incisions may reached out into the crow's feet or your laugh lines at the outer corners of your eyes. Your surgeon will separate your skin from muscle and underlying fatty tissue. Surgeon removes excess fat and trims swagging skin and muscle. After this surgeon will close incisions with very fine sutures.If you have fat under your lower eyelid and don't want to remove any skin, then transconjunctival blepharoplasty may be performed. Surgeon makes incision inside your lower eyelid with no visible scar on eye. This procedure usually performed on younger patients.

Nature of Anesthesia

Eyelid surgery is usually done under normal anesthesia--which makes insensitive area around your eyes with oral or endovenous sedatives. During the blepharoplasty, you will be insensitive to the pain and relaxed. You will be sleepless under normal anesthesia during blepharoplasty so you can feel little discomfort.Some surgeons using general anesthesia. Under general anesthesia you will be asleep during whole blepharoplasty.

What should be your plans for Blepharoplasty Surgery?

It is important to consult with your surgeon as an initial step. If you have any allergies just tell your surgeon and also your comlete medical history related to your medication. If you are using any drug, vitamins or smoking then be sure to inform your surgeon. Your surgeon will test your tear production and your vision. Discuss with your surgeon carefully the benefits and your expectations through Blepharoplasty. If you are using glasses or contact lenses, bring them along.

You should know about the techniques and anesthesia for Blepharoplasty. Ask to your surgeon, he will explain the type of facility where the surgery will be performed, and the risks and blepharoplasty cost involved. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.

Who Needs Blepharoplasty (eyelid surgery)?

The person who needs Blepharoplasty should be physically healthy,realistic in their expectations and psychologically stable. Blepharoplasty will be suitable for those who has droopy and baggy eyelids. Blepharoplasty most for 35 years or older but you may consider it at a younger age too.

Eyelid surgery (Blepharoplasty) can make your facial appearance better and enrich your self-confidence, But one can not expect a drastic change through blepharoplasty or change in people's behavior toward you. So, before you go to blepharoplasty surgery, examine your expectations carefully and consult them with your surgeon.

Before you go for eyelid surgery, consult with your ophthalmologist. Because blepharoplasty becomes a bit risky with thyroid problems which includes dry eye or lack of sufficient tears, hypothyroidism and Graves' disease, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes.

What is Blepharoplasty Surgery?

Eyelid surgery or also called blepharoplasty is a surgery to remove fat from the upper and lower eyelids. Blepharoplasty surgery is a solution for drooping upper eyelids, puffy bags just below your eyes and the features that make you feel older and may even interfere with your eyesight. Blepharoplasty can be done separately, or with other facial surgery such as a facelift or browlift.

Blepharoplasty Sitemap:

 Blepharoplasty Homepage
 Facts About Blepharoplasty
 About The Blepharoplasty
 Nature of Anesthesia
 What should be your plans for Blepharoplasty Surgery?
 Who Needs Blepharoplasty (eyelid surgery)?
 What is Blepharoplasty Surgery?
 Upper Blepharoplasty Procedure
 Upper Blepharoplasty Surgery
 Insurance Coverage for Blepharoplasty
 Blepharoplasty Operating Room
 How Do I Select Blepharoplasty Surgeon?
 Post Blepharoplasty Guidelines
 Blepharoplasty Cost
 Word of Caution
 Process of Blepharoplasty
 Scope of Blepharoplasty
 Purpose of Blepharoplasty
 Curing After Blepharoplasty
 What should be suitable age for Blepharoplasty?
 Reasons Behind Baggy Eyelids
 How to judge a Blepharoplasty Surgeon?
 Benefits of Laser Blepharoplasty
 Laser Blepharoplasty
 Variations in Eyelid Ptosis Surgery
 Repair of Droopy Eyelid-Eyelid Ptosis Surgery
 Instructions After Asian Blepharoplasty
 Asian Blepharoplasty Procedure
 Asian Blepharoplasty/ Double Eyelid Surgery
 Functional Blepharoplasty
 Advantages and Disadvantages of Upper Blepharoplasty
 Variations in Upper Blepharoplasty
 Blepharoplasty Removes Dark Circles Under Eyes
 Signs and Symptoms for Blepharoplasty
 Transconjunctival Lower Blepharoplasty
 Lower Blepharoplasty Surgery
 Benefits of Skin Resurfacing
 Skin Resurfacing After Blepharoplasty
 New York City Blepharoplasty
 Blepharoplasty for Repositioning of Eyelid Fat
 December Archive
 November Archive
 October Archive
 September Archive
 August Archive
 Skin Approach Lower Blepharoplasty
 Variations and Advantages of Skin Approach Lower Blepharoplasty
 Eyelid and Eyebrow Tissue Fillers in Blepharoplasty
 Transfer of Fat by Injection in Depression Area
 Overview of Blepharoplasty and Blepharoplasty Surgeon
 Tips for Cosmetics Use After Blepharoplasty
 Information for Blepharoplasty in New York City
 Cosmetic Blepharoplasty
 Cost of Cosmetic Blepharoplasty Surgery
 Blepharoplasty for Men
 Blepharoplasty Differs from Face and Body Lifts
 Information on Beverly Hills Blepharoplasty
 List of Blepharoplasty Surgeons in Beverly Hills
 The Natural Blepharoplasty
 Pennsylvania Blepharoplasty
 Trust Your Blepharoplasty Surgeon
Possible Risks and Complications in Blepharoplasty
 Treatment for Cosmetic Complications of Upper Blepharoplasty
 Treatment for Functional Complications of Upper Blepharoplasty
 Lower Blepharoplasty Complications Treatment
 Lower Blepharoplasty Functional Complications Treatment
 Guidance before Blepharoplasty Surgery
 Good Morning Instructions of Blepharoplasty
 Blepharoplasty via Medical Tourism in New York City
 After Blepharoplasty Avoid too Much Exposure to Direct Sunlight
 Eye Creams and Gels for Blepharoplasty
 Reason behind Unsatisfied Patients
 Procedure to get New York City Blepharoplasty
 Celebrities turn to Blepharoplasty for baggy Eyelids
 Blepharoplasty Surgery Process Information
 Two Easy way to Help Swelling Disappear after Blepharoplasty
 Blepharoplasty for Permanent Eyeliner and Brows
 Upper Blepharoplasty- Eyelid Surgery Without Crease Formation
 Asian Double Eyelid Surgery- Blepharoplasty also popular in Men
 Advanced Upper Blepharoplasty with Myoplasty
 Asian Blepharoplasty (Double Eyelid Surgery) is different from Occidental Blepharoplasty
 Information on Blepharoplasty in Los Angeles
 Blepharoplasty for Inborn Crease Imbalance
 Selective Tissue Sparing Blepharoplasty
 Transconjunctival Blepharoplasty to Avoid Hound Dog Eyes
 Transconjunctival Lower Blepharoplasty has no chance of Lower Eyelid Retraction
 Top Ten Instructions after Blepharoplasty (Eyelid Surgery)
 Upper Blepharoplasty-No Ectropion Risk
 Pinch and Peel Lower Blepharoplasty
 Blepharoplasty–A good Facial Rejuvenation for Patients
 Blepharoplasty in Conjunction with Coleman Fat Injections
 Brow lifting for Men
 Get Rid of the Dark Circles Under the Eyes