Eyelid Surgery Portland Oregon – Blepharoplasty Information
Eyelid surgery is performed to rejuvenate both the upper and lower eyelids, which allows patients to look more refreshed and well rested. The procedure is known as a blepharoplasty or “eyelid lift”. It is a surgical procedure to improve the appearance of both upper and lower eyelids. Blepharoplasty surgery can be performed on just the upper lids, just the lower lids, or both, depending upon patient’s desires and aging process.
Who is a candidate for upper eyelid surgery?
The primary goal for upper eyelid surgery is to remove loose and inelastic skin in the upper lids creating the tired or hooded look. There is usually a small amount of fat in the upper lids on the inner corner, which can also removed as well. You are a good candidate for upper eyelid surgery if you have access skin obscuring the natural fold or resting on the eyelashes. Removal of skin and fat significantly helps rejuvenate the upper lids. This is called upper blepharoplasty procedure. An upper blepharoplasty procedure can also be performed for medical necessity when there is significant visual loss impairing the patient’s visual fields. Many patients have asymmetry of the upper eyelids, which can also be addressed as well. In our practice, the incision is placed inconspicuously in the upper eyelid crease, which heals quite well in that location.
Who is a candidate for lower eyelid surgery?
The primary goal for lower eyelid surgery is to get rid of the ”eye bags” or fatty deposits creating the “puffy look.” There are three compartments of fat in the lower lids, and a portion of this fat is removed which removes the puffiness look and rejuvenates the lower lids. This fat does not respond to weight gain or loss, and is independent of patient’s metabolism. Pigmented skin in the lower eyelid skin and dark circles are not removed with surgery. The orbital fat is removed from the inside of the eyelid, which is known as a trans-conjunctival approach. When patients are less than 50 years of age, this is usually all that needs to be performed, therefore there’s no external incision. When patients are over 50 years of age and have loose and inelastic skin in the lower lids, then a small pinch technique of lower eyelid skin can be performed at the eyelash line. This incision is closed with tissue glue, so no sutures are required for the lower lids.
Consultation with eyelid surgery specialist Dr. William Portuese: A consultation for an upper and lower blepharoplasty procedure usually takes approximately one hour in our office. This in entails obtaining a thorough medical history from the patient, in addition to any specific eyelid issues. It’s important to note if there is dry eyes present. Consultation with Dr. Portuese lasts approximately 30 minutes, and an additional 30 minutes is spent with our patient care coordinator and office manager. At the time of scheduling the surgery, a pre-operative consultation with one of our registered nurses is performed.
Before undergoing elective cosmetic surgery on the eyelids, it is important that all medical conditions have been addressed, and are under control, such as high blood pressure. It’s also important patients refrain from taking any blood thinners such as aspirin, non-steroidal anti-inflammatories like ibuprofen, vitamin E and herbal supplements for two weeks before and after the surgery. This helps reduce any bruising after the surgical blepharoplasty procedure. Significant medical issues will require clearance by the patient’s primary care physician, cardiologist, or internist.
Day of the eyelid surgery
Patients check in the day of the surgery with our front office administrative staff. One of our registered nurses will then admit the patient into the surgery center area. It’s important that patients have not had anything to eat or drink past midnight the day before, since a general anesthesia is going to be administered by one of our board-certified physician anesthesiologists. The patients will also meet and greet with the physician anesthesiologist prior to the surgery. Dr. Portuese makes precise markings to indicate where the skin and fat will be removed on both the upper and lower eyelids. The excess skin and small amount of fat is removed from the upper eyelids and dissolvable sutures are placed in the upper eyelid crease for minimal detectability. The significant fatty deposits creating the puffy look in the lower lids are removed through an incision on the inside of the lids. Histocryl tissue glue is then used to close the lower lid incision along the eyelash line. Once the surgery has been completed, the general anesthesia is then turned off by the Physician Anesthesiologist. Patients are then brought into the operating room for their surgery. After the surgery, patients are woken up and brought to the recovery room and then discharged home with their caretaker. Some patients elect to undergo upper eyelid surgery under local anesthesia. All lower lid surgery is performed under general anesthesia for safety and comfort.
How long is the recovery time for upper and lower eyelid surgery? The recovery period after upper and lower eyelid surgery usually lasts approximately two weeks. There are no bandages placed across the eyes. Anticipate two weeks of visible bruising and swelling. Dissolvable sutures are placed in the upper eyelids, while the lower lid incision is closed with tissue glue. The tissue glue and the stitches all dissolve at approximate 7 to 10 days. The incision in the upper lid stays pink for one to three months before it finally settles down to a fine white line. Most patients take two weeks off social activities and work environments. We ask patients to not exercise for two weeks after their eyelid procedure. Patients are able to place makeup on their upper eyelids once the stitches dissolved at approximately 10 days.
How much does eyelid surgery cost?
The cost of any type of cosmetic surgery such as a blepharoplasty is determined by the amount of time it takes to perform the procedure in a formal operating room, time monitored by a physician anesthesiologist under general anesthesia, and the surgeon’s fees for performing the procedure in addition to the post operative follow-up appointments for one year. Our price list for cosmetic eyelid surgery is located on our website.
Does medical insurance cover the cost of a blepharoplasty? Medical insurance sometimes participates in payment for functional eyelid surgery. When patients have a very significant obstruction of their visual field of view, then an upper blepharoplasty procedure may be approved as a medically indicated surgery. Visual field obstruction tests, a full set of facial photographs, and medical chart notes documenting reflex distance of the pupil to the eyelid margin are submitted to patient’s medical insurance for preauthorization, once medical necessity has been documented. Anticipate co-pays and deductibles associated with your medical insurance.
After an upper or lower blepharoplasty procedure, patients return to the office for a postoperative check up with Dr.William Portuese at one week. Additional follow-up appointments are usually made at one month and three months, at which time the postoperative photographs are taken. The final results from an upper lower blepharoplasty are very long-lasting, usually over 10 to 15 years