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Blepharoplasty FAQ

Q: How precise can browlifts be? Can it only be 2-4mm if that is what you desire?

A: The range you quote, of about 2 to 4 mm, is about as far as you would want to go for a browlift. Any more, you’d get the “surprised celebrity” look we are all familiar with from the internet. At my center, we even do 1-mm brow lifts to give you a naturally alert and refreshed look. Brow lifts are almost always done under local anesthesia, which means that you can be awake and help direct your final outcome by giving feedback on the look we are going for. I hope this helps.

Q: Is muscle around eyes excised during blepharoplasty?

A: I spare the eye muscles rather than excise them during blepharoplasty, but this depends on patient anatomy and need. Sometimes the muscles have grown so lax that they drag the eyelid downward. Minimal excision and/or tightening may help. It’s a minimally invasive surgery and recovery time tends to be quick, with return to normal activities within a few days. I hope this helps.

Q: What is an eye tuck? 

A: An eye tuck or blepharoplasty will work to tighten the eye area, but will not affect the rest of your face. In upper blepharoplasty, the excess skin that causes drooping eyelids is removed. The muscle may be excised or tightened. You may require some fat removal, though from your photos it looks like you would not need it. The incision is made in the eyelid crease to hide the scar. The lower lids can also be treated, with excess skin being removed, fat repositioned to fill out hollows, and the muscles tightened.The end result is smoother skin around the eyes and a rested, rejuvenated, natural appearance. I hope this helps.

Q: My eyes have been uneven since birth, not sure if I need only one, or both eyelids surgery? 

A: From the photo it looks like you probably have left-eye ptosis and perhaps some in your right eye as well. This can be corrected by a ptosis repair. Be sure to find someone who has long years of experience treating eyelid ptosis successfully. Most likely the muscles underneath the lids will need tightening and excess skin will be removed. I hope this helps.

 

Q: Is 26 too young for upper and lower blepharoplasty? My right upper eyelid is almost completely covered and when I smile, I form large bags under my eyes. I’ve tried many eye creams, eye pads, serums, etc. No matter what makeup or concealer I use, I always look tired and older than what I am. I’ve consulted a plastic surgeon and he said that I should get it done it if bothers me. However, I am worried that I’m too young and that I’d have to do this again. Do you think I should get this done and will it really fix my problems and for how long?

A: You have significant drooping in your upper eyelids, which makes you an excellent candidate for blepharoplasty, regardless of your young age. The hooded lids are making you look significantly older than you are. The under-eye area could also be improved by lower blepharoplasty, however, you may opt for fillers to improve this area. As far as needing surgery again, your eyes will continue to age whether you have surgery now or not. You may choose at some point in the future to have another rejuvenating procedure. However, your eyes will look better in 10 years if you get the surgery now, rather than waiting til then. I hope this helps.

Q: When I smile my eyelids look swollen & I have eye bags under eyes. How do I treat this?

A: While I would need to see you in person to evaluate your situation, bags under the eyes are generally caused by pockets of fat. These can be moved into a better location during lower blepharoplasty. If there is excess skin present, that can be removed during the same procedure. The heaviness in your upper lids could be caused by a number of factors, but might be resolved by upper blepharoplasty, which would open the eyes.  I hope this helps.

Q: My left eyelid has been droopy since I was born but as I get older it is getting worse. I have phoned cosmetic surgeries in my area but keep getting turned down for surgery as they only accept people 30+ years old for blepharoplasty. Would it be possible for me to get surgery at all?

A: Your drooping eyelid, otherwise known as ptosis, is caused by a weakened Müeller muscle in your upper lid. It is not uncommon for this condition to worsen with age, as you have noticed. I would treat your ptosis by lifting the lid at the point where it crosses the iris. You are not too young for such a procedure. I hope you find someone who will help you.

Q: How Much Does Eyelid Surgery Cost? How much does a blepharoplasty cost?  Are the prices different for blepharoplasty on the upper eyelids vs. the lower eyelids?

A: Even more than other plastic surgery procedures, blepharoplasty must be handled with care, as the eyes are an essential facial feature.   Rather than worrying about cost, first find an expert plastic surgeon who will evaluate your anatomy and devise a treatment plan that works best for you. In North Carolina, blepharoplasty can run between $2,000 and $7,000, depending on the patient’s needs.  Typically, a lower blepharoplasty will cost more than an upper blepharoplasty.  

Q: How Long Until Plastic Surgery Stitches Dissolve? I had upper eyelid surgery 8 days ago, and the doctor used dissolvable stitches. How long does it normally take for stitches to dissolve? Is there anything I can do to make them dissolve faster?

A: In my practice, I do not use dissolvable stitches. I remove stitches for eyelid surgery after one week. If you are concerned that your stitches are not dissolving, you should call your surgeon. I hope this helps.

Q: Can Asymmetric Eyes or Eyebrows Be Fixed? I am interested in fixing my asymmetrical eyes. One of my brows sits noticeably lower and that same eye looks much smaller than the other eye/eyebrow. Is this a problem that can be fixed to create a more balanced, symmetrical set of eyes for myself? I am a young woman in her twenties, not an older person so I am not sure what type of surgery would be best, but I plan on consulting soon.

Answer: The short answer is that a brow lift can make your eyebrows look more symmetrical and will raise the skin on the “smaller” eye, bringing it more into balance with your other eye. However, it may be that the ocular bone is actually smaller on that side of your face, so that the eye will always appear smaller than the other one.


Q: I’m 24 years old and have indented lines under my eyes and puffiness in the outer corner. Is a blepharoplasty or fillers a better option?

A: It’s hard to say without an in-person exam which treatment option is best for you. It appears that you have some hollowness under the eyes, which the use of fillers can often treat effectively. Lower blepharoplasty is a better option if you have prominent bags under your eyes. Please visit a board-certified facial plastic surgeon for a consultation to see which eye enhancement procedure will benefit you most. I hope this helps.

Q: Can an upper blepharoplasty be reversed? I had one done two weeks ago and I do not like the results. Can I get it reversed now instead of waiting for it to heal?

A: Surgical procedures cannot be “reversed.” However, in many cases revision surgery can be done to fix results that the patient is unhappy with. However, I suggest to wait until your eyes are fully healed before considering revision surgery. Your eyelids are still undergoing changes and it is possible that you will be happier with your results once the incisions have fully healed and the swelling has resolved. Two weeks post-surgery is too early to see final results from a blepharoplasty. I hope this helps.

Q: I’m 18 and have very low eyebrows when I relax my brow muscles, giving me a very unattractive and angry look. Because of this I constantly have my eyebrows slightly raised to make my eyes look normal. This causes me to have 2 horizontal wrinkles on my forehead which are very noticeable in certain lighting. I’ve noticed this problem since I was 13 and would like to get rid of it. I’m only 18 but what procedure would you recommend I get to fix this? Thank you.

A:  A brow lift or endoscopic forehead lift might be good options to consider to help raise your eyebrows. Both procedures are great for opening up the eye region and are done by making incisions to the hairline which can be easily hidden. Although you are relatively young, people from all ages undergo brow or forehead lifts. Since this seems to have been a concern of your for years now, I suggest consulting with a board-certified facial plastic surgeon with a good track record of successful brow and forehead lift procedures to find out which approach will work best for you. I hope this helps.

Q: The skin on my upper eyelids has started sagging down, making me look older than I am. Under eyebrow filler helped a little bit, but would an upper blepharoplasty be better? Also, I have wrinkles under my eyes that only show up when smiling, would a lower blepharoplasty take care of that?

A: While it is impossible to say if you are a good candidate based on your photo alone, in general, if a significant amount of excess skin is present on the upper eyelids, an upper blepharoplasty would be a good option to consider. Upper blepharoplasties can open up the eye area tremendously and create a brighter, more youthful look. As for wrinkles underneath the eyes, a lower blepharoplasty will not do much for those. Laser resurfacing or a chemical peel are the best treatments for under eye fine wrinkles. You should visit a board-certified plastic surgeon for a comprehensive evaluation to come up with a custom treatment plan to address your specific concerns. I hope this helps.

Q: My incisions are messy and there are bumps of skin 6 days post laser upper blepharoplasty. Any suggestions?

A: From your photos, it appears as though you are healing normally without cause for concern. Incisions from blepharoplasty surgery are never pretty the first week or so, but after that they begin to flatten out and start to look much better. If you are concerned, please visit your surgeon for a follow-up visit. I hope this helps.

Q: When can I use my contacts after eyelid surgery?

A: Generally, patients should wait about two weeks before resuming contact use following eyelid surgery. I would advise you to check with your surgeon and follow his advice, however. I hope this helps.

 

Q: I have wrinkles and hollowness under my eyes that I want fixed. I’m 21 years old but my eyes age me a lot. Will a lower blepharoplasty help?

A: From your photos, it does not seems as though a blepharoplasty would be the answer. You do have significant hollows under your eyes, which is caused by a lack of volume. In someone your age, the best way to treat this concern is most likely with hyaluronic acid dermal fillers such as Restylane. These fillers add volume and can produce wonderful results under the eyes. See a board-certified facial plastic surgeon for a consultation. I hope this helps.

Q: I want my eyebrows to be significantly higher. Can this be achieved non-surgically or do I need a brow lift?

A: For a significant lift, surgery is the only option. However, for many people, especially those on the younger side, a small lift is all that’s needed to brighten the eye area. This small lift can be achieved through Botox, and will last approximately 3 to 4 months. Please see a board-certified facial plastic surgeon who can walk you through your options and help you to decide the best course of action. I hope this helps.

Q: I can’t afford to miss more than two weeks of work following eyelid surgery. What’s the standard blepharoplasty recovery time?

A: Most of my patients are able to return to work two weeks after a blepharoplasty. You will most likely still have some swelling at that point, but most of the bruising should have resolved and many patients feel comfortable returning to their everyday work and social activities at the two-week mark. 70% of swelling should resolve after 3 weeks, while final results can usually be seen at 3 to 6 months.

Q: What are the requirements to have insurance cover a blepharoplasty? 

A: Usually, a blepharoplasty is not covered by insurance; however, there are certain cases where it can be. If your extra skin is so loose and baggy that it significantly obscures your vision, you may be eligible for insurance to cover your procedure. You’ll have to visit an ophthalmologist to have a test done to see if you might qualify.

Q: How long is recovery after a brow lift? How much pain is there afterwards and how safe is it?

A: At my practice, recovery from a brow lift usually takes around 1 to 2 weeks. The majority of swelling and bruising takes place within the first 10 days, but patients can feel free to return to work after the bandages have been removed, which generally happens 1 to 3 days following surgery. There is less pain associated with brow lift recovery than people think, and prescription medications will be prescribed to help you through the first few days. After that, over the counter medications should be enough to manage any pain or discomfort. Brow lifts are very safe as long as they are performed by a skilled, board-certified facial plastic surgeon.

Q: My eyes are still puffy and swollen 25 days after an upper blepharoplasty, and I’m having trouble opening my eyes. The scars also hurt and feel tight. Is this temporary? What can be done?

A: At 25 days after upper blepharoplasty surgery, in most patients the swelling has resolved enough that they do not have trouble opening their eyes. Every patient heals differently, but I would advise paying your surgeon a follow-up visit to make sure that you don’t have some kind of infection or complication slowing your recovery. I hope this helps.

Q: I had a blepharoplasty 4 days ago, and I need to go back to work next week. I’ve read that I’m not supposed to wear eye makeup for 2-3 weeks, but everything is healing well and my incisions are sealed by next week, is there any reason not to wear makeup sooner?

A: I would consult your surgeon before wearing any makeup so soon after your blepharoplasty. While in theory it should be fine to wear makeup a week after surgery as long as you are extremely careful and gentle with both application and removal (makeup and makeup removers can both irritate newly-healed skin and cause complications if not handled with the utmost care), your surgeon knows your individual case and can advise you best. I hope this helps.

 

Q: I’m scheduled to have a lower blepharoplasty and fat transfer to my cheeks, but I’m in the process of losing weight. I lost about 30 lbs already, still have about 25 to go. If I lose the 25 lbs, will I lose the fat that was grafted to my cheeks?

A: Congratulations on your weight loss so far. If you lose more weight, yes, the fat in your cheeks will likely reduce as well. If you are concerned about it, it may be better for you to wait until you have lost the weight before having your surgery. I hope this helps.

Q: Should I get fillers first or just go straight to a lower blepharoplasty to treat my genetic eye bags?

A: Fillers can often provide a great improvement, but they are temporary and ultimately, surgery provides the best long-term option. If you are considering surgery, my advice would be to listen to the pros and cons between surgery and fillers.  After that conversation, you can decide what is going to be the best for you.   Be sure to find an experienced, skilled, board-certified facial plastic surgeon for your consultation. I hope this helps.

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