Eyelid Surgery (Blepharoplasty)
Our eyes convey our emotional and physical well being, and are said to be the mirror of our soul. Over time the accumulation of loose skin and puffiness can result in a tired, aged appearance. With cosmetic eyelift surgery (blepharoplasty) and other non-surgical procedures, skin is tightened, bags are removed, and hollows are softened to achieve a more youthful, rested, and vital look. Our approach is individualized for each patient depending upon their anatomy as well as the effects of the aging process. Our preference is for conservative, less invasive techniques.
Why you should choose Dr. O’Connell for your eyelid surgery
- Dr O’Connell is a board certified plastic surgeon with over 3 decades of surgical experience, who can evaluate your eyelids in the context of your overall facial aesthetics to maintain facial harmony
- In most case, Dr. O’Connell performs blepharoplasty as an outpatient procedure without need for general anesthesia.
- Dr. O’Connell was chosen to demonstrate his technique of upper blepharoplasty using local anesthesia on the CBS Early Show in 2005.
- Dr. O’Connell believes that blepharoplasty should be volumizing and he eschews the hollow periorbital appearance that can sometimes follow blepharoplasty.
- Because he trained at Cornell Medical Center, Dr. O’Connell is highly skilled in “single stitch” upper blepharoplasty.
- When visual obstruction is present, we will work with your insurance carrier to help you obtain coverage for your upper blepharoplasty.
- Dr. O’Connell was an originator of the “no touch blepharoplasty” technique.
- At The Aesthetic Center we have the latest non-surgical options for eyelid rejuvenation including full field and fractionated lasers, chemical peels, ThermiSmooth® radiofrequency and the latest injectable fillers.
What is eyelid surgery?
In short, blepharoplasty is a surgical procedure to improve the appearance of the upper and lower eyelids or both. Blepharoplasty is commonly used to treat skin excess, or hooding, of the upper eyelids and “bags,” or fat herniation of the lower eyelids. Sometimes there is fat herniation of the upper eyelids that accompanies the hooding and often skin excess and wrinkling accompanies the bags of the lower eyelids. Because of the many possible variations in eyelid anatomy it’s important to individualize blepharoplasty for each and every patient. Dr. O’Connell will carefully review your eyelid anatomy and evaluate how the aging process has affected their appearance. The various surgical and non-surgical options along with their risks and potential benefits will be reviewed. In most cases, Dr. O’Connell will prefer the most predictable, least invasive and safest technique with the most rapid recovery process. Currently there many effective minimally or non-invasive options for eyelid rejuvenation. The Aesthetic Center is at the forefront of these advanced techniques that include alternative surgical approaches such as transconjunctival fat removal and pinch excisions as well as smoothing the skin with use of laser resurfacing and radiofrequency techniques.
Dr. O’Connell is one of the originators of the technique known as “no-touch” blepharoplasty. In 2000 and 2002 he published two articles about this technique and he continues to perform no-touch blepharoplasty today. Our practice currently utilizes the Sciton Joule laser for no-touch blepharoplasty along with pinch excision and fat removal without an external incision. Blepharoplasty is commonly combined with other procedures such as a facelift or brow lift.
Eyelid surgery candidates
Candidates for blepharoplasty should be in good general health and also have good ocular health. Because the eyelids are part of the face, Dr. O’Connell will carefully evaluate your eyelid anatomy in the context of overall facial aesthetics to help you determine which procedures might provide the best aesthetic results for you.
Blepharoplasty may be an option if you have:
- Droopy or “hooded” upper eyelids. This can interfere with your field of vision and make it difficult to open your eyes completely. Removing excess tissue from the upper eyelids can improve vision and make your eyes appear more youthful, open and alert.
- A tired appearance of the lower eyelids with “bags” under the eyes.
- A wrinkled or droopy appearance of the lower eyelids.
Preparing for eyelid surgery
As part of the preoperative process you may be asked to:
- Provide Dr. O’Connell with the results of a routine eye exam performed within the prior year by your ophthalmologist or optometrist.
- Stop taking aspirin, anti-inflammatory drugs, vitamins, supplements and other medications that can increase the risk of bleeding.
- Obtain a medical evaluation (that sometimes includes an EKG and lab testing) from your primary care physician.
- In all cases a responsible adult must drive you home from your surgery and stay with you for the first night following your surgery.
Eyelid surgery procedure steps
Upper eyelid surgery
Upper blepharoplasty utilizes a gently curved incision on the skin of the upper eyelid designed to remove excess, hooded skin. The decision is designed to fall into the natural crease to the extent possible. While Dr. O’Connell occasionally removes fat from the nasal aspect of the lid via the same incision, he believes that, whenever possible, facial aesthetic surgery should be volumizing. Because of this he makes every effort to produce the appearance of a full, youthful upper eyelid without hooding and with adequate space for eye-shadow.
Lower eyelid surgery
Lower blepharoplasty commonly involves a skin incision located slightly below the lashes to provide access for bag removal and skin tightening. Alternatively, fat can be removed through an incision on the inside of the eyelid; this is called the transconjunctival approach. The transconjunctival approach can be combined with a small excision of eyelid skin and/or laser resurfacing to reduce lines and wrinkles – this is known as the “no-touch” technique of blepharoplasty.
Eyelid surgery recovery
Following blepharoplasty you will be provided with pain medication as well as antibiotic ointment. In most cases you will return home about 1-2 hours following the procedure to rest comfortably and apply cool compresses with your head elevated. You will be given written instructions that detail how to care for your eyes and how to administer your medications. In most cases sutures are removed by 4-5 days following surgery. Dr. O’Connell invariably closes the upper eyelids with a single running stitch per side that is easily and quite comfortably removed.
Most patients are able to return to sedentary activities within a few days. Return to exercise will depend somewhat upon the type of techniques that are utilized.
Dr. O’Connell will see you several times during the early postoperative period to insure that healing is progressing normally and to review your care.
Eyelid surgery risks and safety information
All medical and surgical procedures carry risk and the ultimate decision whether to have surgery is a personal one based upon whether the potential risks of eyelid surgery are acceptable to you.
Risks of eyelid surgery include:
- Bleeding including the very rare possibility of blindness.
- Difficulty closing your eyes.
- Lid malposition, including ectropion and lid lag.
- Unfavorable scarring.
- Dry eyes.
- Risks associated with anesthesia.
- Chronic pain.
Dr. O’Connell will fully discuss these and other risks with you and answer all your questions prior to surgery so that you may make an informed decision as to whether to proceed with blepharoplasty.
Eyelid surgery cost
According to recent statistics from the American Society of Plastic Surgeons, the average cost of blepharoplasty is $2,818 (this does not include anesthesia, operating room facilities or other related expenses). Costs can vary widely depending upon technique chosen.
In most cases Dr. O’Connell is able to perform blepharoplasty in our nationally accredited and state licensed outpatient surgical facility. This enables him to perform the procedure in a luxurious, private and cost-effective way.
When choosing a board certified plastic surgeon for blepharoplasty remember that education and experience are far more important than the final cost of the surgery.
As a member of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery Dr. O’Connell has met rigorous standards that include board certification by the American Board of Plastic Surgery. Do not be confused by other official sounding boards and certifications – the American Board of Plastic Surgery is recognized by the American Board of Medical Specialties and there is no ABMS recognized certifying board with the words “cosmetic surgery” in its name.
Eyelid surgery and insurance coverage
Health insurance does not cover cosmetic surgery.
When eyelid surgery is performed to address skin excess in the upper eyelids that impair vision it may be covered by insurance. The staff at The Aesthetic Center will assist you in the insurance reimbursement process and there is no added charge for this service.
Eyelid surgery words to know
- Blepharoplasty: Eyelid surgery to improve the appearance and/or function of the upper eyelids, lower eyelids or both.
- Transconjunctival incision: This refers to an incision on the inside of the eyelid made in order to perform blepharoplasty surgery. This is sometimes referred to as the transconjunctival technique or transconjunctival blepharoplasty.
- No-touch blepharoplasty: The no-touch technique usually involves fat removal through a transconjunctival incision with skin removal either through a smaller external incision and/or skin resurfacing with a laser.
- Pinch blepharoplasty: A less invasive technique where skin is removed from the lower eyelid without lifting the remainder of skin from underlying tissues.
- Tear-trough: The depression or groove located where the lower eyelid meets the cheek. This is often addressed as part of the overall eyelid rejuvenation plan.
- Laser resurfacing: A treatment where the appearance of the skin is improved by use of a laser.
- Ectropion: A drooping appearance of the lower eyelid also known as an inferior eyelid malposition.
- Milia: A whitehead that commonly occurs in the eyelid area following blepharoplasty.
- Hematoma: A collection of blood beneath the skin or in another area.
- General anesthesia: An anesthesia technique where the patient is completely asleep.
- Local anesthesia: A technique where the local area is “numbed” by injecting a drug such as lidocaine or “novocaine.”
Where is blepharoplasty performed?
Dr. O’Connell performs most blepharoplasties in our office-based surgical facility.
What about non-surgical options for blepharoplasty?
At The Aesthetic Center we’re fortunate to offer the latest non-surgical options for blepharoplasty. These are primarily intended to improve skin excess and wrinkling and they include use of chemical peeling, laser resurfacing as well as radio frequency. Injectable filler is also utlizied to volumize and soften the tear-trough.
How are the tear-troughs treated?
The hollowing in the central area where the lower eyelid joins the cheek is known as the tear-trough and this is an important part of the eyelid and cheek aesthetics. Dr. O’Connell prefers to treat the tear-trough with volumization utilizing injectable fillers. This is an advanced technique and we strongly advise prospective patients to seek a highly trained and experienced injector for this procedure.