For patients who are looking for a more in-depth facial rejuvenation, Piedmont Cosmetic Surgery and Dermatology offers both Blepharoplasty and Facelift procedures to meet every patient’s needs. These procedures are outlined below, and more information can be found by contacting our office.
What is Blepharoplasty?
Blepharolplasty is cosmetic eyelid surgery in which excess skin, fat, and muscle from around the eyes are removed to correct droopy eyelids and bagginess under the eyes. The goal of the surgery is to create a more rested appearance and the illusion of larger, more alert eyes. Sometimes, blepharoplasty is performed to improve vision problems, particularly when excess upper eyelid skin begins to interfere with peripheral vision. The surgery can be performed on the upper and lower lids, at the same time, or separately. It is important to know that blepharoplasty will not remove “crows feet” nor will it alter rough or darkened skin around the eyes.
Upper eyelid blepharoplasty not only enhances the rested and refreshed facial appearance, but in women, provides a platform above the lashes for more convenient make-up application. The technique of upper eyelid “supratarsal fixation” more reliably assures this result. This technique also allows the cosmetic surgeon the ability to “westernize” the oriental eyelid if requested.
Lower eyelid blepharoplasty eliminates the bags which are the result of herniation of the fat pads away from the orbital rim. This occurs because of genetics and aging. When present, these bags create a fatigued or exhausted appearance. If excess lower eyelid skin is present, then excision of the redundancy can be performed.
How is the procedure performed?
Blepharoplasty can be safely performed in the office under local anesthesia. For upper eyelid surgery, the surgeon excises an elliptical configuration of skin and may remove some muscle. The herniated fat pads are then removed. The wound margins are then sutured together and may be reinforced with Steri-strips. For lower eyelid surgery, the surgeon may choose to cut in the eyelid magin itself, or directly below it. In cutting below the eyelid margin, redundant skin as well as fat pads can be removed. The wound margins are then sutured together and may be reinforced with Steri-strips.
What happens preoperatively?
Preoperative evaluation includes a thorough history, blood tests to evaluate any bleeding difficulties, and an ophthalmologic exam which includes testing for visual acuity, peripheral fields of vision, and tear production.
What happens postoperatively?
Oral and topical antibiotics are taken and applied twice a day for the week following surgery. Cool, gel-like compressions are applied continually for the first 24-48 hours after surgery. It is important for the patient to keep his or her head in an upright position for the first 24 hours after surgery. This helps to reduce swelling and bruising. Pain medications are taken for several days after surgery. Finally, dry eyes are treated with ointment at night and eye drops during the day. This typically resolves within 3-4 weeks.
- Make-up should not be applied until a couple of days after the sutures are removed.
- Contact lenses should be avoided for at least two weeks following the surgery.
- Driving should be avoided until vision has returned to normal.
What is it?
Cervicofacial rhytidectomy (facelift) is a cosmetic surgery that involves removing and tightening redundant skin of the cheeks, jowls, and neck. In most instances, the procedure imparts a rested and refreshed look and has a tendency to lessen the effects of aging from 5 to 15 years. Most patients note an alleviation of their “dis-ease” of facial aging within months of the procedure and by 6 months to one year; have a general comfort concerning their appearance. Many relate that they no longer think about their appearance after the surgical recovery period.
Who is the best candidate?
Best candidates are those patients who are seeking facelift results for themselves and are not doing it because someone else wishes for them to have it done. The best results are realized in those between 45 and 55 years of age who have reasonable expectations concerning the results of the procedure. Persons who have medical problems such as recent cardiovascular disorders (heart attack and stroke) or bleeding disorders may not be candidates for surgery.
How is the procedure done?
Tumescent facelift, the type of facelift performed at Piedmont Cosmetic Surgery and Dermatology Center, is done in an in-office surgical suite. Tumescent solution, which contains lidocaine and epinephrine, is injected under the skin to anesthetize the area and reduce bleeding. The solution also helps to establish the surgical plane in which the surgeon will be working. Chin liposuction may be performed prior to the surgery to reduce excessive fat in this area. Next, the surgeon cuts the skin in front of, below, and behind the ears. The skin is lifted and separated from underlying structures by a process called undermining. This undermining also establishes the cheek and neck flaps. The surgical plane that is created is well above the muscular layer, which contains vital nerves that allow for facial expression. The surgeon then tightens the underlying muscles with 4 to 10 non-absorbable sutures and cuts away ½ to 2 inches of redundant skin of the cheek and neck flaps. The surgery is completed by suturing or stapling the skin of each flap with the skin on the temporal scalp, the skin surrounding the ear, and the skin next to the posterior scalp. Most facelifts are performed in less than 4 hours.
What happens postoperatively?
Dressings are changed daily for the first two days after surgery. Sutures and staples are removed between 7 and 14 days. Scars are expected but should be minimal, particularly those in front of each ear. Swelling and bruising is greatest during the first week and resolves in 1 to 3 weeks. Most people can get out in public in 7 to 10 days and return to work in 14 days.
How long will the results last?
Most patients are satisfied with the results of their facelift and enjoy a youthful, refreshed appearance for 5 to 10 years. Some elect to undergo second and possibly third facelift procedures with excellent results, although subsequent facelifts are more technically demanding.
What are the potential complications?
While most people experience minimal difficulties with a facelift procedure, it is possible to experience one or more of the following:
- Skin infection
- Blood collection under the skin (hamatoma) or excessive tissue fluid under the skin (seroma)
- Nerve damage
- Persisting numbness around the ears