You may be a good candidate for eyelid surgery if you have any of the following conditions:

• Excess skin that hides the natural fold of the upper eyelids
• Loose skin that hangs down from the upper eyelids
• Puffiness in the upper eyelids that creates a tired look
• Excess skin and fine wrinkles of the lower eyelids
• Puffy "bags" and, in some cases, dark circles

Eyelid surgery needs to be approached with extra caution if you have any of the following medical conditions:

• Thyroid problems, such as hypothyroidism or Graves' disease
• Lower eyelids that droop significantly and reveal the white beneath the iris (the eye's colored portion)
• Eye problems, such as "dry eye," a detached retina or glaucoma
• High blood pressure or other circulatory disorders
• Cardiovascular disease
• Diabetes

During this meeting, your plastic surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery. You should arrive at the consultation prepared to provide complete information about previous surgeries; past and current medical conditions; medications you are taking, including herbal remedies and nutritional supplements; and allergies, especially those that affect your eyes.

As part of the plastic surgery consultation, your surgeon will assess the amount of excess fat and skin in your eyelid areas, the position of your eyebrows, and the condition of the muscles around your eyelids. The surgeon also may suggest other cosmetic treatments to meet your appearance goals. For example:

• A sagging brow can be tightened and smoothed with a forehead/brow lift.
• Crow's feet near the eyes can be minimized with a chemical peel, laser skin resurfacing or Botox Cosmetic.
• Dark circles beneath the eyes that can't be helped by blepharoplasty can be treated with a bleaching medication, chemical peel or laser treatment.
• Lower-eyelid muscle tone can be improved with additional eyelid surgery.

The specific method for your eyelid surgery will be determined by your features and your plastic surgeon's preferences.

Upper eyelids
Typically, the incision begins within the natural crease of the eyes inside corner and extends slightly beyond the outside corner into the crow's feet or laugh lines. Through this incision, excess skin and fatty tissue are removed. The incision line follows the natural contour of the upper eyelid and is camouflaged when healed.

Lower eyelids
Usually, the incision is concealed just below the lower lashes. Through this incision, excess skin, muscle and fat are removed. Your plastic surgeon may also make special adjustments. For example, the fat beneath the eye can be redistributed to eliminate puffiness or bulges. In some patients, the underlying muscle will be tightened.

Your cosmetic surgeon may decide that the best approach for removing fat from the lower eyelid is with a transconjunctival blepharoplasty. In this procedure, an incision is placed inside the lower eyelid.

This technique requires no external incision, but it cannot be used to remove excess skin. Laser resurfacing or chemical peel is sometimes used in conjunction with this procedure to minimize fine wrinkles near the eyes.

When the date for your eyelid procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after eyelid surgery. A number of points may be covered, including:

• Avoiding certain medications that may complicate surgery or recovery
• Stopping smoking for a period of time before and after surgery
• Arranging for help and special care following surgery

Frequently, general anesthesia is used on patients undergoing eyelid surgery. However, for some patients, local anesthesia and intravenous sedation is used. With either type, you'll remain comfortable throughout the procedure. Your plastic surgeon will monitor your physical status throughout the operation and during your recovery.

When surgery is complete, you will be taken to a recovery area. You may experience any of the following:

• Blurred vision – This temporary condition is caused by the ointment that may have been applied to lubricate and protect the eyes.
• Tightness around the eyes – This sensation will diminish once the swelling goes down.
• Discomfort – Some discomfort is common after any type of operation. It can be controlled with pain medication prescribed by your physician.
• Bruising and swelling – The amount and duration of bruising and swelling varies greatly among individuals. You can purchase camouflage makeup to help you hide the effects of surgery until the bruising and swelling lessen.

Although everyone heals at a different rate, you can expect that your recovery will follow this general timeline.

If you're like most people who have the procedure, you'll be very pleased with your new, refreshed and alert appearance. You may find that you feel more confident in business and social situations. Friends and colleagues may tell you that you appear happier or more rested, without realizing you had eyelid surgery.

Most traces of eyelid surgery will disappear after several weeks. However, the skin around your eyes must be treated with extra care for several months. When you go out during the day, you should wear sunblock on your eyelids and darkly tinted sunglasses to protect your eyes from wind and sun irritation.

The results of eyelid surgery are long-lasting. However, keep in mind that your face will continue to age. Your plastic surgeon can advise you about the best way to maintain your results.

The Centre, P.C. also recommends the use of the VitaMedica Nutritional Supplement Program, a comprehensive pre- and post-surgery nutritional supplement system designed specifically for patients undergoing plastic surgery procedures.

To learn more about eyelid surgery, or blepharoplasty, call or email The Centre, P.C. to schedule your cosmetic consultation.