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Contact Dr. Kapoor to ask a question,
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Dr. Kapoor in the News |
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View the CBS News video of Dr. Kapoor
discussing the availability of financing
for plastic surgery. Click play below.
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Eyelid Surgery (Blepharoplasty)
Q. Who are the best candidates, and what are the risks?
Most are healthy men and women, age 35 or older, who don't want to look tired even when they're not. If droopy, baggy eyelids are common in your family, and you're younger than 35, you need not wait years or decades to have the problem corrected. But regardless of your age, be aware of the risks if you have a thyroid problem (e.g., hypothyroidism; Grave's disease), diabetes, high blood pressure, dry eye (not enough tears), cardiovascular disease, a detached retina, or glaucoma.
Even if you don't have any of these problems, the procedure-like other cosmetic surgery procedures-might cause an infection or an adverse reaction to the anesthesia. Among the minor complications that sometimes occur following blepharoplasty are a few days of double vision or blurred vision, temporary swelling at the corner of the eyelids, or a slight asymmetry (not balanced) in healing or scarring. Also, after the surgery some patients may find it difficult to close their eyes when sleeping, and in rare cases this may be permanent. Also rare but possible is ectropion- the lower lids are pulled down-and additional surgery may be needed.
Risks can be reduced by consulting with, and having the procedure done by, a highly qualified plastic surgeon.
Q. What's the first step?
During your consultation at Dr. Kapoor's office, your condition will be evaluated, your medical history will be examined, your vision and ability to produce tears will be tested, and you'll be asked if you have any allergies, if you're taking any vitamins or medications, and if you smoke. Any of these can affect the outcome of the operation.
Dr. Kapoor will then discuss your goals and expectations and whether or not the procedure is appropriate for you. If it is, you can then schedule it, and you'll be given instructions on preparing for surgery. You'll need someone to drive you home after the surgery and also, perhaps, help you at home for a few days.
Q. Where will the surgery be performed?
In most cases, Dr. Kapoor performs this type of surgery at a Beverly Hills surgical center or in one of the hospitals he's affiliated with in Los Angeles, on an outpatient basis. Rarely does it require a hospital stay. Usually, a local anesthesia is administered to numb the area around the eyes, and an oral or intravenous sedative is also given. As the surgery is performed, you'll be awake but feeling no pain-just some tugging or mild discomfort. If general anesthesia is administered, you'll be asleep throughout the procedure.
Q. What happens during surgery?
Depending on how many eyelids will be operated on, the operation takes from one to two hours. Typically, the doctor will make incisions along the natural lines of your eyelids, in the creases of your upper eyelids and/or immediately below the eyelashes in the lower lids. Cutting a bit deeper into these incisions, he will then separate the skin from the underlying layers of fatty tissue and muscle, remove the excess fat, sand perhaps trim any sagging skin and muscle. Finally, he will close the incisions using ultra-fine sutures. Or, if you want only some pockets of fat removed from under your lower eyelids-and you're young with thick, elastic skin-the doctor may make an incision inside those eyelids, so that there's no visible scar.
Afterwards, the doctor may lubricate your eyes with an ophthalmic ointment and apply bandages where needed. As the anesthesia wears off, any discomfort can be controlled with the pain medications prescribed.
An eyebrow lift-to correct sagging brows that can make you look sad, angry, or tired and add years to your appearance-may be performed by itself or together with other surgery.
Q. Then what?
After eyelid surgery, it's important to keep your head elevated for a few days and to apply cold compresses to the surgical area to reduce swelling and bruising. Depending on the patient, bruising may last from two to four weeks, decreasing after the first week. It's also important to clean your eyes with eye drops or a special solution provided. During the first few weeks there may be excessive tearing, your eyes will be sensitive to indoor light, sunlight, wind and other irritants, and you may temporarily experience blurring or double vision.
The sutures will be removed several days to a week after the surgery, and then the swelling and discoloration should go down. You'll begin to look better and feel better, and be able to watch TV or read. But if you wear contact lenses, don't put them in for at least two weeks; even then, they may feel uncomfortable for a few more weeks until your eyelids recover from the surgery. Avoid moderate activities for at least three days (five days would be even better), and avoid strenuous activities for three weeks, especially those (bending, lifting, sports) that raise your blood pressure. Also avoid alcohol for several weeks.
Healing takes time, and scars from eyelid surgery may stay pink for three months or longer, until they fade to a nearly invisible fine white line.
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