Several things happen to the lower eyelid as aging occurs. A unique type of fat surrounds the eye and its muscles. As we get older, the membrane that holds that fat into the orbit weakens, causing bulges or bags to form underneath the eyes. Mid-face volume decreasing unmasks these bulges under the eyes and can contribute to the skin wrinkling and sagging. Often, people complain of having dark circles under their eyes, but what they are actually seeing is a shadow underneath the eyes created when overhead lighting shines down on the bulges. After surgery, a smooth contour is created and the shadow goes away, leaving no signs of dark circles. At times, the muscles of the eye sag and cause what is called “festooning,” or multiple bags under the eyes. A lower lid blepharoplasty may help reduce any one or several of these problems.
The Two Different Approaches to Lower Blephs and What to Expect with Each
A trans-conjunctival blepharoplasty may be performed for the patient with minimal wrinkles but significant fat in the lower eyelids. With this procedure, the surgeon makes no external incisions; instead, he re-positions the fat and sometimes partially removes it through a small incision inside the lower eyelid. This results in a quicker recovery and no external scar formation. This approach is often combined with Fractionated CO² laser resurfacing to tighten the skin of the lower eyelid.
A transcutaneous blepharoplasty is a better alternative for the patient with excess skin or redundancy in the muscles surrounding the eye. With this approach, the surgeon makes a small incision just below the eyelashes trailing out into one of the crow’s feet. Through this incision, a dramatic tightening of the lower eyelid skin and muscle may occur. Patients heal rapidly with sutures removed at five days. Occasionally, bruising remains for seven to ten days after surgery. Redness in the lateral portion of the incision may last for several weeks but may be covered up with makeup after seven days.
We do require all patients get clearance from their eye doctor prior to surgery. We supply the clearance form when the quote is given. These are simple tests, but it is important that Dr. Finn knows everything about your eyes to insure there are no underlying conditions that surgery could compromise.
Lower Blepharoplasty is usually performed under IV sedation as an outpatient procedure in our accredited private surgery suite. You will need a driver and somebody who can stay with you for 24 hours after the procedure.
Deciding to Schedule
You will receive a surgical quote and any clearance forms required at your consultation with Dr. Finn. Should you decide to proceed with Dr. Finn, you will contact our patient care coordinator, Shannon Jones. At this time, you will select a procedure date that works for both you and Dr. Finn and pay a $500.00 non-refundable booking fee to reserve this date. Once the surgery date is set, we schedule a pre-operative appointment two weeks prior to surgery.
At your pre-op, you will have ample time with Dr. Finn to discuss your upcoming procedure in great detail and have all your questions answered. You will bring the required clearance forms to this visit unless we have already received them. We will review all pre- and post-operative care, prescribed medications, and any provisions we may give you for use pre- and post-surgery. You will review and sign the consent for surgery, and the balance will be due at the conclusion of this appointment.
What to Avoid Before Surgery?
It is vitally important to avoid all blood thinning medications/supplements for two weeks prior to surgery. This includes any aspirin or aspirin-containing products as well as any anti-inflammatories such as ibuprofen or naproxen (including Motrin, Aleve and Advil). Generally, you may take Tylenol (Acetaminophen). Avoid supplements such as Vitamin E, multi vitamins, and omega 3 fatty acids (fish oil and flax seed oil.) You will be given a complete list of medications/supplements to avoid at your pre-op. All these medications can contribute to bleeding problems following surgery and can increase the amount of bruising.
What Can I Do to Speed Up My Recovery Time?
We want you back to your normal routine as quickly as possible, so in addition to avoiding blood thinners, we provide our surgical patients with a supply of Arnica Montana and Vitamin K cream which are both clinically proven to help reduce bruising and swelling. Vitamin K cream applied to your skin two weeks before surgery tends to reduce bruising. Arnica Montana is a homeopathic herb that helps to reduce swelling and bruising. We also have a laser called the V Beam Perfecta that aids in speeding up stubborn bruising! It targets the pigment in the bruise, causing it to break up and dissipate much faster than on its own. We encourage surgery patients to take advantage of this laser treatment at no charge as often as you want while the bruising is still present. We will also go over surgery specific tips at your pre-op that can help speed up the down time!