AGING AND HANGING SKIN FROM EYELIDS REMOVED PERMANENTLY. GUARANTEED!
ALL OF OUR SURGERIES ARE PERFOMED UNDER LOCAL ANESTHESIA WITH MINIMAL SIDE EFFECTS AND LITTLE DOWN TIME.
PRICES START AT $995.
The lower eyelid surgery
Surgery Videos-Graphic Images
It is extremely critical that a surgeon that operates in the lower lids must have an ophthalmology background as the lower lids are known to re-bleed and cause blood to pool at the back of the eye causing blindness. Therefore, patients must choose a surgeon carefully and ask the question, " Dr. if there is a complication with the surgery, and there is a blood in the back of my eyes, who would fix it." Most surgeons cannot handle this type of emergencies.
What is a Blepharoplasty or eyelid surgery?
Blepharoplasty or eyelid surgery, also known as cosmetic eyelid surgery is a surgical procedure that rejuvenates the eyelids. It can be performed on the upper eyelids, lower eyelids, or both. This is perhaps the area in cosmetic surgery that requires the surgeon to be the most “ultra conservative.” Aggressive surgery in the eye can leave the patient with irreversible changes that may severely affect the function and the aesthetics of the eye.
Dr. Araya customizes the Blepharoplasty or eyelid surgery in Washington dc surgical clinic for each individual. He avoids removal of too much fat to avoid the “sunken eye” look. On certain patients he uses fat to fill the tear trough and smooth the eyelid-cheek junction. He is meticulous and conservative so that the shape of your eyelids will never change.
Lower Eyelid Bags
The lower eyelid may age in one of two ways. There may be premature eyelid aging, which is hereditary. People with this hereditary condition begin to demonstrate lower eyelid “bags” during the late twenties and early thirties. Most people, however, begin to show signs of eyelid aging in their early forties.
As the lower eyelid ages, the fat that surrounds the eye begins to accumulate under the eye and develop the “bags” that are visible. The skin also begins with age and develops wrinkles. The eyelid muscle can descend and give the eyelid a droopy look. As the malar fat (cheek fat) pad descends, a loss of volume can develop between the lower eyelid and the cheek. This creates a line that sharply demarcates the lower eyelid from the cheek.
The lower eyelid surgery
The goal of the lower Blepharoplasty or eyelid surgery is to provide a smooth lower eyelid contour that blends with the cheek. This is done by removing the fat that protrudes underneath the eye, removing some of the excess skin, and then elevating and repositioning the eyelid muscle. This must be done in a manner that will maintain the patient’s natural eyelid shape and avoid any malposition. Malposition is the name given to describe the change in the lower eyelid position that can occur from a poorly performed Blepharoplasty or eyelid surgery.
The lower eyelid Blepharoplasty or eyelid surgery can be performed via two different methodsin our Washington dc surgical clinic. The skin muscle flap technique is performed through an incision just underneath the eyelashes. The skin and muscle are elevated to reach the fat pockets. The fat pockets are then removed. The amount removed must be just the right amount. If too much is removed, the eye may appear hollow after surgery. If too little is removed, then bulges will still be visible after surgery.
After the fat is removed, I tighten the eyelid muscle. This allows the contour of the eyelid to blend with the cheek. It also tightens the eyelid to prevent any eyelid malposition. The incision is then closed with tiny continuous stitch. This is my preferred technique for most patients that have lower eyelid aging. The technique allows me to remove the excess fat and tighten the eyelid muscle. The combination of these two rejuvenates the lower eyelid and cheek complex.
The second technique is the trans-conjunctival technique. I prefer to use this technique for young patients that need little to no skin removal or patients with very prominent eyes. The trans-conjunctival technique involves an incision inside the eye to access the fat. The fat is then removed and a small pinch of skin may be removed, if necessary, from underneath the eyelashes.
Lid Surgery Post Op Instruction
MEDICATIONS
• Antibiotics. Start your antibiotics Keflex 4 times a day and if you were given Cipro, take it twice a day.
*Pain Medication. Take Tylenol over the counter as needed. DO NOT take any other painkillers without the clearance from the surgeon.
• Eye Ointment. DO NOT apply Ophthalmic Eye Ointment to cover any visible incisions unless cleared by the surgeon.
*Artificial eye drops ( upper lids and lower lids)- use every 2-3 hours as needed for dryness or burning sensation
*Antibiotic eye drops (lower lids only)- use as prescribed on the medication bottle.
• Constipation. Sometimes decreased physical activity as well as pain medications may lead to constipation. Any over the counter stool softener such as Metamucil or Colace can be used.
• Nausea. Some pain medication/antibiotics may make you feel nauseated. It is best to eat something small 20 minutes before taking pain medication. Keep hydrated with small sips of non-caffeinated beverages
• Medications to Avoid. Avoid medications containing aspirin or ibuprofen (Advil, Motrin, Ibuprofen, aleve, aspirin others) for two weeks before and after surgery. These medications will increase bleeding.
• Substances to Avoid. Avoid alcohol, nicotine, and caffeine, for these will dramatically slow the healing process.
NIGHT OF SURGERY
• Ice Compresses. Apply ice compresses made of gauze sponges that are dipped into iced water (not an ice bag) to your eyes for 15-20 minutes every hour for the first two days while you are awake.
• Head Elevation. Stay upright and do not lay flat. Keeping your head elevated will minimize swelling. Continue this for one week.
NUTRITION
• Diet. A light low-fat diet is best after surgery. You may start a regular diet after your surgery as long as you are not feeling nauseated or vomiting.
• Hydration. Stay hydrated. Avoid alcohol for 48 hours and while you are still having to take pain medications.
BATHING • You may wash your hair and face the next day after your eyelid surgery. Do not cleanse the eye area and avoid submerging your face in water.
• Hot Tubs/Baths/Swimming Pools. No tub baths or Jacuzzi until your incisions have healed, and approved by your surgeon.
HOW TO TAKE CARE OF YOUR INCISIONS
• Cleaning your incisions. Occasionally, crusting will occur around the sutures. This is normal and will resolve. You can gently wash your eyes with baby shampoo and clean your incision with hydrogen peroxide on a q-tip if this occurs. Do not try to pull off any crusts. Showering daily will minimize crusting.
• Sun Exposure. Avoid and minimize sun exposure. Even a mild sunburn can worsen swelling and irritate an incision that is healing.
• Scar gel. Do not apply unless cleared by the surgeon.
Healing stages
• Swelling and Discoloration. It is completely normal for your eyes to appear swollen as well as have purple-bluish bruising around the eye and eyelid. The bruising will be greater on the second and third day after your surgery. This is temporary and over the course of the next 1-2 weeks this will improve. Cool compresses will minimize swelling and bruising.
• Mild Bleeding. Some mild bleeding is not unusual at the incision sites the first few days after surgery. If you try to do strenuous activity, increase your blood pressure by straining on the toilet, sneezing, heavy lifting or bending forward you will aggravate the bleeding and swelling.
• Numbness around the eyes. Parts of the eyelids may feel “numb” or lumpy after the eyelid operation. This is temporary and to be expected and may take months to feel normal again.
• Pain and Itching. You may experience some itching during the healing process. This is normal and it starts after 5-7 days and will resolve in a few weeks.
• Blurry Vision. Patients often experience some blurring of vision for 2-3 days after surgery. This is generally due to swelling and/or ointments that have been used during surgery.
• Suture. We use absorbable suture but at your first post-op office visit your sutures will be removed if needed and the progress of your healing will be assessed. Sutures are usually removed 5-7 days after your procedure. Subsequent office visits are important in order to monitor proper healing.
• Weak or Dizzy. You may experience some weakness or dizziness- this is rare. This may be more evident if you try to stand up too quickly. Take a minute to go from lying down to standing. The sensation of feeling lightheaded will get better in a few days as well as by staying well hydrated.
• Scars. After all stitches have been removed, the scars will appear a deep pink color. With time, the pink will fade and become white, the firmness of the scar will soften, and they will become less noticeable. There will be “bumps” on the entry points of the sutures that will clear over time. Each individual varies with respect to healing, but it takes approximately a year for these changes to occur and the scars to look their best. Once your surgeon advises you, you may apply a Silicon based scar gel to your scar for enhanced healing.
• Final Result. Expect to see your final result from 4 weeks up to one year as the healing process takes time.
ACTIVITY
• Glasses. You may wear sunglasses and eyeglasses the day after surgery
• Limit Strain on the Eyes. The less TV, computers, phones and other screen devices the less strain on your eyes and better your healing and recovery.
• Driving. Do NOT operate a vehicle or make important decisions until you have been off pain medications for 24 hours. Use good judgment.
• Return to work. Most patients require approximately 2-7 days off work depending on their job responsibilities. Depending on the amount of physical contact your job involves and also the amount of swelling and discoloration you develop you can decide when you are ready to be in the public eye.
• Exercise. Normal activity can be resumed a few days after surgery. You can resume an exercise regimen in approximately 3 weeks after surgery, though start easy and build back up to your previous exercise levels. Just know that swelling may transiently be worse with exercise.
• Travel. Automobile travel can resume immediately. Airline travel is restricted until 1 week post op. You will notice increased swelling with airline travel and this can happen even 6-8 weeks post op related to the pressure changes that occur.
DON'TS
• DO NOT place anything frozen directly on the skin.
• DO NOT submerge your face in water or get your eyelid incisions wet while the incisions are still healing.
• DO NOT take Aspirin, Ibuprofen, Naproxen or other blood thinners until your surgeon advises you it is safe.
• DO NOT apply make-up to the incision lines or the eyelids for one month.
• DO NOT wear fake eyelashes or contact lenses for two weeks.
EMERGENCY SITUATIONS – WHEN TO CALL THE EMERGENCY NUMBER OF DR. ARAYA (202-340-8856) OR GO TO THE HOSPITAL. Emergencies are rare for lid surgeries.
• Signs of Infection. Spreading redness, worsening swelling, increased drainage or drainage of pus, worsening pain and warmth at incision site. Temperature over 100 degrees Fahrenheit.
• Excessive Bleeding. Bleeding that persists after applying pressure for 20 minutes.
• Medication Reactions. If you develop hives, rashes or itching you may be having a medication allergic reaction.
Most of all, BE PATIENT during the healing process. If you have further questions, you are urged to call the office at 202-452-1332 or call/text the Surgeon. We are here to help you through each step of the way!
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