blepharoplasty

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Beautiful eyes are an attractive physical trait that is shared by men and women alike. The shape and contour of your eyelids contribute to their aesthetic appeal


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Each face ages differently, but there are a number of common symptoms that affect almost everyone over time

Facial aging is usually characterized by loose skin, wrinkles and the appearance of bags or a general hollowness underneath the eyes. With time, the collagen and elastin that help our skin to stay smooth, full and healthy-looking begin to decrease.


what cause the bags under the eyes?

The soft tissue of the face eventually starts to deflate, deteriorate and descend. This process takes a noticeable toll on the area surrounding the eyes, where the skin is very delicate. Saggy skin weighing down the upper eyelids, wrinkles, puffiness and undereye bags can all detract from the appeal of your eyes, creating an undesirable appearance of general fatigue, even when you’re feeling quite the opposite.
An eyelid lift is a cosmetic surgical procedure that lifts the upper eyelids, eliminates sagging lower eyelids and removes bags.

Cosmetic eyelid surgery, or blepharoplasty, is a common routine procedure that hundreds of thousands of men and women undergo annually in North America. It is one of the top five cosmetic surgical procedures performed according to the American Society of Plastic Surgeons[1].

Eye lid surgery involves the removal of excess fat and skin as well as a tightening of lax muscles that contribute to:

Wrinkles on your eyelids and around the eyes:

Once the skin in this region has begun to lose its elastin and collagen, it also becomes difficult for it to rebound from the stress that our natural squinting and blinking movements take on the tissue. The lower eyelids then begin to wrinkle.

Undereye bags:

The loss of underlying fat in the lower lids couples with diminished skin elasticity to undermine the support structures surrounding the eyes. When this process occurs, the remaining fat pockets often begin to move forward and settle beneath the lids, creating “baggy,” tired looking eyes.

Sunken eyes:

As the facial fat from the cheeks and mid-face begins to migrate downward, the lower lids are left without support. This creates an excessively hollow or sunken looking lower eyelid.

Droopy eyelids:

Weakening tissues cause the upper eyelids to droop. This can obstruct your vision. The lower eyelids may also droop, causing more of the white part under your iris to show (sclera).

Blepharoplasty may be performed alone or in conjunction with other restorative procedures, such as a facelift. The optimal outcome resulting from your cosmetic eyelid surgery is a transformative one–you will look refreshed and more youthful.

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Lower eyelid lift surgery


Eyelid Surgery Toronto

Deterioration, deflation and descent are the primary issues that our surgeons work to correct when performing a lower eyelid lift. Also known as a lower lid tuck or lower lid blepharoplasty, the procedure is routinely performed, extremely safe and can be performed on an outpatient basis. It is accomplished by making a small incision either within the tissue of the lower lid or directly underneath the eyelashes. From there, your surgeon is able to remove the fat pads that cause baggy eyes, tighten any excess skin and drastically reduce the appearance of wrinkles.

Fat is carefully removed fat from the lower lids in order to avoid overcorrection, which can leave patients with hollow-looking eyes. The amount of skin removed from the area is also limited, especially when operating on older patients with weaker facial muscles. Excising too much skin can create an overly round eye shape.

With an ideal outcome, the patient’s lower eyelid transitions smoothly into the upper cheek, without any lumpiness or excess skin. For this reason, careful evaluation of the area, including the cheeks, is performed before the procedure. If the lower lid is affected by descended cheek fat (typically in the form of a line beneath the lids called the arcus marginalis), a cheek lift may be performed at the same time. Once the cheek is properly repositioned in alignment with the lower eyelid, the arcus marginalis will be eliminated and the patient will be left with a more youthful, refreshed look.

For patients who present only minimal signs of lower eyelid aging, other treatments may be recommended, such as soft tissue fillersphotofacial rejuvenation or Skin Remodeling System instead of a surgical tuck.

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Are you a candidate?

An eyelid lift is designed to correct the appearance of your eyelids that has been affected by the aging process. You should be relatively healthy, both emotionally and physically, and have realistic expectations.

Anyone with signs of aging in the upper and/or lower eyelids may be candidates for blepharoplasty surgery. Smokers should quit smoking four weeks prior to surgery and should not resume again after the procedure has been completed.

!Some patients are candidates for both lower and upper eyelid surgeries. Individuals of Asian heritage can have an Asian blepharoplasty, also known as “double eyelid surgery”. Please speak with the clinic and surgeon to see which procedure is right for your desired look and expected result.

Consultation

During your consultation, you’ll talk to your craniofacial plastic surgeon about your desired results. Your health will be assessed. You’ll be informed about the related risks of blepharoplasty so you can make an informed decision on whether to undergo treatment or not.

ISSUES TO CONSIDER WITH BLEPHAROPLASTY

1

Upper Lid VS Lower Lid Blepharoplasty

Upper lid and lower lid blepharoplasty are very different procedures and a distinction should be noted between the two. The main difference is in how the upper and lower eyelids age. The issue with the upper eyelid is hooding of skin over the lid and the main concern with the lower lid is large, often dark, bags under the eyes.

2

Removing Excess Skin with Blepharoplasty

Removing excess skin and fat of the upper eyelid will help to restore a more youthful appearance by rejuvenating the eyes with a smooth and consistent crease and by eliminating wrinkles.

Skin removal on the lower lids must be done very carefully, as removing too much skin on the lower lid can have adverse effects that leads to functional and aesthetic problems. A common issue many patients face when too much skin has been removed is dry eyes, a sad appearance, and/or the inability to fully close their eyes. This should not be a concern with an experienced and well trained surgeon.

3

Removing Excess Fat with Blepharoplasty

Fat removal of the lower lids is a typical technique for a desirable outcome when bags under the eyes are present. Over-removal causes a hollow, unattractive appearance so a delicate balance needs to be made to eliminate bags and puffiness and signs of aging safely and with the best possible aesthetic outcome in mind. Excess lower lid fat is typically repositioned, rather than outright removed, to help contour the lower eyelid and cheek area.

The upper lids must have the excess fat removed with care and experience, and taken from just the right areas because removing too can lead to a ‘skeletonized’ look. An important sign of aging in the upper lids is fat loss; therefore the upper Blepharoplasty technique should not take away too much excess fat for a youthful and healthy appearance.


Preparing

You’ll receive a full set of pre-surgery care instructions that will detail what you should do to better prepare for your surgery. These instructions will help you make the surgical experience an easier one and facilitate your recovery as well. You’ll be asked to stop smoking for a few weeks before your surgery and refrain from taking specific medications that may increase your risk of bleeding and bruising.

Your surgery

Anesthesia will be administered. It may be local with sedation.

Incisions will most likely be made in the natural creases of your eyelids for upper blepharoplasty. Through this incision, fat deposits may be repositioned. Tissue may also be tightened and excess skin may be removed.

If the lower eyelids are treated, incisions may be made in the lower lash line. Again, fat may be redistributed, and excess tissue removed. All incisions will then be closed and dressed.

When you awake from your surgery you will be in the recovery room. There will be small white tapes (steri-strips) covering your incisions. You will be able to go home when you have fully recovered from the sedation. There must be a driver who will be responsible for taking you home following your cosmetic eyelid surgery. A few patients react to the anesthetic after surgery with nausea and vomiting. This usually lasts less than 24 hours and should be treated with lots of fluids, Gravol and rest.

RECOVERY AFTER EYELID SURGERY

After the blepharoplasty procedure, the patient will be moved to the recovery room and will be monitored as they awaken, and rest until they feel ready to go home. Patients can leave the same say accompanied by a family member or friend.

Resting and relaxing at home in the following days post-surgery will aid in a fast and full recovery. Strenuous activities should be avoided as well such as watching television, looking at computer screens and reading, to not strain the eyes.

To reduce swelling and bruising it is recommended that patients sleep in a reclining chair or sleep with their head propped up using multiple pillows.

The pain experienced after an blepharoplasty is usually moderate but light sensitivity for the first three days after surgery is common and to be expected. Pain medication will be prescribed to manage pain, and bruising will last for up to a couple of weeks.

Follow up appointments will generally be scheduled one week after surgery. Patients can also return to work one week after their procedure. Patients can resume walking as exercise after 1-2 weeks and more strenuous exercise (going to the gym) after 4-6 weeks. Follow up appointments will also be scheduled 6 weeks, 6 months and a year after surgery.

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FREQUENTLY ASKED QUESTIONS ABOUT EYELID SURGERY

There is always some inherent risk with every surgical procedure, including blepharoplasty surgery. However, when an eyelid surgery is done by a highly experienced surgeon, the risk of complications is low and very few patients experience adverse effects and complications.

There are more risks for patients with pre-existing medical conditions such as high blood pressure, pre-existing eye issues or diabetes. The surgeon will assess your health and overall wellness as part of the consultation even before making any recommendations. For patients with medical conditions that prevent the surgeon from proceeding with surgery there are other treatments, including less invasive cosmetic procedures, which will be proposed for the patient’s consideration.

During the consultation the surgeon will provide detailed information on the risks involved and the aftercare instructions will help to prevent complications from arising throughout the recovery process.

The procedure usually takes one hour for upper lid, and one hour for lower lid, if no other procedures or treatments are being combined in the same surgery.
Most patients completely heal and scarring is extremely minor and well hidden.


Your facial contouring plastic surgeons

You have the choice of having your blepharoplasty performed by two board certified plastic surgeons


Dr. Jeffrey A. Fialkov

Because the area around the eyes is complex, patient satisfaction governing a positive result relies on a surgeon who possesses a thorough understanding of eye anatomy, complemented with the ability to design a customized surgical plan. Dr. Fialkov is a board certified plastic and reconstructive surgeon who has achieved natural and attractive results for thousands of his cosmetic eye surgery patients. As Associate Professor at University of Toronto, he has the ability to perform complicated reconstructive surgical procedures on patients who require the restoration of eye function. International plastic surgeons from across North America, Europe and the Middle East, certified by their respective medical boards, come to Dr. Fialkov for subspecialty training in newer and more complex craniofacial surgical techniques. He can help you determine whether the procedure is suitable to achieve your goals.

Dr. Kunaal Jindal

Dr. Kunaal Jindal is a member of the Canadian Society of Plastic Surgeons and a fellow of the Royal College of Physicians and Surgeons of Canada. He is the lead researcher of Functional Considerations in Aesthetic Eyelid Surgery[2], a study that examines blepharoplasty and how surgeons can minimize complications by accurately identifying functional concerns during the pre-surgery planning process. His research was published by Plastic and Reconstructive Surgery, the official journal of the American Society of Plastic Surgeons.

Whichever surgeon you choose you’re in excellent hands!

For more information about cosmetic eyelid surgery in Toronto, please call 416-256-5614 to book your private medical consultation with Dr. Jeffrey A. Fialkov or Dr. Kunaal Jindal.

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