content frame eyelid surgery

This is the Eyelid Surgery page. The technical name is Upper and Lower Lid Blepharoplasty.

The General Purpose of This Operation The basic goal of eyelid surgery is to improve the appearance of the lids to prevent people from having a "tired" look. The upper lid operation improves the appearance by removing the lax, excess skin that hangs down toward the eye lashes and obscures the eyelid itself and the natural eyelid crease. The upper lid operation also removes the fat pads that can create a bulge at the lid and nose junction. A crisp upper lid makes you eyes appear wider and less tired and also allows eyelid make up to be visible and more attractive. It must be remembered that the anatomy of the upper eyelids must be evaluated along with the position of the eyebrows and therefore sometimes a forehead lift will need to be discussed. More information on forehead lifts is available by selecting the Forehead Lift button above.

The lower lid operation improves the appearance by removing and/or re-positioning the bulging fat in the lower lids that makes the lids look puffy or swollen. In most patients I do a specialized technique which does not remove all of the fat, but re-positions the fat in a special way to give a more youthful appearance to the anatomy of the lower lids. A small amount of skin is also removed to tighten the lids. In some patients the outer edge of the lid will also be suspended to tighten the lid and improve the appearance. Because of some of these specialized techniques I do not do the transconjunctival approach to lower lid blepharoplasty.

Remember that eyelid surgery does not improve the fine wrinkles in the lids and the crow's feet area. Fine wrinkles need to be addressed separately, usually with laser skin re-surfacing. More information on laser surgery is available by going back to the Welcome Page and selecting the Laser Surgery button or click here to go directly to the Laser Surgery page.

The plan for the upper lid operation starts with marking the excess upper eyelid skin to be removed. The 2 separate fat pads will also be removed.			The plan for the lower lid operation starts with marking an incision below eye lashes. The 3 fat pads are exposed. These fat pads will either be removed or re-positioned.
Consider the upper lid operation mostly a skin operation.	The edges of the skin are then sutured together.	A small sliver of skin will be removed prior to closure.	Consider the lower lid operation mostly a fat operation.


Before Upper Lid Surgery	After Upper Lid Surgery


Before Upper Lid Surgery	After Upper Lid Surgery

Insurance Coverage Lower lid surgery is never covered by insurance because it is strictly to improve the appearance of the lids. Most often upper lid surgery is also considered cosmetic surgery and is not covered by insurance.

Upper eyelid surgery can be submitted for insurance coverage if the degree of the deformity meets certain criteria. First, the patient must have legitimate claims of obstructed vision from the extra skin. It usual has more credence if the patient is actively employed and the obstructed vision affects their work. Second, close up photographs of the lids must show that the skin hangs over the front edges of the eyelashes. Third, visual field examination by an ophthalmologist or optometrist must show significant obstruction of the visual field that then improves to a large degree when the excess skin is held out of the way.

Insurance Covered Blepharoplasty	Insurance Covered Blepharoplasty

Before Insurance Covered Upper Lid Surgery Patient's Skin Obstructed Vision and Affected Him At Work	After Insurance Covered Upper Lid Surgery

The Operation The upper lid operation is done as an outpatient procedure or day-surgery at Decatur General Hospital using IV sedation anesthesia and local anesthesia. It is done in the main operating rooms at Decatur General Hospital and takes just over 1 hour to perform. We do the operation in the morning and you will get discharged to home late in the afternoon. You will go home with supplies to do cool compresses to the eyes that evening. I discharge you from the hospital with a prescription for narcotic pain medication, an antibiotic and a nausea medication.

When lower eyelids are done alone or in combination with the upper eyelids the operation is done as an outpatient procedure or day-surgery at Decatur General Hospital using general anesthesia. It is done in the main operating rooms at Decatur General Hospital. It takes just over 1 hour to perform a lower lid operation alone and just under 3 hours to operate on the upper lids and the lower lids at the same time. We do the operation in the morning and you will get discharged to home late in the afternoon. You will go home with supplies to do cool compresses to the eyes that evening. I discharge you from the hospital with a prescription for narcotic pain medication, an antibiotic and a nausea medication.

It is crucial that for 10 days prior to your surgery you do not take any aspirin, arthritis or other muscle ache pain medicines. These medicines will make you bruise more and can lead to other complications. The ONLY pain or headache medicine that is safe to take is Tylenol (acetaminophen) because this does not affect blood clotting and bleeding.

Postoperative Discomfort All patients are unique and the response to post-operative discomfort is variable. Most patients state that eyelid surgery is not that uncomfortable. Patients say that the eyes feel tight or heavy. Some patients take the narcotic medicine only for a day or two and then switch to Tylenol for pain. As I said, patients are all unique and their pain tolerance is very different. When the upper lids are done alone almost all patients feel normal by 2 weeks and when all four lids are operated on they feel normal by 3 to 4 weeks.

I will remove the skin sutures in the office 5 days after the surgery. Removing the sutures pinches and sometimes can be uncomfortable.

Time Off From Work For a desk job that does not require any heavy lifting you should expect to be away from work for 1 week for either type of lid surgery. For a job that requires physical exertion or heavy lifting you should expect to be away from work for 2 to 3 weeks depending on your exact job description.

By one week from the surgery you will have some minor residual swelling but no bruising. You will probably not feel comfortable in contact lenses for 2 to 3 weeks after the surgery. You may have some light sensitivity and intolerance to windy conditions outdoors. The recovery for doing surgery on all four lids at the same time is always a little longer then the recovery for just operating on two lids.

Postoperative Visits To The Office You will need to come to the office the day after your surgery for a quick check. Arrange for someone to drive you to this appointment because you will be on narcotic medications and your eyelids will be swollen and your vision maybe a little blurry. At this first postoperative check I will just do a quick check of your lids. You can take a full shower in the evening after this check. Soapy water will not hurt your incisions, but soapy water may get in your eyes because they may not close fully unless you remember to squeeze them closed.

Your next appointment will be in 4 days so that I remove your sutures 5 days from your surgery. The next appointment will be in another 5 to 7 days and at that time we may begin some lid massage exercises and we will begin discussing issues like returning to work.

Your next appointments will be weekly for a few weeks until I feel sure your lids are doing well. Then I will see you monthly for a couple of months. I will see you at approximately 6 months and 12 months after your surgery and do a final assessment of your result, assess the quality of your scars and get your final opinion on the surgery.

Resuming Normal Activities As discussed in the above sections, you can shower daily beginning 24 hours after your surgery. You cannot do any strenuous work or heavy lifting for at least 2 weeks after the surgery.

Photographs May Not Be Reproduced, Written Text and Descriptions are Copyrighted and May Not Be Reproduced


Before Upper and Lower Lid Surgery	After Upper and Lower Lid Surgery