Your Eyelid Surgery Procedure

On the morning of your surgery, clean your face thoroughly and don't apply any makeup. Be sure to take high-quality sunglasses to the hospital or surgical suite; you'll probably need to wear them home, even if it's dark outside.

Eyelid surgery is often an outpatient procedure. It can take as li tt le as half an hour, though additional procedures will naturally require more time.

The doctor may recommend operating on both the upper and the lower eyelids. Eyelid surgery p ro cedures differ according to where the incisions are placed and what is done with the excess tissue. Lower eyelid incisions may be transcutaneous - through the skin - or transconjunctival - on the underside of the eyelid, completely hidden. A transconjunctival ap p ro ach has advantages. It prevents lower eyelid retraction, in which the lid becomes lax after surgery and may even pull away from the eye.

Sometimes skin and fat must be removed, and when the lower eyelid is already lax or there's a lot of extra skin, the lid must be tightened. In these cases, a transcu­taneous incision is often a be tt er choice.Though it's made through the skin, this inci­sion is virtually invisible to others if it's done properly and it heals normally.

In some eyelid surgery procedures, fat is rearranged rather than removed. And although muscle, fat, and skin are all available for removal, the surgeon may remove (or reposition) only excess fat, especially in younger patients with herniated fat around the eyes but no skin sagging.

External incisions will be hidden in the natural creases of your eyelids. Upper lid tissues will be removed - fat, muscle, or skin, or a combination - and then the incisions will be closed.Your surgeon may use ordinary sutures or the type that dissolve on their own. If only fat is to be removed from your lower lids, the doctor will probably do so through incisions on the insides of the lids or with a laser. More extensive lower lid work - skin removal and lid tightening - may require transcutaneous (external) incisions. Sometimes doctors use a laser to sculpt upper lid fat that remains and to resurface lower lid skin. After closing the incisions, the surgeon may apply ointment to your eyes followed by cool compresses.

Many surgeons accomplish a similar result using lasers to remove lower eyelid fat bags, loose skin, and crows feet. With the patient sedated and the lid anesthetized, the surgeon turns down the lid and uses a CO2 laser as a cu tt ing tool to expose, remove, and sculpt the fat bags.The lid is then turned back, and the skin of the lower eyelid is resurfaced.This procedure removes 70 to 80 percent of the fine wrinkles and tightens the loose tissue.

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