(949) 346-1279
4501 Birch Street, Suite B
Newport Beach, CA 92660

Blepharoplasty Orange County Blepharoplasty Eyelid Surgery

BLEPHAROPLASTY INTRODUCTION

Blepharoplasty is a surgical procedure designed to rejuvenate the eyes by removing excess skin or fat and by repositioning and reinforcing surrounding tendons. Blepharoplasty can be both a functional and cosmetic surgery. Your surgeon at Orange County Plastic Surgery in Newport Beach will utilize the latest, most innovative techniques with years of experience to produce visually stunning results. The following information has been prepared to familiarize you with facts about the surgical procedure known asblepharoplasty. You are requested to read this information thoroughly and to discuss any questions, which might arise, with your surgeon before you proceed with the surgical procedure known as blepharoplasty. You are also requested to keep this form as a reference for instructions in the post-operative period. Blepharoplasty is designed to remove excess skin and bagginess, or to rearrange the fatty deposits, to

 give the eyes a more youthful appearance.

It must be understood that most of the wrinkles around the eyes are etched into the skin and cannot be removed by a blepharoplasty procedure, without the addition of a skin wrinkle treatment.

Blepharoplasty is designed to improve your appearance as much as possible at the present time. One must accept the judgment of your plastic surgeon and realize that he will remove or reposition as much of the excess or drooping tissue as he feels can be safely taken done in order to obtain the optimal result for each patient. If a blepharoplasty patient presents with droopy brows, it may be impossible to obtain a significant improvement of upper eyelid appearance without first raising the brows. The blepharoplasty procedure by itself (without a brow lift) does not improve droopy eyebrows. In fact, removing excess upper eyelid skin in someone with low brows may cause the brows to droop further. Your surgeon may discuss a forehead lift with you if he feels that a significant portion of your problem is caused by a low brow position.

Before&After

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Blepharoplasty Patient 3031

35 year old male before and after an upper eyelid blepharoplasty and rhinoplasty

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Blepharoplasty Patient 3032

50 year old female before and after a lower eyelid blepharoplasty, brow lift and facelift

BLEPHAROPLASTY PREOPERATIVE PREPARATION

You may visit your surgeon as many times as you wish to have all of your blepharoplasty questions answered. At your final preoperative visit, your final blepharoplasty questions will be answered and you will confirm that you have understood the procedure to be performed, that this material has been explained to you, that you have read and understand these information sheets, and that you accept the risks by signing the informed consent forms. You will be given prescriptions for pain and anti-nausea medication and instructions for their use. As with all other elective procedures, the patient should avoid ibuprofen (Advil®), all Aspirin® products multi-vitamin preparations is not harmful), and all anti-inflammatory products for two weeks before blepharoplasty surgery, as these inhibit

the clotting mechanism, increase your chances of unnecessary operative bleeding and subsequent bruising. All blepharoplasty patients will be asked to stop smoking at least a month prior to blepharoplasty surgery in an effort to maximize your body's ability to heal the incisions following the blepharoplasty operation.

For a few days prior to the blepharoplasty surgery, thoroughly cleanse your face with one of the MD Performance® Professional Skin Care line of cleansers.

Certain laboratory tests will also be required within two months of blepharoplasty surgery. If you are over the age of 50 or have had any history of cardiac problems, you will have to obtain a cardiogram by your family physician or any state licensed laboratory. You may have blood drawn by our office nurse during your final blepharoplasty preoperative visit, or, if you prefer, at your family doctor’s office or any laboratory (e.g. Kaiser Hospital, etc.).

Regular makeup may be worn until the night prior to blepharoplasty surgery, but please pay extra attention to insure removal of your makeup the night beforeblepharoplasty surgery and wash your face again thoroughly on the morning of your surgery with a MD Performance® cleanser. Do not apply anything (including moisturizers) to your eyes or face on the morning of blepharoplasty surgery, and please check one last time to make sure your mascara and eyeliner have been removed.

Do not eat or drink anything (except medications prescribed by your surgeon or your personal physician) after midnight prior to blepharoplasty surgery or as instructed by your anesthesiologist. Wear loose fitting clothing to the Newport Beach Orange County Surgery Center, which will be easy to get into after the operation (a shirt or sweat suit with a zipper or buttons is ideal). Do not wear anything that has to be pulled over your head - a garment with a zipper or buttons is recommended.

Your anesthesiologist may call you the night before blepharoplasty surgery to discuss the anesthetic care plan with you. But if you miss the call or your anesthesiologist does not call you, do not worry as you will be able to discuss your anesthesia and have all your questions answered in the morning, at the Surgery Center prior to your procedure eyelid surgery to remove excess skin in Newport Beach (Orange County Surgery Center in Newport Beach, Southern California or the Tracy Surgery Center in Northern California). It is imperative that someone drive you to the surgical facility and accompany you inside on the day of your blepharoplasty surgery. When you arrive at the Surgery Center, the receptionist will record the name and phone number of the person who is to take you home. You must make arrangements to have a responsible adult spend the rest of the day and the first post-operative night with you. You will not require much “nursing care” but it is not safe to be by yourself while your mind is not clear, shortly after receiving anesthetic medications.

BLEPHAROPLASTY OPERATION

The blepharoplasty operation is performed using local anesthetics with intravenous medications, or under a light general anesthetic, to make you comfortable throughout the blepharoplasty procedure. The anesthesiologist will administer the medications and monitor you to ensure your safety and comfort. The blepharoplasty incisions are placed in the normal skin folds of the upper lids, and or beneath the eyelashes of the lower lids or just inside the lower eyelid. Because incisions are placed in natural skin creases and such creases are not symmetrical from one side to the other, each patient’s blepharoplasty incisions will look significantly different during the healing phase. The approximate operating time is two hours for four eyelids. The delicate sutures are removed five to six days post-operatively.

In most instances, these scars will be difficult to see after healing has occurred.

BLEPHAROPLASTY POST-OPERATIVE CARE

All external incision should be cleansed with peroxide on a Q-Tip and a light layer of Vaseline applied four times per day. Patients can expect bruising and swelling of the face, especially if combined with an eyelid procedure. The discoloration will be most noticeable on the second and third days, and diminishes anywhere from one to six weeks after surgery, depending on ancillary procedures performed at the same sitting. Most patients who only have a midface lift, with perhaps light makeup, can resume everyday tasks approximately three to four days after surgery. Bruising and distortion will be minimal with a thread lift of the neck, and many patients can return to work or their normal social routines within a few days. You may shower and begin using MD Performance® Professional Skin Care Cleansers

and Moisturizers by the second or third day. You may begin walking as soon as you feel able, but all lifting, straining and other vigorous activity is to be avoided until all bruises have faded. The best rule of thumb is to avoid any activity that causes you discomfort and to enjoy those that do not.

Most patients are pleasantly surprised to discover the relatively mild degree of post-operative discomfort. Patients are requested to call the office if the discomfort is not readily quelled by the pain pills, or if significant bleeding appears around the incisions. The external sutures will be removed four to ten days post-operatively.

Before&After

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Blepharoplasty Patient 3033

48 year old male before and after an upper and lower eyelid blepharoplasty

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Blepharoplasty Patient 3034

59 year old female before and after a lower eyelid blepharoplasty with tear trough microfat grafting

BLEPHAROPLASTY POSSIBLE COMPLICATIONS AND SCARS

All surgical procedures entail some degree of risk. It is unethical for any doctor to guarantee a favorable result from the operation you are considering. We can only promise to do our best for each individual patient. Complications and bad results from this operation are uncommon, but they do sometimes occur. It is possible that this blepharoplasty operation will not improve your appearance or help the function of your eyelids as much as you had expected. It is even remotely possible that your appearance and the function of your eyelids will be worse after the blepharoplasty operation than preoperatively. Some laxity, wrinkles and asymmetries ALWAYS persist! Problems which can occur include: bleeding, infection, abnormal discoloration or pigmentation of the skin of the eyelids, dry

eyes, abnormal folding-in or folding-out of the eyelid skin, an inability to fully close the eyes, or a pulled down lower lid lash line. Complications of blepharoplasty (eyelid surgery) can cause prolonged healing, change in or loss of vision, unpleasant-appearing and painful scars, the inconvenience and cost of further surgery, and the possibility of requiring eye drops or ointment, temporarily or perpetually. Occasionally, the whites of the eyes will become temporarily bloodshot-this could last for many weeks, but always resolves spontaneously.

It is very important to understand that no person is perfectly symmetrical from side to side. Even following the most successful operation, some side-to-side discrepancies will persist. There are other possible complications from this operation in addition to the ones that have been mentioned. However, it is not possible to advise you of every conceivable complication.

The purpose of this information is not to frighten or upset you, but to insure that your decision to have this blepharoplasty operation is not made in ignorance of the risks of eyelid surgery. Most patients have a very satisfactory result following the blepharoplasty procedure and complications actually occur rarely.

There are no dietary restrictions post-operatively. Rarely is pain medications required. However, you are cautioned to avoid alcoholic beverages while taking any medication for pain, sleep or tranquilization.

Scars

The surgical scars are permanent; however, the incisions are placed so that they are barely discernable on normal visual observation, barring complications. If this problem occurs, treatment by excision or steroid injections may be indicated, but it may be impossible to improve an unsightly scar.

SOCIAL ACTIVITY AND MAKEUP

Vigorous activity should be limited for a week or two after the blepharoplasty operation, basically until all bruising and swelling have subsided. All other activities can be undertaken as your bruises subside and you feel comfortable with your appearance. The wearing of makeup may be resumed a day after suture removal. Our office staff located in Orange County Newport Beach, will not only be able to assist you with makeup application to help hide bruising and incisions, but will also give you guidance regarding skin care as you are healing and thereafter.

FEES

All fees will be discussed freely in advance by the office staff. Financing may be arranged if desired. Occasionally, in cases demonstrating severe “hooding” due to excess upper eyelid skin, which causes visual impairment, a small portion of the fee may be covered by your insurance carrier. In some instances, it may be possible to verify the amount covered by your insurance carrier in advance; the office staff can assist you in making this determination, but cannot guarantee a level of payment. The office staff will provide you with the necessary information to submit to your insurance carrier. Your insurance company may cover a part of the fee if the operation is designed to correct a deformity caused visual field obstruction. Payment of all fees, however, is the patient's responsibility; all fees are due

prior to surgery and the proceeds of the insurance check will go to you when the check arrives (minus a 6% billing fee if you chose to use our billing service). If requested, the office staff will assist you with forms, but recovery of any insurance benefits is between you and your insurance company. Insurance companies never pay for the entire fee and never pay for eyelid operations which are solely designed to improve your appearance.

In compliance with suggestions adopted by the American Society of Plastic Surgeons®, it is customary for the patient to pay all fees for cosmetic surgery prior to the desired operation. This insures that the patient is sincere in her motivation and can afford the surgery, thus creating a better patient/physician relationship. A non-refundable deposit will be required to secure your desired surgery date. The remainder of the fees must be paid prior to the surgery, usually at the time of the preoperative visit, but never later than two weeks before surgery. Additional fees are also required for laboratory tests, surgical facility fees and the anesthesiologist. If additional surgical procedures become necessary, additional facility, laboratory, anesthesia, implant costs and professional fees will be incurred. The surgical facility and anesthesiologist fees quoted will be based on our best faith estimate; the final fee may vary as these fees are based on surgical time, and it is not always possible to predict exactly how long a procedure will take to complete.

It is important that you understand that the patient is responsible for all costs associated with all secondary surgical procedures or for the treatment of any complications that may arise as a result of this elective surgery.

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