Brow Lift & Upper Eyelid Surgery, Our surgical procedures that we perform in our certified center in the office are done under local anesthesia having been trained specially in anesthesia I understand the benefits of local anesthesia vs general station and our patients wish frequently more than ever to be done in the safety of local anesthesia with sedation.
Starting from the top services that we are involved in almost on a daily basis because we do operate four days a week are: the brow lifts. In the brow lifts it depends upon the degree of brow decension as to what the procedure will be. If it is a full brow descension the patient wishes to have a brighter look to them then that is usually done by procedure called endoscopic forehead lift and it is a procedure that five of us developed in the country for plastic surgeons over 25 years ago.
I’ve been fortunate to write two books on it and I teach it at the national and international level. But that particular procedure is done under general anesthesia. In the office for lesser degrees of brown lifting we do it by a procedure called lateral brow lift where under local anesthesia a very limited incision is made behind the hairline for elevation of the brow. Patients to quite well.
There’s minimal discomfort and generally the brow look elevated but not absurdly elevated but elevated with improvement of the hooding to that is underneath the lateral brow. Frequently our patients present with both brow descension and upper lip skin because they do go together. If the brow is descending significantly it will contribute about ten to fifteen percent of extra skin to the upper lid. So it is incumbent upon us surgeons to be able to tell patients I think you should probably consider more brow lift than upper-lip blepharoplasty if the brow is the major contributor to extra skin to the upper lid.
If the brows are perfectly fine but there are extra skin to the upper lid with fat then it is an upper lid blepharoplasty. An Upper lid blepharoplasty is done in the office under local anesthesia is a very quick procedure but it must be done meticulously to not only consider removing fat and we remove that very conservatively but also to remove the extra skin that will allow you to close your eyes safely when you’re asleep.
If too much skin is removed and the globes are for example two large than one may get iinto problems with the inability to close the eyelids. Along with the removal of extra skin and fat there are patients that present with primary descension of the upper lid and that particular procedure is one more of skin not of skin removal but of adjustment of the muscles that control the position of the upper lid.