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Eyelid Surgery

“All the great artists realized the eyes convey
both attention and emotion.”

The aesthetic goal of surgery in the eye area is to transform a sad or tired appearance into an open and friendly look. As the eyes convey not only attention but emotion as well, a careful analysis is important. With any surgery of the eyelids, the artistic goals should consider the overall appearance of the position and shape of the eyelids and their relationship to the eyebrows. Dr. Edward Szachowicz performs upper and lower blepharoplasty, often called eyelid surgery, to help his Minneapolis-St. Paul patients look naturally refreshed and more youthful.

 

Candidates for Eyelid Surgery

Dr. Szachowicz performs eyelid surgery at his Edina, MN, plastic surgery practice for Twin Cities women and men who want to address any of the following concerns:

• Lax skin and fatty protrusions in the upper eyelids
• Fatty bulges under the eyes
• Sagging lower eyelids

When planning the procedure, Dr. Szachowicz considers a variety of factors including:

• History of dry eye or excessive tearing
• Very deep or shallow placement of the eyes
• Position and tone of the eyelids

Asymmetry is common with the eyes and the eyebrows. It’s important to understand that some measure of asymmetry will remain after surgery. Most people are surprised to realize how the position of the eyebrows influences the amount of excess skin in the upper eyelid — the more the brow sags, the more excess skin accumulates around the upper eyelid. Many times, surgery on the upper eyelids and a brow lift (forehead lift) are performed at the same time for optimal results.

Upper Eyelid Surgery Procedure

Upper eyelid surgery begins with marking the incision in the crease of the upper eyelid with the patient sitting in an upright position. Any protrusions of fat are outlined at this time as well.

• Excess skin and muscle are removed as marked beforehand.
• Any fat causing puffiness in the upper eyelid is then removed. Most often these bulges form in the inner part of the upper eyelid near the nose.
• The incision is then closed using a delicate suture that weaves under the skin to avoid the formation of stitch marks or tiny cysts.
• Paper tape is then placed over the edges of the incisions during healing.

Dr. Edward Szachowicz

(Sack-o-which)

Your face can reflect the way you feel inside through a facelift or another surgical procedure by Dr. Szachowicz.

Meet Dr. Szachowicz

Combination Brow Lift and Upper Eyelid Surgery

The trans-blepharoplasty direct brow lift is a newer approach Dr. Szachowicz uses to elevate the outer eyebrow at the same time as the upper eyelid lift. This combination gives optimal rejuvenation to the eye area with the advantage of only one incision in the eyelid.

The incision in the upper eyelid is in the crease, the same as it usually is in surgery on the upper eyelid, and the procedure then includes a release of the eyebrow at the bony ridge above the eye. The eyebrow is elevated into the desired position and is then anchored in place to the brow bone with a bio-absorbable fixating device called an Endotine®. With the eyebrow now in a more youthful position, and the hooding removed by elevating the outer portion of the eyebrow, only the true excess of skin in the upper eyelid is removed. The incision in the crease of the eyelid is then closed normally using fine sutures.

The small Endotine implant holds the raised eyebrow in the desired position until healing is complete, and is then absorbed naturally by the body. This procedure is warmly accepted by people who already feel that they have too much skin on the upper eyelid and want a more complete rejuvenation of the eye area than just a routine blepharoplasty can offer. Recovery is similar to surgery on the eyelid alone.

This procedure is an excellent option for those with a high forehead or thinning of scalp hair, and it is preferred for the earliest signs of relaxation of the brow.

Lower Eyelid Surgery Procedure

Transconjunctival Lower Eyelid Surgery for Fatty Bulges

Dr. Szachowicz will make an individual assessment of the condition of the lower eyelid skin, the tone of the eyelid, and the fatty protrusions in the lower eyelid. If there is no excess skin, and there is good tone in the lower eyelid, then a “hidden incision” or transconjunctival blepharoplasty may be the best option. Dr. Szachowicz believes in preserving the fat around the eye, and chooses to reposition the fatty bulges into a smooth layer that softens the bony rim and gives a full, youthful result. This is the most common approach for rejuvenation of the lower eyelid. Most procedures on the lower eyelid look their best when combined with elevation of the cheek with a facelift procedure.

Transconjunctival surgery on the lower eyelids:

• Begins with a small incision hidden on the inside surface of the eyelid;
• The fatty bulges are exposed and opened along the lower bony rim of the eye;
• The fatty bulges are then draped over the bony rim, creating a smooth layer of fat that provides fullness in the hollows under the eyes; and
• The incision is closed using dissolvable sutures

If any excess skin is present, a small “pinch excision” of skin is done along the margin of the eyelash. Any creped appearance of skin of the lower eyelid is best treated using Fraxel® laser resurfacing to thicken the thin, delicate skin of the eyelid.

Muscle Tightening Lower Eyelid Surgery

If the lower eyelid has lost tone, tightening the muscle of the lower eyelid may help to re-suspend the eyelid. With this approach the excess fat is removed, and the muscle of the eyelid is tightened to support the eyelid. This proceeds as follows:

• An incision is made just beneath the lashline and the layer of skin and muscle is exposed.
• Excess fat is removed and the muscular layer is tightened into the outer corner of the eye.
• Excess skin in trimmed, and the incision is closed using a fine suture.

Dr. Szachowicz was wonderful and he has made my eyes look even better with a much more natural appearance. —Anonymous

Recovery From Eyelid Surgery

Surgery on the upper and lower eyelids does require that you do no heavy lifting or strenuous activity for 1 to 2 weeks after the surgery to minimize the risk of bleeding around the eye. Swelling usually diminishes at 1 week. Residual bruising then fades thereafter. Dr. Szachowicz uses homeopathic arnica montana pellets and gel after surgery to accelerate healing. Fraxel laser resurfacing of the skin of the eyelid is usually planned any time after 6 weeks of healing.

Risks of Eyelid Surgery

Most people have no complications after eyelid surgery. Major risks such as visual loss are extremely rare. Infrequently, the shape of the eyelid or its position may change, and some fatty protrusions may re-occur. Dr. Szachowicz, an experienced facial plastic surgeon, will discuss the benefits and risks of surgery on the eyelid during your consultation.

Your Consultation

Your cosmetic consultation with Dr. Szachowicz is your personal time to discuss your goals and to receive information on those procedures he may recommend to achieve your desired goals. As part of this discussion, Dr. Szachowicz utilizes a state-of-the-art computerized image simulation system to illustrate possible outcomes for the rejuvenated YOU!

Please bring pictures of yourself when younger – knowing more about your aging journey helps Dr. Szachowicz customize your procedure(s).