(Overview)WHAT IS  Eyelid Surgery (Blepharoplasty)?

Blepharoplasty, also known as eyelid surgery, is a surgical procedure that improves the appearance of the upper and lower eyelids by tightening muscles and tissue or removing excess fat and skin. This procedure can be performed on men and women alike, and offers a younger, more refreshed look that reflects across the whole face.

Dr. Giuffre has been performing Blepharosplasty with excellent cosmetic results for many years. Whatever your reasons for surgery are, Dr. Giuffre personalizes the procedure according to your needs and treatment goals to obtain your ideal eyes.

Types of Blepharoplasty

Functional Blepharoplasty – This procedure may be necessary if the patient’s eyelids are sagging in their field of view. If deemed medically necessary, the patient’s medical insurance may cover it. There are specific criteria set out by AHS in order for this surgery to be covered by AHS:

  • The patient must be at least 65 years old

  • The excess eyelid skin must block the visual axis, in other words, the skin is overhanging the eyelashes to cause a “blinder effect” on vision

  • The loss of peripheral vision must be demonstrated using a “Hess Screen” test done by an Ophthalmologist

  • A muscle that actually opens the eye may start to loosen and detach.  This is called “senile eyelid ptosis:” 

    • There are two muscles that open your eyelid. As patients age, one of the muscles that open the eyelid may detach. This produces a droop in the eyelid, where the actual eyelid margin starts, drops, and covers the coloured part of the eye. It can descend so low that it starts to cover the pupil and block vision. The surgical repair for this is covered by AHS. There are other causes of eyelid ptosis other than ageing.

Cosmetic Blepharoplasty – Cosmetic blepharoplasty can be done on either the upper or lower eyelids. Lower eyelids are usually fat not skin that needs to be removed and can be done with a transconjunctival blepharoplasty. During a transconjunctival blepharoplasty an incision is made inside the lower eyelid where the fat will be removed, leaving no visible scars.


AM I A GOOD CANDIDATE FOR  Blepharoplasty


Most often this is done as a person gets older and gravity begins to change the eyelid appearance. Occasionally a younger person, who inherits a heavy upper eyelid, will have the same features as an ageing eyelid. The best candidates for blepharoplasty are individuals who are in good overall health and who do not smoke or have any serious eye conditions. If you have loose, sagging skin or puffy bags around your eyes, this procedure can help reduce these unwanted effects and leave the eyes looking young and fresh.

It is important for patients to have realistic expectations before undergoing surgery in order to be satisfied with their results. While this procedure can enhance your appearance and may improve self-confidence, it cannot alter your entire appearance or change the structure of your face.

During your consultation, Dr. Giuffre will discuss whether a blepharoplasty is right for you.


Blepharoplasty PROCEDURE

Patients may choose to have this procedure on their upper or lower eyelids, or both. Depending on these choices, the procedure can take anywhere from 45 minutes to 2 hours.

If the upper eyelid is being treated, an incision is made along the natural crease of the eyelid. Once the incision is made, Dr. Giuffre may reposition fat deposits, tighten muscles and tissue, or remove excess skin in order to leave the eye looking younger and refreshed. For the lower eyelid, an incision is made just below the lash line in order for excess skin to be removed.

After the procedure is performed, the incisions are closed with sutures, and usually wrapped in gauze to allow the area to heal.


RECOVERY AFTER Blepharoplasty

After the surgery is completed, ice packs are placed on the eyes for a short period of time in the recovery room before the patient goes home with their ride. The patient cannot drive home and will need a ride from a friend or relative. 

The use of ice packs over the first 24 hours will decrease swelling and bruising. On day 5-6, the patient returns to have the sutures removed. There will be bruising and swelling for 7 – 10 days after surgery. The amount will vary from patient to patient. Dr. Giuffre will give you specific instructions on how to care for your eyes after surgery. The use of Aspirin, Advil and Herbal supplements are discouraged as these products will increase the bleeding and bruising during and after surgery.

One week off work is recommended, and patients should avoid exercise and strenuous activities for at least two weeks. 

Dr. Giuffre provides his home phone number to his cosmetic patients in case there is a patient concern.  In the rare instance that a patient requires hospitalization, Dr. Giuffre has admitting privileges to all of the major hospitals in Edmonton.


Blepharoplasty RESULTS

Results of a blepharoplasty procedure are visible as swelling and bruising subside, and will continue to improve for up to a year after surgery. This procedure is designed to produce long-lasting results. While surgery cannot prevent your eyes from aging, most patients are satisfied with their results and do not seek repeat procedures.

The scars from the blepharoplasty procedure are usually well concealed and will fade with time until they are virtually unnoticeable. The incision is hidden in the crease of the eyelid in an upper blepharoplasty, and just below the lashes in a lower blepharoplasty.




RISKS OF Blepharoplasty

With any surgery there are surgical and anesthetic risks.


Aside from the rare risks of an anesthetic event, some of the general and specific surgical risks for this procedure would include:


  • Excessive swelling (called chemosis)

  • Dry eye: with an ageing lower lid, the adherence of the lid to the eyeball is lax. This may be exaggerated during the healing period. If this is severe, additional surgical manoeuvers may be required to correct this.  The eye will be exposed to more air and light which may produce or worsen a dry eye. Lubricating the eye with drops or gels is recommended in this postoperative period. Failure to treat dry eyes can cause cornea damage.

  • Vision: this surgery will have no direct effect on your vision. Your eyeglass prescription will not change.

  • Ectropion: the scleral show (white part of the eye below the colored iris) is exaggerated. 

  • Scarring

  • Infection

  • Sensation change to the eyelash for up to 3 months

  • Discomfort: this is mild to moderate. Most patients may require pain medication for a day or two after surgery. Avoid driving a vehicle if you are taking narcotic medication.

  • Asymmetry

  • Bleeding (hematoma)

  • Corneal dryness or corneal abrasion

  • Time off work and exercise


*This list is not complete.


During the consultation with the patient, Dr. Giuffre will outline and explain each of the risks in detail.



FAQS

How long does the surgical improvement last?

With the exception of the younger patient having surgery for an inherited heavy eyelid at a much younger age,  most patients in their forty’s and onward will often enjoy the results of the surgery for many decades . Repeat blepharoplasty surgery is very uncommon.

How often do I need to come back for a checkup after the surgery? 

Postoperative visits include a 5-6 day post op visit, to have the sutures removed, and a 6 week visit in the office to review the preoperative photograph and the surgical result. If there are any patient concerns, Dr. Giuffre provides his home phone number for patient's direct access.

After the 6 week visit, if there are any future requests for an appointment, they are made directly with Dr. Giuffre office and an expedited visit is arranged.