The eyes have it. What is “it”? Your eyes speak volumes. They can show your emotions, sparkle when you are full of joy, and they also can show signs of aging. You may be noticing that your wrinkles seem to be spreading like a crack on a broken windshield. Or maybe your eyes look hollow with a puffy pouch of weariness beneath each eye. As you age, your eyes are the first to show your age and should be the first part you attempt to fix.

Why are the Eyes the Most Vulnerable?

The skin that surrounds your eyes is extremely thin and sensitive. This is why this area (your eyelids and under-eye area) easily loosens, gets thinner each year, begins to bag and sag, and is likely to fall prey to laxity caused by aging. The undereye tissue naturally doesn’t have much soft tissue. There’s no fat or muscle in that area, therefore, the chances of the skin starting to appear sunken in with age are highly likely, especially since this is the portion of your flesh that is covering the eye socket where there is empty space in your skull. Dark circles and those annoying bags that can appear under the eyes can be caused by not getting enough sleep and/or dealing with too much stress. For some people, the skin under the eye is thinner than most and they constantly deal with the circles and puff no matter how well-rested and at ease they are.

What Options Do You Have For Treatment?

There is a multitude of at-home products you can try, but there are also treatments you can have performed by a trustworthy doctor. Blepharoplasty is surgery performed on the eyelids to improve the health of the skin and bring a more youthful appearance to the eyes. The surgery can be performed on either the upper or lower lid, but some patients have both done.

What Problems Can Eyelid Surgery Treat?

Some people have eyelid surgery due to functional issues with the lids of their eyes, others opt to have the surgery to “fix” something they do not like about their eyes. No matter what the reason, the surgery will serve to renew the under-eye and eyelid areas of the eyes. Some specific issues that are treatable with eyelid surgery are:

• saggy loose skin creating bulky folds that disturb the upper eyelid’s contour (can sometimes be so severe that it causes vision impairment)
• deposits of fat in the eyelid that make them appear to be puffy or swollen constantly
• under-eye baggage
• lower eyelids that droop so severely that the white below the iris can be seen
• extra skin on the lower lid

Are You A Good Candidate for Blepharoplasty?

Some people may want to have a rejuvenation procedure done on their eyes not realizing they’re actually not a good candidate. To be considered a good candidate for the procedure you must be:

• a healthy person who has no medical problems that would slow the healing process post-op
• a non-smoker
• clear of any eye conditions that are considered to be serious in nature

The lids of your eyes are a part of your face. If you are seeing a droopiness to your upper eyelid, it could possibly be caused when the forehead and brows are in a relaxed state. The doctor you choose as your doctor will decide if you need eyelid ptosis (requires a different surgery).

In-office Consultation

At a face to face in-office consultations, the Doctor will go over all of your options and the two of you can come up with a comprehensive surgical plan for you.

Whether or not you are a first-time patient, or you’ve had several procedures, you should have an in-office consultation to discuss concerns and goals, says Dr. Anthony Bared, a Miami-based surgeon who specializes in facial surgeries such as blepharoplasty. Together you will come up with your treatment plan. During the consultation, Dr. Bared may recommend that you have a different procedure done, or possibly a combination of procedures as an approach to reaching your cosmetic goal and maintain a natural look post-op. This may include a facelift or laser resurfacing.

Dr. Bared also analyzes his patient’s medical history. He will overlook and conditions that may cause this elective surgery to be a risk. There are some health-related issues that Dr. Bared can require to be managed better before he will perform the surgery. The doctor may order some tests from the patient’s PCP as a safety precaution.

How Eyelid Surgery is Performed

Eyelid surgery usually doesn’t have to be under general anesthesia. Both Upper and lower eyelids can be performed under local anesthesia with no dangerous risks involved. Occasionally, Dr. Bared will combine local and or with Intravenous sedation as an added measure of insurance on the comfort of his patient. The surgery can be done with such high levels of discretion that the sutures can be hidden in the creases of the lid skin or on the inside of the lid.

Keep in mind that a patient cannot make their way home on their own. A driver is required to get home or to the place where they are lodging. Post-op assistance is needed for at least 24 to 48 hours after the surgery. Someone must be there to assist the patient with all their needs. The anesthesia used combined with medication prescribed for relief of pain during recovery can make the patient feel very fatigued and a bit foggy. Additionally, the eyes will be very swollen for the first few days.

Upper Eyelid Blepharoplasty

Dr. Bared can access the tissues of the eyelid crease when he performs upper eyelid surgery. He will have marked guidelines on the eye which he draws on before the surgery begins. The guidelines give him a precisely detailed line, he will use his expert hands to cut away the excess skin from the eyelid and create an alert and youthful look by altering the muscle of the eyelid.

It is not uncommon for surgery on the upper eyelid to be combined with a forehead lift. This double procedure serves to adjust the position of the brows and smooth wrinkles that may be in the forehead. If the combo-procedure is performed, the forehead is worked on first so that no adjustments need to be made to the lids if tension is created by the forehead lift.

Lower Eyelid Blepharoplasty

When operating on the lower lid, the incision may be created inside of the mucous membrane of the lid so that it’s hidden by the line of eyelashes. This gives access to the tissues for the procedure without disrupting the areas surrounding the eye.

When fat pads migrate into the eye, this can be repositioned during the procedure. This will likely address both puffiness and a hollowed look in the under eye. A fat transfer can be performed as well using fillers to re-contour the eye and create a natural framing for the eye that is youthfully attractive.

The Recovery

After the surgery, you will need a bit of time to recover. The following day there will be obvious swelling and bruises. The swelling and bruising will start to ease within a couple of days and should be unnoticeable after a few weeks.

During the first two days, you will want to use ice packs to assist with bruising and swelling. Bandages should remain on the eyes to protect any infection or debris from getting into the incisions. After a few days, the dressings can be left off if the patient is comfortable. It can be up to a week before the stitches in the incision can be taken out.

There are dissolvable stitches that can be used so having to see the doctor for suture removal isn’t required. Without ten days, the patient should be able to carry on a normal walk of life and go back to work. Once it’s been two weeks, any side effects from the surgery should have subsided completely. If medicated eye drops are prescribed, take them as instructed and do not stop until your label says you should. If you wear contact lenses, you should not start using them again until your doctor says you should.

Laser Skin Resurfacing for the Eye

Laser skin resurfacing is also referred to as a peel (by laser). The procedure is safe for minimizing eyelid wrinkles and reducing the baggage beneath the eyes.

CO2 Laser Skin Resurfacing can improve the appearance of:

• acne scarring
• skin spots from liver damage
• aging skin
• skin damaged from the sun
• laugh lines (around the eyes, mouth corners, and across the forehead)
• complexion
• scars that superficially stemming from an injury
• unresponsive skin post-facelift

No matter if you choose to have laser resurfacing, eyelid surgery, or a combination of several procedures, be sure you are comfortable with your physician. The in-office consultation is a time when you can be prepared to ask any questions you feel are important in gauging whether you want this particular doctor to be your doctor.