Our eyes are how we visually communicate with others.  And, often, our age begins to demonstrate itself around the eyes earlier than the rest of our features. Patients are often describing how they “look tired” or “look old” when they feel energetic and vibrant. Changes that take place in the contours and soft tissue around the eyes are the culprits.  Extra sagging skin and puffiness can change bright open eyes into tired, aged eyes.

That puffiness is not swollen tissue. Rather, it is fat behind the eyes that is poking through. This is not the type of fat that is used for energy storage and that changes with diet and exercise. Instead, this is a stable fat that functions more like a shipping-packing material. It fills in the space between muscles, nerves and blood vessels in the orbit behind the eye itself. As we age, our eyes slightly descend in the orbit which pushes the fat forward. Depending on genetics and age, that fat can push through the thin, fibrous layer and present to the outside world as “puffiness.”

There is a solution to this. Both for the upper and lower eyelids, the protruding fat and the extra skin can be removed in a safe and reproducible fashion:  the blepharoplasty. With the patient under anesthesia for comfort, the skin and the fat are meticulously removed to recreate the youthful contour and appearance. Typically, this will take 30 minutes for either the upper or lower blepharoplasty, or one hour for both. When external incisions are required, the incisions are strategically placed in natural creases of the eyelids for camouflage.

We are all very sensitive about our eyes and so one of the first questions I get is “is this going to hurt?” And, the simple answer is no. Blepharoplasties are relatively painless surgeries. Of course, there is some mild incisional tenderness that resolves quickly. However, even though I give patients pain medication for the postoperative period, most patients tell me they use very little of it on the first day/night only, and often the feedback is that the pain medication was not needed at all.

There is always going to be some bruising and swelling of the eyelids following surgery and the amount can vary. I give instructions about how to easily and comfortably ice the surgical area for the first 72 hours. And, when done vigilantly, the icing really helps blunt the degree of bruising and swelling.  Regardless of the degree of bruising and swelling, it will mostly resolve in the first 7-14 days. 

Most patients feel like they can get back to full activity the day after surgery, but, to further blunt the bruising and swelling, I ask patients to hold off on strenuous activity for 7-10 days following surgery.

The small sutures will be removed at 6-7 days following the surgery. Now, there may still be some mild bruising at this point, but patients can use makeup following suture removal. Due to the eyelid skin’s quality and healing potential, the incisions heal very quickly and the incisions virtually disappear.

In terms of bang-for-your-buck, blepharoplasties give the most benefit of all cosmetic facial surgery of the aging face, with the least cost, recovery and downtime. Blepharoplasties can quickly transform a tired, sullen expression into a vibrant one.  Come in and let me see if a blepharoplasty is right for you. Contact us today to schedule your appointment with Dr. Garlich.