Question:

Can I be too old or too young for eyelid surgery?

Answer:

There are two groups of patients that seek eyelid surgery:

(1) younger patients, who genetically have heavy upper lids or baggy lower lids

(2) people in or around their 40s, who may notice gravitational changes to the area around the eyes, like excess skin in the upper eyes , or bulging “bags” in the lower eyelids from fat, or both, creating a “tired” or old appearance.

Eye surgery is thus a personal choice based not only on age, but on your particular anatomy and inherited traits. It is always important to have a personal evaluation to assess your particular goals.

Question:

Will a lower blepharoplasty remove the dark circles under my eyes?

Answer:

In some cases, performing a lower blepharoplasty with fat transposition (i.e. moving the lower eyelid fat from bulging areas to sunken-in areas) may significantly reduce the appearance of dark circles, as the fat creates a more youthful appearance by filling thinner spots under the skin. This changes the reflection of light, decreasing the appearance of dark circles.

Question:

My eyes are noticeably asymmetrical. Can blepharoplasty make my eye look more symmetrical?

Answer:

The human face is by nature asymmetrical. It is normal to have, and expect slight asymmetries from one side to the other. Patients that have severe asymmetries due to previous surgery, or genetics may benefit from eyelid surgery to soften the asymmetries, but not eliminate them.

Question:

Will upper lower blepharoplasty reduce the wrinkles (like crow’s feet) around my eyes?

Answer:

Eyelid surgery deals with gravitational changes, mainly skin and fat. During the aging process our skin looses its collagen, which causes the skin to become thinner and less pliable. Those developments change the skin composition and create more wrinkles. Because of those changes, the skin needs to be treated so as to minimize the appearance of wrinkles. Depending on your genetics and lifestyle, different options may be available to minimize wrinkles, such as lasers or medical grade chemical peels.  The aging process is different in everyone, so you will need a consultation with Dr. Siegel to form a plan for your unique situation.

Question:

Will eyelid surgery make me look surprised or startled all the time?

Answer:

When an experienced, technically skilled, and judicious plastic surgeon performs any procedure, the typical goal is to create a younger version of you, and not necessarily a different version of you. Your outcome should draw praise from friends and family.

Many people had plastic surgery with natural-looking results, such that no one would know they had plastic surgery.  But it’s the bad outcomes that inherently get all the attention. You can achieve a balanced, more-youthful appearance by choosing the right surgeon.

Question:

Will eyelid surgery make me look like I’m of a different race?

Answer:

If done incorrectly, yes (unless you want to adopt characteristics associated with a different ethnicity).

Good eyelid surgery typically is not that extreme.  Performing a balanced, gentle and harmonious eyelid procedure should bring out the natural crisp and youthful appearance that your eyes may have lost as part of the aging process. Dr. Siegel’s approach is to reverse the signs of aging around your eyes to make you look a younger version of you, not a different you.

Question:

Will eyelid surgery alter my facial expressions?

Answer:

When performed correctly, blepharoplasty makes you appear more rested and more youthful, but not like a different person or a stoic version of yourself.  It will not change your expressions or the way you express yourself to others. There are various approaches to blepharoplasty, though, so it is crucial for you to meet with the right facial surgeon to ensure that your results match your expectations.

Question:

Will eyelid surgery make my eyelids harder to close?

Answer:

Dr. Siegel has performed thousands of eyelid surgery procedures.  By taking very precise measurements and markings before your surgery, he ensures the right balance between removing redundant skin and preserving the skin you need. His experience ensures your results are natural and functional, so that you can close your eyes without any tension.

Question:

Is eyelid surgery the same as “Westernization” surgery?

Answer:

Asian eyelids are anatomically different from Caucasian eyelids:  there is a less-defined crease or no eyelid crease, while more fat and an extra skin fold is present.

Westernization of the eyelids, performed on patients of Asian descent, is a different type of surgery from the traditional Caucasian eyelid surgery. By altering its anatomical features it creates an upper eye similar to those in Caucasian eyes.

Question:

I’ve already had eyelid surgery from another surgeon, but am not satisfied with the results. Can Dr. Siegel help me?

Answer:

Revision or touch-up surgery is often performed to correct or improve on a procedure that resulted in less-than-ideal results. Revision eyelid surgeries are usually more complicated, as the surgeon will have to contend with existing scar tissue from the initial surgery. Each case is different, and a thorough evaluation will be required to asses what is possible and to ensure your goals are realistic and can be achieved.

Question:

Are there non-surgical alternatives to eyelid surgery that can give me similar results?

Answer:

The gravitational changes to the face become noticeable in most people in their early 30’s, and non-surgical options when performed correctly may reverse some signs of aging and restore or preserve your youthful features. As the aging process continues into the late 30’s, injections will have a diminishing effect, regardless of the amount used.

Fillers, though very popular, tend to have many drawbacks. In particular, and in the last several years, I have significantly reduced using fillers, especially around the eye area, for multiple reasons.  One is that they make dark circles appear.  Also, because fillers are designed to absorb water, patients’ salt intakes may make them appear swollen. Women patients tend to appear puffy certain days during their menstrual cycle, and I have also found that the longevity of fillers is too variable.  That is important because if patients are dissatisfied with their outcome, they may not get the expected reversal of filler results promised by the manufacturer.

A word on laser and energy devices.  These devices have exploded in popularity. In my experience, a laser can be used appropriate for skin rejuvenation, but not for lifting. Often I see patients who have undergone multiple treatments to various parts of the face to lift saggy structures, and not only are they disappointed with the lack of any visible results, but also invariably those patients have a compromised blood supply and have developed new scar tissue.  Those issues make further surgery more difficult to perform and they put the patient at a higher risk of complications.

Question:

Can I combine eyelid surgery with other surgeries?

Answer:

It is very common for patients to combine eyelid surgery with other facial rejuvenation procedures.  That’s because of convenience, and because is aging process is not confined only to the eyes.  To achieve better balance many patients choose to combine eyelid surgery with a brow lift or a facelift.

Question:

Should I also get a brow lift with my eyelid surgery?

Answer:

Facial aging is unique to each person. Which areas or structures can or should be addressed with eyelid surgery is best determined at the time of consultation. For that reason Dr. Siegel does not make general recommendations, and can only provide recommendations after a consultation.

Question:

I don’t know anyone who can help take care of me after eyelid surgery. What should I do?

Answer:

The effects of anesthesia and the pain medication may impair your ability to function normally for a few days after surgery.  That is one of the reasons having a responsible party stay with you is important. If nobody is available to help you after surgery we can put you in touch with a recovery nurse.  Although that will involve a separate fee, it will prevent any mishaps and help you heal smoothly after surgery.

Question:

Do I need to stop eating before my eyelid surgery?

Answer:

The type of anesthesia used will vary, depending on your comfort level and the procedure you are having. For procedures performed under local anesthesia – similar to going to the dentist – no special preparation is required. For safety reasons, patients undergoing any sedation (through an IV or general anesthesia) must stop eating and drinking at midnight prior to your morning surgery.

Question:

What should I wear during the surgery?

Answer:

We suggest patients wear comfortable and loose fitting clothes and easy-to-change shoes the day of your surgery. that will ease your transition before and after surgery from your surgical gown.

Question:

How long does a blepharoplasty operation usually take?

Answer:

Surgery time is dependent on each surgeon’s skill and experience, and on how challenging a particular surgery is. A longer or shorter surgery time does not signify a better or worse outcome, but the skill of your surgeon does.

Though every patient is different and Dr. Siegel’s goals is to achieve the best possible result, not rush through surgery.  On average, upper eyelids surgeries take under 1 hour, whereas lower eyelids are more involved and generally take 60-90 minutes.

Question:

Do I need to take time off work for eyelid surgery and the recovery period?

Answer:

Expect a small amount of swelling and bruising after surgery. Because most people do not like to announce that they just had cosmetic surgery, most patients take about 5 days off work.

Question:

Will I be able to see right away after eyelid surgery, or will my eyes be bandaged up?

Answer:

Although you should be able to see after eyelid surgery, you vision may be blurry for a few hours due to the lubricant ointment placed at the beginning of surgery.  Your surgery will be performed safely, and a lubricant ointment (similar to Vaseline) will be applied to your eyes during surgery. Usually there is minimal discomfort and swelling after surgery, and bandages are not required.

Question:

How much pain will I be in after eyelid surgery?

Answer:

The eye area is sensitive. Dr. Siegel’s approach to gentle surgery, combined with the use of a long-lasting local anesthetic, ensures that discomfort will be minimal after surgery. While you will get pain medication, most patients find that plain Tylenol is sufficient to manage any mild discomfort that may persist after the local anesthetic has worn off.

Question:

How much bruising and swelling can I expect after eyelid surgery?

Answer:

Dr Siegel’s extensive experience with facial surgery allows him to handle tissues in a gentler fashion.  He also uses the least-invasive approach by maintaining the supportive structures of the face.  This translates to more-natural results and shorter healing times.

It is important to discontinue any over-the-counter medications, such as ibuprofen or aspirin, at least 2 weeks prior to surgery to minimize bleeding and swelling. Most patients have minimal swelling and bruising, and will look presentable in public a few days after eyelid surgery.

Question:

How long will it be after eyelid surgery before I can take a shower?

Answer:

You can shower about 24 hours after eyelid surgery, generally.  Patients are able to shower the day after surgery. We ask patients to be gentle when washing their face and eye area, to prevent any stitches from coming loose. Usually a light ointment is applied to the incisions for the first few day to maximize healing.

Question:

Will I need to sleep on my back while recovering from eyelid surgery?

Answer:

Dr. Siegel’s approach involves a gentle surgery that results in minimal bruising and swelling. To aid in your recovery you should sleep at a 30-degree angle, or the equivalent of about 2-3 pillows under your head. Though we recommend sleeping on your back (if possible) to prevent accumulation of fluid on one side of the face, some patients find it more comfortable to side-sleep with the head elevated.  In our experience this position does not slow recovery, as long as you remain elevated.

Question:

When can I start wearing glasses or contacts again after my blepharoplasty?

Answer:

Glasses can be worn immediately after surgery. Depending on the type of eye surgery you had (upper, lower, or both) and how you put in your contacts, to avoid traction on the eyelids Dr. Siegel may recommend no contact lenses for around 7-14 days. Your particular case and individual instructions will be discussed at your pre-op visit.

Question:

How long will there be stitches in my incisions?

Answer:

The skin around the eyes heals very quickly.  Dr. Siegel uses a combination of very fine absorbable and non-absorbable stitches for the upper eyelid incisions. The sutures are usually removed 5-7 days after surgery. Most lower eyelid surgeries are performed from inside the eye, so no stitches are required.

Question:

Can you give me dissolving sutures?

Answer:

Dissolving sutures are made of animal material, which produce more local inflammation, which means the incisions stay red for longer. Using non-absorbable stitches allows for incisions that fade to your natural skin color more quickly.  Many patients are afraid on the pain associated with removing sutures from the eye area. That is an understandable fear, but an unnecessary one: Patients experience no discomfort a week after surgery when the sutures are removed.

Question:

When can I resume exercise or do strenuous physical activity after eyelid surgery?

Answer:

Once the stitches have been removed, it takes several weeks for the internal tissues to heal. Increasing your heart rate, heavy lifting, and bending your head below your waist may cause your incisions to open and bleed, slowing the healing process.

Avoid strenuous exercise for about a month after surgery.  But you can resume light exercise 1-2 weeks after surgery.

Question:

How long after eyelid surgery before I can wear makeup again?

Answer:

Makeup can be worn on the face the day after eyelid surgery, so we ask our patients not to wear any cosmetic eye products on their upper eyelids until sutures have been remove, about 5 days after surgery.

Question:

I get keloid scars easily. Can I still have the surgery?

Answer:

Yes.  Keloid scars are made by certain cells, and specific parts of the body, such as the abdomen.The eyes do not have keloids producing cells. If you have gotten keloids from other procedures, you are still safe to undergo eye surgery without keloid formation.

Question:

How soon can I start smoking again after surgery?

Answer:

Smoking slows down your healing by lowering the amount of fresh blood tissues receive. A non-smoker will always heal faster than a smoker, because oxygen is vital for healing and non-smokers can breathe in more oxygen more easily.

Dr. Siegel recommends not smoking at all after surgery, because your chances of complications increase. Some patients find it hard to quit completely during that time, in which case reducing the number of cigarettes or your time smoking each (or both) lowers your risk of complications somewhat.  The less you can smoke, the better.

Question:

Should I switch to a nocturnal gum or patch?

Answer:

No. Using nicotine or patches actually delivers a higher concentration of nicotine in your blood.  It does decrease your cravings for cigarettes, but it actually slows down your healing even further than smoking.

Question:

How soon can I drink alcohol again after eyelid surgery?

Answer:

Alcohol, like nicotine, impairs your healing. Furthermore, alcohol may interact with medications used during anesthesia, as well as your medications taken after surgery-mainly antibiotics and pain pills. For those reasons we do not recommend you consume any alcohol even right after you have finished all your prescriptions.  The longer you can avoid alcohol, the better.

Question:

If eyelid surgery can be performed with a CO2 laser instead of with a scalpel, which one is better?

Answer:

There are many tools to perform the same procedure, results will be mainly dependent on what your particular surgeon feels comfortable using, not necessarily on the device or tool used. While lasers are “cooler,” they do not necessarily produce better results.  Dr. Siegel prefers not to use CO2 laser for the surgery itself, because the heat produced by the laser slows down overall healing. He frequently will use CO2 to treat the skin around the eyes, for rejuvenating purposes only.