How a Blepharoplasty Is Performed

[mybodyparts]

A Blepharoplasty normally takes from 1 to 3 hours to perform. If you are having upper and lower blepharoplasty the surgery will last closer to 3 hours. If this is the case, the upper Blepharoplasty will more than likely be performed first. Larger amounts of skin are excised for upper Blepharoplasty and the swelling is more intense than with the lower lids. The exception is when unusually large bags are present.

First, you will have monitoring pads attached to you so that the surgical team can properly monitor your vital statistics before, during and after your operation. When you are brought to the operating room, electrodes will be plugged into these pads which are connected to the monitoring equipment.

Once you are on the operating room table, you will then be given your choice or your surgeon's preference in anesthesia as discussed prior to your surgery date. If you had been given an oral sedative or valium prior you will have less anxiety. They will more than likely insert an IV for a saline drip to keep you hydrated and have a vascular doorway for anesthesia, antibiotics, and other medications. If you haven't been given a sedative, it is more stressful for some patients. If you feel that you may experience anxiety inquire beforehand regarding an oral sedative. Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time. It's the initial placement of the IV that may sting a bit. Some people get heir IV placed in the crook of the elbow, some the hand, it all depends upon your veins though. So if your veins are not very prominent this can be a problem. You are then brought to the O.R. if you aren't on the table yet. After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein. This is called a catheter. The catheter is taped to your skin so it is not accidentally knocked or pulled out and is ready to be used as a sort of entryway for anything the surgical team deems necessary for your body. This is usually done before you get into the actual O.R., by a nurse, and you have a saline bag hooked up to you. The medications will usually be given with a drip system with this saline. As said before, the saline will keep you hydrated both during and post-operatively.

If you have chosen an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they spring open the stopper and it starts heading towards your body. The the effects of the anesthesia are felt soon after injection or opening the stopper - a few seconds in fact. It may feel similar to a sensation of heat entering your arm or hand at the catheter site. It then feels as though it is creeping up your arm, then it jumps from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized. The anesthesiologist or surgeon will then determine if you are sedated properly, your stats are stable and if you are ready for the surgery to begin.

You will then be marked with a surgical marker for the incision placement areas although sometimes this can be done before you are sedated. Your treatment areas will then be scrubbed with Betadine or other antimicrobial agent, although the surgical marker markings will remain, although not as dark. You will more than likely be injected with a solution of Lidocaine and epinephrine. The epinephrine is a vasoconstrictor and will impede your skin's ability to bleed excessively, the Lidocaine is a pain reliever. The incisions will follow along the natural lines and creases of the upper and lower eyelids. All efforts possible should be made in order to achieve inconspicuous scars. Although, the incisions may extend into the crow's feet area (aka smile lines) at the outer corners of your eyes if necessary.

The surgeon will separate the skin from underlying fatty tissue and muscle and remove the excess fat if needed. Sometimes atrophied muscle due to the effects of age and gravity is removed as well. The surgeon then trims the excess sagging skin, if applicable. In the case of fat removal only from the under eye area (bags) a transconjunctival blepharoplasty may be performed instead. With a transconjunctival blepharoplasty, a small incision is made within the inner portion of the lower lid. With this procedure, the fat is removed through this incision resulting in no visible scarring. Normally, this procedure is carried out in younger patients or patients where the skin elasticity is great.

After all of the necessary trimming, removing and tucking have been executed, the surgical team will perform a sponge, gauze and instrument check. The incisions are then closed with very fine, hair-like sutures. These sutures will be left in from 2 to 5 days. But more than likely closer to 3 days. The surgeon will lubricate your eyes with an ointment and will perhaps apply a pressure dressing. Of course there may be differences in surgical technique depending upon the preference of your surgeon and the individual needs of the patient.

You are then gently awakened and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released. This is dependent upon the individual but may take up to two hours or more. Your eyes may feel tight, hot and quite tender as the anesthesia wears off. If you feel any discomfort you may want to ask for a pain reliever which you will more than likely have been asked to bring with you. You may even feel emotional or upset, this will depend upon your body's reaction to anesthesia. You may also experience rigors or shivering. This may feel uncontrollable and is usually from the medications, more than likely epinephrine that is used as a vasoconstrictor - and the cold saline which will have been introduced into your system for the last few hours, and still may be. The fact that the operating room is usually very chilly, surely does not help matters in this regard. The recovery nurse usually has wrapped you in a warm blanket but if not, request one. Some facilities may also offer their patients a heat lamp. These extras certainly make your recovery more comfortable.

Some patients feel nothing different than waking up from a good night's rest, although if you have had General you may feel a little sick, hopefully your surgeon gave you something to lessen this. Your prescribed medication should alleviate any pain or discomfort. However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately. You will be driven home by your spouse, significant other or friend as you will not be able to see, much less drive yourself home.

[dani1]

It can take 3 hours? It's hard to imagine a surgeon working on eyelids for 3 hours. I mean, the eyelids are so small!