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Eyelid Surgery in New York

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Eyelid surgery or blepharoplasty can create more open, larger, and brighter appearing eyes. In women, excess skin of the upper eyelid can interfere with makeup application and obscure the natural contours of the eyelid. In both men and women, loose, sagging, bulging tissues often make the eyes appear smaller and contribute to a more tired or stressed appearance. Frequently, the anatomy at the junction of the eyelid and the cheek produces a deep circle or tear trough that exacerbates the tired look you may see in the mirror.

Eyelid surgery is a very delicate procedure that is accomplished by removing loose skin and fatty tissue through very fine incisions based on careful measurements of your eyelids. Excessive removal of fat can produce a hollow, unnatural appearance, so Dr. Forley takes extra care to remove very precise amounts of tissue as needed to maintain the structure of the eyelids and allow for proper eye closure. The goal of eyelid surgery is to produce a significant improvement in eyelid appearance with the utmost safety.

In some cases, repositioning of the fat of the lower eyelid over the bony rim is performed to create a smooth transition from the lower eyelid to the cheek when a tear trough is present. Dr. Forley uses the latest techniques for releasing the deep bony attachment of the tear trough from an incision on the inside of the eyelid before transposing the eyelid fat to fill the hollow. In some cases, a non-surgical approach may be desired using hyaluronic acid fillers, such as Restylane® or BELOTERO BALANCE®, to smooth out the appearance of the tear trough.

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Is This For Me?

You should consider eyelid surgery if:

  • You have excess loose skin and fatty tissue that produces a heavy, hooded appearance of the upper eyelid or a baggy lower eyelid.
  • People keep asking you if you are tired even though you are not.
  • Your eye make-up is difficult to apply because of loose eyelid skin.
58 year old female 4 months following upper & lower eyelid surgery

The Consultation

During your consultation, Dr. Forley will ask you to describe what concerns you most about your appearance. He will also inquire about your medical history and any eye conditions that you may be important to consider before deciding on your treatment plan. Following a careful examination of your upper and lower eyelids, Dr. Forley will describe the treatment options that would benefit you including both surgical and non-surgical options. The outcome that can be expected from each approach will be discussed in detail and he will show you examples of the results from his before and after photos.

There are limits to the amount of tissue that can or should be removed from the eyelid. Excessive removal of fat can produce a hollow, unnatural appearance. In some cases, fat is preserved and repositioned to achieve the desired result. Excessive removal of skin can inhibit proper eyelid closure. The key to the best result is precise planning and selection of the appropriate technique based on careful measurements of your eyelids.

Eyelid surgery cannot remove every wrinkle from the eyelid area and sometimes is supplemented by laser treatments to enhance the final result. Differences that exist in the eyelids on both sides may be improved after surgery, but slight differences will always be present.

59 year old female 7 months following fat transposition lower eyelid surgery and temporal brow lift

Preparation

If you have any type of eye disease or symptoms, these must be carefully investigated and considered in planning your blepharoplasty surgery. After examining you, Dr. Forley may request a consultation from an ophthalmologist prior to performing surgery.

The Procedure

It is important that decisions regarding the amount of eyelid skin and fat removal be made with you in the upright position immediately prior to surgery. Measurements made with you in the sitting position enables the most accurate correction in the operating room.

By using very fine electrosurgical instruments for many aspects of the procedure, risks of bleeding and the amount of bruising following the procedure are greatly reduced, speeding your recovery.

Incisions for upper eyelid surgery are designed so that the final scar is located within a natural eyelid crease of the upper eyelid. Surgery of the lower eyelid uses incisions immediately beneath the eyelashes or on the inside of the eyelid to make them inconspicuous.

During the procedure, excess skin is removed from the upper and lower eyelids to improve the contour. If fatty tissue is producing bulges or bags, only the excess is removed to produce a natural lid appearance. If a hollow appearance or tear trough at the junction of your lower eyelid and cheek is present, fibrous ligament release and repositioning of eyelid fat across the contour depression will be performed to achieve a fuller, more youthful appearance. In some cases, fat grafts may be used to enhance the contour in the tear trough.

58 year old female 4 months following upper & lower eyelid surgery

What to Expect After Your Procedure

There is usually minimal discomfort following eyelid surgery. You’ll have some swelling for the first two or three days after surgery, but it decreases rapidly by the third day. Bruising will occur to some degree but varies from patient to patient.

When sutures are removed on the fourth or fifth day after surgery, you can immediately apply makeup to the eyelids to hide any residual traces of bruising. You can usually return to your normal activities in about a week.

The Stages of Recovery

  • Day of surgery: Usually performed as an outpatient procedure in our accredited office surgery facility. A nurse can be booked to monitor you overnight.
  • Bruising and swelling resolve: 5-10 days or less
  • Return to work, social activity: 7-14 days or less
  • Aerobic or strenuous activity: 14-21 days

We encourage a rapid return to normal activity. Strenuous exercise that would push your pulse over 100 should be avoided for about two to three weeks to prevent an increase in your blood pressure that could make you bleed.

Potential Risks and Complications

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Risks of injury to the eye, infection, or bleeding which could impair vision are extremely small, but do exist, and will be discussed during your consultation with Dr. Forley

We will give you more detailed information about these and other rare risks in our written information, and encourage you to discuss any which concern you during your consultation.

If aging changes exist in areas of the face besides the eyelids, additional procedures may be necessary in those areas for optimal facial appearance.

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1. It will be obvious that I had it done. A natural, unoperated look is the outcome that Dr. Forley strives to achieve in all of his surgical procedures. He uses advanced techniques in both upper and lower eyelid surgery to provide you with a more rested, youthful appearance. 2. I was told that removing fat would improve my lower eyelid appearance. That may be true in some cases but simply removing fat may produce a hollow appearance or may exacerbate the under eye circles, known as tear troughs, that can appear as a deep demarcation between the lower eyelid and the cheek. Dr. Forley uses fat preservation or transposition techniques to blend the lid-cheek junction to create a youthful, natural result. 3. I’m too young to have eyelid surgery Chronological age is not the determining factor in deciding on eyelid surgery. There are various anatomic reasons that can create a baggy or tired looking eyelid that may have nothing to do with your age. Dr. Forley will assess your eyelid and cheek anatomy in making recommendations for surgical improvement or present you with non-surgical options if so desired. 4. Eyelid surgery is painful. Most patients experience minimal discomfort following eyelid surgery. Although bruising and swelling will vary amongst patients, the lack of any significant discomfort is a very common experience during the recovery period. 5. I will have trouble closing my eyes after surgery. The careful measurements and precise techniques used by Dr. Forley should avoid any effect on your ability to close your eyes after surgery.
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