Eyelid Surgery Introduction, There are various reasons why people need eyelid surgery, including droopy upper or lower eyelids blocking vision or causing tearing, lower eyelid bags which are cosmetically unacceptable, and eyelids that have rolled in or out, causing eye discomfort. Many people also have drooping eyebrows or foreheads, which can also bought their vision.
These conditions can all affect your quality of life, making reading, driving, and watching TV difficult. They may also cause your eyes to water and make you feel more tired. Whatever the reason, there are a number of procedures we use to correct these problems. After your evaluation, I’ll discuss which surgery, if any, may help you. Here I’d like to explain what happens before, during, and after your surgery so you’re aware of everything you may experience.
There are several things that you must do prior to surgery to ensure your surgery goes as smoothly as possible and there are no delays or unnecessary complications. First, you’ll receive instructions to have a pre-operative physical exam. Your primary doctor will ensure you are healthy enough to receive anesthesia. You’ll also be given a list of medications to avoid prior to surgery. Most of these medications thin your blood, such as aspirin, Warfarin and Plavix, and many other over-the-counter medicines, and certain supplements like vitamin E and fish oil. If you’re using any of these medications, let us know so we can discuss when to stop them and then restart them after surgery. Failure to do this can result in unnecessary bruising and bleeding or could cause a serious bleeding complication.
The night before surgery, you’ll be instructed to stop eating or drinking at midnight. Eating or drinking on the morning of surgery will result in cancellation of your surgery. Take a shower the morning of surgery and don’t apply any make-up to your face. Dress in comfortable clothes that are easy to take off and don’t wear any jewelry. When you arrive at the surgery center, you’ll be checked in and asked questions about your health history. You’ll have an IV placed and the anesthesiologist will come and explain his or her plan for your anesthesia. Once you are brought into the operating room, you’ll be wrapped in warm blankets and given oxygen to breathe. You’ll have numerous sensors placed on your body to monitor you during the surgery.
I’ll clean your face with alcohol and mark the areas where I’ll make my surgical incisions. Depending on the type of surgery, you’ll either be awake but sedated or completely asleep. Either way, we’ll help you drift off to sleep while numbing medicine is injected under the skin. During the surgery, you’ll be kept comfortable. If at any time you feel discomfort, you can let me and the anesthesiologist know and we’ll give you whatever you need to be more comfortable. During the surgery, we may ask you to open your eyes and look up and down.
This will help us to attain symmetry with your eyelids. Immediately after your surgery, you’ll be taken to a recovery room. In most cases, you’ll have ointment placed on your incisions and ice placed over your eyes. It’s rarely necessary to patch the eyes closed. And in most cases, you’ll be ready to leave the surgery center within 30 to 60 minutes after your surgery. You’ll need to have a friend or family member drive you home. In the days and weeks following surgery, there are many things you can do to aid in your healing. Using ice for 20 minutes on and off for the first 48 hours will greatly reduce your swelling.
Apply ointment as directed on the day of surgery to keep any absorbable sutures moist and allow the incisions to heal quicker. You’ll be given medicine for pain control. In most cases, pain is mild and only lasts the first day or two. You’ll want to avoid any vigorous physical activity in the first one to two weeks, which can worsen swelling and cause the stitches to open up. Sleeping with the head elevated the first few days can also reduce swelling. You may shower the day after surgery, but should avoid any pulling or rubbing of the skin. Use a towel to pat the surgical areas dry.
Do not rub them. Avoid excessive cleaning of the surgical areas as this can lead to suture breakage prematurely. Complications are always possible with any surgery and knowing how to deal with them is important. Many people experience oozing or mild bleeding from their incisions in the first few days after surgery and this is normal. Holding direct pressure over a bleeding area for several minutes will nearly always make it stop. If bleeding persists despite several minutes of direct pressure, notify our office. Sutures are thin and delicate and can break, sometimes for no apparent reason. If your sutures break and your wound appears to be opening up, let our office knows.
Infections are also rare in these types of surgeries, but can occur. Using the ointment as directed and avoiding touching the wounds is the best way to avoid infection. If the wounds become red, painful, or there’s a cloudy, smelly discharge, notify our office. During the first week after surgery, you can expect to look pretty rough. You’ll have some significant swelling and bruising and you may not feel comfortable in public without some sunglasses. Swelling tends to be worse over the first one to two days, then slowly reduces day to day. Most swelling is gone within three weeks. But in some patients, this can last more weeks. Bruising generally clears up by two weeks.
We usually see patients back after a week and then another six weeks to ensure they have healed well and are happy with their outcome. Just a few words on insurance considerations. In most cases, insurance, including Medicare, pays for eyelids and brow surgery. In these cases, we must demonstrate how the eyelids are limiting your vision, which we do with a visual field test. We’ll also take photographs, which your insurance company will require to authorize your surgery. Preauthorization takes around three weeks.
We generally schedule you at least three weeks from your visit to ensure that the preauthorization process will be completed by then. Cosmetic procedures are not covered by insurance. In many cases, however, we combine cosmetic procedures with medically necessary surgery so that patients can recover from both simultaneously. It’s also much cheaper to do the surgeries at the same time. Lower eyelid lift to remove bags and tighten the skin is the most common cosmetic surgery we perform.