This surgery is performed in an outpatient clinic using local anesthetics. You may also be given a sedative to relax you during the procedure. Usually, a pre-operative consultation is performed during which time you meet the surgeon, discuss the procedure, and are examined.
Depending on the nature of the cosmetic problem, different procedures may be offered. For example, if your eyelids are droopy because of laxity of the forehead structures, a brow lift (see next section) may be offered instead of blepharoplasty. On the day of the procedure, the first step is examination and marking the upper eyelid. Local anesthetic (usually lidocaine) is injected into the upper eyelid to numb it.
Removal of the excess skin is then performed using either a scalpel, carbon dioxide laser, or radiofrequency cutting. For those patients with bulging fat in the upper eyelid, the fat is then gently removed. The wound is then closed with sutures. Your surgeon may prefer absorbable (dissolving) or non-absorbing sutures that will be removed later.
This is performed in a similar manner as described above. However, depending on the nature of the cosmetic defect, different techniques may be used. For patients with both bulging and droopy lower eyelids, an incision is made on the outside of the eyelid, just below the eyelash line.
The various eyelid tissues are separated from one another and the bulging fat is identified and gently removed. The excess skin is then cut out and the wound is sutured. For patients with bulging but not droopy eyelids, an incision is made along the inner side of the eyelid.
The eye itself is anesthetized with eye drops and then the eyelid skin is injected with local anesthetic. A shield is placed over the eye to protect it. Incisions are made in the inner lower eyelid and the bulging fat is gently removed.
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