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Precision Surgery with First Intraoperative CT Scanner in USA

 
     

As we all know, the eyes are a prominent facial feature. Although the eyes are expressionless structures, the surrounding skin conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Unfortunately, wrinkles and deep lines as well as puffiness under the lids develop as you age. In addition, exposure to the sun as well as hereditary factors contribute to the aging process, all resulting in changes of expression. In many cases, people may look fatigued, worn out and older than their true age. Beyond possible visual impairment, these changes in your appearance can cause stress and anxiety.

We can perform blepharoplasty to correct sagging eyelids, bags or pouches beneath the eyes, as well as excess folds around the eyes. This surgical procedure involves the removal of excess skin and fat on upper and lower eyelids and is often performed in conjunction with other surgical procedures including facelifts, eyebrow and forehead lifts. Blepharoplasty can be done under general anesthesia (with you asleep) or under IV Sedation. Both are very comfortable options. Pre-medication is utilized prior to surgery to decrease swelling after the operation.

Dr. Matouk is trained in several surgical procedures, such as blepharoplasty, forehead lift and brow lift in order to eliminate the majority of these problems.

Before Surgery

To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your eyes and face are made in order to take the most effective surgical approach. The amount, distribution and type of excess skin to be removed are carefully reviewed.

Dr. Matouk will provide you with pre-operative instructions that may include the elimination of specific drugs containing aspirin several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection.

The areas that will be excised are marked and digital photographs and computer imaging is performed in order to determine the amount of improvement after surgery.

     
 

The Procedure

Dr. Matouk will trace the natural lines and creases of your face and make incredibly fine incisions from the inner to the outer edge of the eyelid.

Local anesthesia is given around the eyes. An intravenous line is started so that sedation may also be given. During the procedure you will be awake but comfortable and relaxed. General anesthesia is rarely used.

This procedure is performed on an outpatient basis at our surgical center. It is important to arrange for care after the surgery. Someone must drive you home and be available to care for you for the first 24 hours.

Complications are unlikely when performed by a surgeon with experience in blepharoplasty. These include: bleeding and swelling, delayed wound healing, infection, drooping of eye upper or lower eyelid, asymmetry, double vision and dry eyes.

Surgery on the upper eyelid is performed first with the incision made in the fold of the lid. The incision is made below the eyelash on the lower eyelid. Any excess fat and skin are removed from the underlying compartments. The amount of fat excised is determined by the degree of protrusion of fat when pressure is applied to the area. Small sutures are used to close the incision and special ointments and dressings may be applied. The surgery can take up to 2 hours. In certain cases, lower eyelid incisions are made inside the lid. Laser may be used at the same time to reduce wrinkles.

 
     

New and Traditional Techniques

Traditional Blepharoplasty:

An incision is made in the crease of the upper lid toward the temples. Once healed, it is not noticeable when the eye is open. On the lower lid, the incision is made along the lash line toward the temples, and is hidden by lashes when healed.

The Transconjunctival Approach:

This is a newer technique for lid blepharoplasty, involving an incision inside the lower lid. Fat can be removed through this incision, but excess skin cannot be eliminated.

Laser resurfacing of the eyelids is a non-surgical alternative that may delay the need for a surgical blepharoplasty. It results in significant tightening of the skin around the eyes, but will not effect the fat around the eyes and may even accentuate it.

The Midface Lift:

In select cases, a n even newer procedure is required called a midface lift.  When performed along with eyelid surgery, this involves the lifting of deep cheek tissues and re-suspending them higher to remove the sunken cheek look that occurs with aging

Please ask your doctor if you have any questions about which procedure is right for you.

Post-Operative Information

Initially, drying of the eyes can occur after blepharoplasty. This condition can be alleviated with medication. In addition, you may be sensitive to bright light and wind for a period of time. Numbness and itching may also occur during the healing process. A final evaluation may occur within several months from the initial surgical procedure.

Sleep on your back or side with head elevated. Blepharoplasty usually causes little if any post-operative pain. The pain relievers prescribed are safe if needed. If you notice significant sharp or dull pain, which persists, or visual loss notify the office immediately. Cold compresses (ice cold wash cloths) may be used over your eyelids for 20-30 minutes six times per day if you wish.

You may use your eyes for reading or TV viewing as frequently as you wish. Use artificial tears as needed for burning or irritation. Do not use contact lenses for at least two weeks. Pulling on the eyelids while inserting or removing lenses may interfere with precise healing. Glasses may be used at any time.

Do not use mascara, eyeliner or eye shadow until approved by Dr. Matouk (usually 10-14 days). Minimal makeup applied to any bruising of the lower lid is acceptable at any time, but do not pull on the lids or incisions. Any apparent redness of the whites of the eyeball is only a form of bruising and will subside during the early healing process.

Do not engage in vigorous exercise or sports for at least three weeks, or until it is approved by the doctor. Stitches are removed at different times after surgery depending upon the extent of surgery carried out, type of stitches, and the type of quality of your skin. We will advise you accordingly. It is not abnormal to feel slight itching and tightness of the eyelids during the early healing period.

Wound care

Cleanse the incision lines three (3) times per day with 50% hydrogen peroxide and 50% water. Apply a thin coating of Bacitracin to the incision lines.

     
 

What to Expect

The area surrounding the eyes will remain swollen in the days following the surgery. It should begin to subside after the first day. Some vision blurring is normal.

The stitches will be removed in 4-5 days. Swelling and bruising will persist for about 10 days, but you can begin wearing makeup to help conceal these concerns. You may expect to resume normal activity within a week to 10 days, and start enjoying your new look within approximately 10-14 days. It may take about 6 months for the scars to lose their redness.

Wrinkling will recur later in life, however it is unlikely that the “bags” will recur because the fat has been removed. Deeper wrinkles around the outer eye extended onto the temple are not greatly affected by the eyelid lift. These areas may be treated with laser resurfacing.

 
     

Insurance

Your insurance company may pay for part of the cost of surgery if the procedure is performed as a result of visual impairment. Because every insurance carrier is different, it is recommended that you check with your own insurance company to determine the level of coverage.