Upper Eyelid Surgery St. Louis - Blepharoplasty Missouri
As we age, the brow droops down and extra skin develops over the upper eyelid as the fat in the upper eyelid disappears. The muscle which keeps the eyelid up may weaken, making us appear “sleepy.” In addition, the deep structures of the upper eyelid weaken, causing the fat which is present below to “bulge.” Furthermore, the lacrimal gland in the upper eyelid which helps keep our eyes moist can also bulge and need to be tightened.
Dr. Cabbabe prefers to avoid removing fat from the upper eyelid routinely. He sees many patients who have had fat removed from their eyelids unnecessarily and have a cadaveric appearance” or “hollowed out” look. Dr. Cabbabe believes in fat preservation in the face and that the issue is one of repositioning the fat rather than removing it and sometimes adding fat.
Certain patients have excess bulging fat from the inner upper eyelid that require conservative removal.
Some patients also have eyelid droopiness, or ptosis, in addition to the extra skin above the eyelid. Patients with eyelid ptosis have an upper eyelid which droops down near the pupil instead of staying well above the pupil. If this is noted, then Dr. Cabbabe will recommend a procedure to tighten the muscle in the upper eyelid at the time of surgery.
Occasionally, insurance companies will pay for these types of surgeries. Generally, a trip to an optometrist is needed to document impaired visual fields as a result of the extra skin or droopiness. During your consultation, Dr. Cabbabe will advise you if this is an option for you.
Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the face to give patients the best results possible to meet their desires. He is also an expert in minimally invasive cosmetic surgery of the face and has published on these topics. His patients have a natural, refreshed look after surgery.
During your consultation, Dr. Cabbabe will carefully examine your entire face including the brow, upper and lower eyelids, face and neck. He will make recommendations in order to help you achieve your desired result while maintaining facial harmony. Dr. Cabbabe believes that the entire face should be in harmony and may recommend other procedures such as face lift, midface lift, brow lift, lower blepharoplasty or neck lift to be done at the same time.
Preparing for Surgery
Dr. Cabbabe will ask that you refrain from taking any aspirin, Plavix, Coumadin, ibuprofen or any other type of blood thinner. He will also ensure that your blood pressure has been properly controlled if you have high blood pressure. On the morning of surgery, Dr. Cabbabe will precisely mark the planned incision line in order to keep the scar concealed in the upper eyelid crease.
The procedure takes about 1-1.5 hours total. This procedure can be done under local anesthesia, local anesthesia with sedation or general anesthesia. Excess skin is removed. The muscle in the upper eyelid will be repaired as needed. Fine sutures will be used and will need to be removed 5-7 days after the procedure.
Patients are able to go home after surgery. Pain medication will be prescribed. Bruising and swelling may be present around the eyes for a short period of time. Dr. Cabbabe will ask that you keep ice on the surgical site to decrease this. He will also ask you to keep your head elevated to decrease swelling and apply antibiotic ointment to the incision line. Patients are able to shower the next day. Sutures will be removed in 5 – 7 days.
Possible, complications after upper eyelid surgery include asymmetries or residual excess skin and could potentially require additional surgery. Injuries to the eye itself are rare but possible. Fat embolism is possible if fat is utilized.