Manuel A. Lopez, MD, FACS

Board Certified Facial Plastic Surgeon

(210) 495-5771 (LPS1)
(210) 495-2367          
Lopez Plastic Surgery
1314 E. Sonterra Blvd, Suite 5104
San Antonio, Texas 78258

Eyelid Lift

Eyelid lift (blepharoplasty) is a safe, effective procedure performed to restore a more youthful appearance and less fatigued look while maintaining or improving visual function. Blepharoplasty is one of the most common facial rejuvenation procedures performed. It generally involves the removal of excess skin and fat around the eyelids. In today’s competitive corporate workplace more women and men are increasingly seeking eyelid surgery to restore a younger look that more typifies their energy level.

When patients come to see Dr. Lopez seeking facial plastic surgery, it’s not uncommon for them to focus on a single aspect of their appearance rather than the overall picture. Blepharoplasty alone is not always the answer to redundant skin about the eyes. Premature aging and dropping of the brow can cause a tired, angry look with frown lines and sagging skin. It is not uncommon for patients who come to Dr. Lopez for evaluation of the eyelid area to simultaneously discuss an browlift.

Along with baggy eyelid skin, an additional source of concern is textural or surface changes (fine little lines) in the skin around the eyes. Although some improvement in facial wrinkles can be obtained from a blepharoplasty, it will not address all the superficial lines that come from premature aging, overexposure to weather, and genetics. Blepharoplasty addresses excess skin and fat; skin resurfacing such as chemical peels and laser surgery addresses textural wrinkles and imperfections. Dr. Lopez often recommends the use of Botox to correct many of the wrinkles around the eyes as well as prevent them from occurring.

As Dr. Lopez is a board certified facial plastic surgeon, trained to perform plastic surgery exclusively on faces and necks, he knows that his responsibility is to evaluate not only the areas of concern but also the motivation behind the requests. Some patients that are not ready for cosmetic surgery are better served with conservative measures, such as Botox for treatment of fine lines and fillers for deeper wrinkles. Patients who educate themselves about facial rejuvenation know when and if the time is right to proceed.

When discussing rejuvenation procedures the best place to start is by looking at before and after photos to see just what can be accomplished. As you will see in the photos, patients often ask to combine an eyelid lift with other cosmetic surgery. Facelifts, chin implants, rhinoplasty (nasal surgery), otoplasty (ear surgery) and lip surgery can also be performed in conjunction with blepharoplasty.

For traditional lower eyelid blepharoplasty, it is common that an incision is made in the lower eyelid skin with removal of excess skin and fat to achieve a refreshed look.

An alternative technique is the transconjunctival blepharoplasty. With this approach, the incision is made just inside the lower eyelid and no external incision is required. Dr. Lopez will evaluate your lower eyelids and determine which approach will produce the optimal result.

At your initial consultation, Dr. Lopez evaluates your bony and soft tissue architecture as well as the form and function of the eyes. Assessment of the upper and lower eyelids along with the eyes themselves provides the basis for what one may expect from blepharoplasty. Skin type, ethnic background and age, along with the degree of deformity and function are important factors influencing the outcome of surgery.

As with all facial plastic surgery, a thorough health assessment and realistic expectations are prerequisites. Your understanding of procedures and routines is essential to a successful final result. Following your consultation, we continue our discussion at the preoperative appointment.


BEFORE EYELID LIFT SURGERY

At your preoperative appointment Dr. Lopez will provide all the instructions for you to follow before and after surgery. An eyelid lift (either upper or lower eyelids) takes about an hour depending on the structure and amount of excess tissue prior to surgery. If you are having a combination of procedures your surgery will take longer. Recovery time from the anesthetic takes about an hour and you will be discharged about four hours from the time of admission.

PREOPERATIVE EYELID LIFT INSTRUCTIONS

  1. Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil, Aleve, etc.) for two weeks prior to and two weeks following your surgery. See our “Medication List” for products to avoid prior to surgery. If you are on any medications that affect bleeding (such as coumadin or warfarin) please notify the office immediately.
  2. Please refrain from tobacco products for six weeks and alcohol for one week prior and three weeks following surgery. Along with delayed wound healing, persistent skin redness and other complications may persist when tobacco and alcohol are not discontinued.
  3. Please notify us of all routine medications and significant health history. We ask that you remain on your daily medications unless instructed otherwise. At the preoperative appointment you will be told which daily medications to take with just a sip of water on the morning of surgery.
  4. At your preoperative appointment you will be given prescriptions for use following surgery including an oral antibiotic, antiswelling medication, antibiotic ointment and pain medications. Please obtain these prescription medications before your surgery so you will have them ready for use when you return home after surgery.
  5. We will ask you to take Arnica, a natural herb that significantly decreases bruising, before and after surgery. We will also ask you to take Vitamin C (ascorbic acid), which helps promote healing, before and after surgery.
  6. You may not eat or drink after midnight the evening before the procedure unless instructed otherwise. You may brush your teeth. Your procedure will be cancelled if you do not follow these instructions.
  7. Remove all make-up and nail polish before arriving for your procedure.
  8. Someone will need to drive you home after your surgery and stay with you that evening. Transportation to the office for dressing removal the day following surgery is also required.

AFTER EYELID LIFT SURGERY

When you wake up from surgery you will notice cold packs on your eyes. These help to minimize swelling and bruising. Your vision will be blurry due to the eye ointment that was placed in your eyes after surgery. You may also notice that tears run down your cheeks, which is due to swelling and will subside during the first week following surgery.

POSTOPERATIVE EYELID LIFT INSTRUCTIONS

Wound care

For the first 72 hours after surgery, keep cold packs on the eyes. While you are awake cold packs should be placed every twenty minutes around the eyes. A small bag of frozen vegetables may also be used. Make sure the bag is not placed directly on the skin. Use a washcloth or towel between the bag and your skin.

At bedtime clean any excess ointment off sutures with a Q-tip. Then apply the eye antibiotic ointment on the eyelid sutures and inside the lower eyelid. Until the sutures are removed, you will apply the eye ointment three times a day to the sutures. It is only necessary to apply the ointment inside the lower eyelid at bedtime. Ointment inside the lower eyelid will make vision blurry, so best to do this immediately prior to retiring for the evening. Sutures that have been kept lubricated with ointment are less painful to remove.

Medications

Most patients complain of discomfort more than pain. Use pain medication as directed/as needed. Vicodin and Percocet contain Tylenol. Do not take additional Tylenol or acetaminophen while taking Vicodin or Percocet. Do not drive or drink alcohol while taking pain medication. Taking pain medication with food helps minimize nausea sometimes associated with pain medications.

  • Start your antibiotic (Keflex) when you get home and one at bedtime. It is not uncommon to have a low-grade fever for 24 hours following surgery.
  • Vitamin C helps promote healing. Take 1000 mg three times a day for one week following surgery.
  • Arnica, a natural herb that significantly decreases bruising, is used under the tongue three tabs three times a day before meals for two weeks.

Diet

Advance diet from liquids to soft food (oatmeal, French toast, yogurt, soup, pasta) to your regular diet as tolerated. You have no diet restrictions. Often the anesthesia you received can make your stomach feel uneasy for the first 24 hours so avoid large meals.

Activity

Rest for entire day after surgery. Sleep with head of the bed elevated or use two to three pillows for one week after surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. No driving for one week following surgery. Seven to ten days off work is recommended.

Bruising can be camouflaged at one week postoperatively with make-up. Always protect your face from the sun. At this point, a hat and sunglasses are a good idea. It is ok to apply sunscreen, cosmetics or facial creams two weeks after surgery. Avoid unprotected prolonged sun exposure for three months following blepharoplasty to prevent pigmentation of incision lines.

Tearing, bruising, swelling, eye fatigue and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Since vision is temporarily compromised, assistance with daily activities is recommended.

Final Result

Following blepharoplasty, it takes time for the swelling to subside and for the skin to heal. Most patients return to work one to two weeks following surgery, depending on the degree of privacy one is trying to maintain. At three weeks postoperatively, swelling and bruising may be apparent to you but not to many of your coworkers and closest friends.

Final results following an eyelid lift are not apparent for one full year following surgery. Dr. Lopez will want to see you 3, 6 and 12 months after the surgery to ensure that you are healing as anticipated.

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