Eyelid Surgery (Blepharoplasty) New York City


Choosing a Blepharoplasty

A blepharoplasty (more commonly known as an “eye lift”) is a surgical procedure that will improve the appearance of your upper and/or lower eyelids. Blepharoplasty for medical reasons can be performed if the upper eyelids are droopy and are interfering with your vision. Most often, a cosmetic blepharoplasty is performed to improve the appearance of your eyelids which can lend to a “tired” look as you age. This “tired” look occurs as the skin of the upper and/or lower eyelid becomes excessive and wrinkled, the eyebrow droops, and fat pooches out from the lower eyelids (creating what we commonly refer to as eyelid bags).

The eyes are not only the window to the soul, they are often the first area to show signs of aging. Droopy eyelids and puffy bags beneath the eyes make patients appear older and more tired than they feel. This can negatively impact self-esteem. Although most blepharoplasty patients are over 35-years-old, blepharoplasties can be performed on younger patients as well. While we often think of lower eyelid “bags” as occurring in older people, it is not uncommon for younger patients to have lower eyelid bags congenitally (from birth). Lower eyelid bags in a young person can make them look tired or aged. In cases like this Dr. Cangello will perform surgery on the lower eyelid with an incision made inside the eyelid (so that it is never seen) to remove the fat.

Am I a good candidate for a Blepharoplasty?

You are a good candidate for a blepharoplasty if you are in good health, live in New York City (or are willing to travel), and are motivated to follow your pre-operative and post-operative instructions.

You may not be a good candidate if you have a medical problem that affects your eyes. These include hypothyroidism, dry eyes, glaucoma, high blood pressure, cardiovascular disease or diabetes. In the case of concurrent medical issues, Dr. Cangello will require approval from your physician(s) before your blepharoplasty can be scheduled. In most instances Dr. Cangello will require you to have certain tests (such as visual field, visual acuity and a test for dry eyes) performed by an ophthalmologist prior to eyelid surgery as well.

It is also important that you have reasonable expectations for your blepharoplasty. A blepharoplasty only makes changes to the upper and lower eyelids; it will not remove crow’s feet or eliminate dark circles under your eyes. If you have additional areas of concern, a blepharoplasty can be performed in conjunction with (get rid of this→as part of) additional surgeries (such as a facelift or brow lift).

The Consultation: Creating Your Plastic Surgery Plan

Your blepharoplasty journey begins with a consultation with Dr. David Cangello in our New York City office. Dr. Cangello will discuss your medical history and the results that you want from your blepharoplasty. For your surgery to proceed safely, you need to be honest about your allergies, medications, personal habits, and previous surgical procedures.

You will also need to inform Dr.Cangello if you have any medical problems that affect your eyes. These include hypothyroidism, dry eyes, high blood pressure, cardiovascular disease or diabetes. Some eye diseases (such as glaucoma) will require that see your ophthalmologist before surgery can proceed.

Dr. Cangello will ask about your goals for the blepharoplasty and the look you hope to achieve. Next, Dr. Cangello will conduct a physical examination, which will include an eye exam and assessment of the eyelids and periocular tissues. A blepharoplasty is not a “one size fit’s all” procedure. Your procedure may require all or some of the following: excision of excess skin, laser resurfacing to tighten and smooth the skin of the lower eyelid, excision of fat bulging from the upper or lower eyelid, repositioning of fat from the lower eyelid into the “tear trough” (depression that runs from the medial part of the eye laterally into the cheek that often contributes to the look of having dark circles) and tightening of the lower eyelid with a procedure called a canthopexy or canthoplasty. (This part here in parentheses makes no sense-→ For example, there are a number of causes of a drooping upper lid. It may be due to relaxation of skin or muscles in either the forehead or the eyebrow. The drooping may also be due to excess skin and fat on the eyelids.)

After the exam is complete, Dr. Cangello will recommend your surgical plan. This may include performing a procedure on, (NOTdoing) only your upper eyelids, only your lower eyelids, or both sets of eyelids. At this time Dr. Cangello will also answer your questions and explain how to prepare for your blepharoplasty as well as what you can expect in your postoperative course.

Preparing For Your Blepharoplasty

Dr. Cangello is committed to achieving the best and most natural “non-operated” results possible. During your initial consultation, he will create a pre-operative plan for you to follow. This plan is designed for your unique needs, to make sure that you have the best outcome possible. Your pre-op plan may include changes in diet and other habits that impact your health. For example, you will be asked to reduce your exposure to the sun and to avoid ANY nicotine containing products for at least 2-4 weeks before and after surgery.

Dr. Cangello will also give you instructions for the days before your surgery. These include stopping certain medications and supplements. You will also be told not to eat beginning at midnight on the day of your surgery.

His staff will also explain what you’ll need to purchase for your recovery process, including cold packs and artificial tears. You will not be able to wear contact lenses for two weeks following surgery.

Where will the surgery be performed?

Your blepharoplasty will be performed at Dr. Cangello’s New York City office. He has a fully accredited (AAASF) state-of-the-art operating room on-site. You are encouraged to ask for a tour of the operating facility when you come in for your consultation.

Types of Anesthesia

Blepharoplasties generally take one to two hours. They can be performed using either general anesthesia or using local anesthesia with intravenous sedation. In either case, you will not feel any pain or remember the surgery. Procedures on the upper eyelids alone can usually be done with just local anesthetic.

Blepharoplasty Surgery Techniques

The exact technique and incision sites are based on many factors, including whether you are having any additional procedures done at the same time. Dr. Cangello will discuss this plan with you prior to surgery.

For an upper eyelid blepharoplasty, the incision is made in a natural skin crease in the eyelid. When healed it cannot be seen. For lower eyelid procedures the incision is made either inside the eyelid (which can never be seen) or just below the lower eyelash margin, which when healed is also imperceptible. An incision is only made on the outside of the lower eyelid when excess skin needs to be removed. Using these incisions, he will gently separate the skin and muscle from the underlying tissue. He will then remove excess fat, skin and muscle needed to create the desired result. Finally, the incisions will closed using tiny sutures.

The Recovery Process

After the surgery, your eyelids may feel tight and achy. They may also feel dry, itchy or difficult to close. Dr. Cangello will prescribe pain medication to keep you comfortable.

Bruising and swelling are very common after a blepharoplasty. Dr. Cangello may advise you to use cold compresses and to keep your head elevated when you are lying down. Bruising will be worst on the second or third day and be much better within two weeks. Dr. Cangello will also instruct you how to clean your eyes and when to use eye drops.

Most patients are asked to avoid any activity for three to five days. Stitches are removed after five to seven days. Most people are comfortable going out in public within 10 days. Contact lenses can be worn after two weeks. You can resume regular activity after three weeks.

Please call our New York City office at 212-644-4416 to set up a consultation about how you can benefit from a blepharoplasty.

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