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  • What is Lower Eyelid Surgery?
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Female Voice: Lower eyelid surgery is done to improve the overall appearance of the lower eyelids. Often times, people feel like they have puffy under eyes, a hollow appearance, or just loose skin underneath the eyes. What we do to repair this is to go in through the inside of the eyelid and redistribute, as well as, remove some of the fat. The fat underneath of the eye is caused from herniated little fat pads from that fat that supports the eye.

We make our incision on the inside of the eyelid, get in there, remove a little bit of fat as well as redistribute some of the fat to this portion of the cheek so that you have a nice smooth transition from your lower eyelid to your cheek. You'll also have an incision on the lower lid right along the eyelash line. That's where we remove some of that extra skin. You'll also have a few stitches over here to the outside corner of the eye where we tighten up the outside corner. This is something that's usually done at outpatient surgery. This is something that we don't typically do in the office.

You'll need to make sure that before surgery you try to avoid all blood thinners, anything like aspirin, Motrin, ibuprofen, anything of that sort. If it's something that's prescribed by your physician, our office will collaborate with them to ensure that it's safe for you to come off of these medications for about 10 to 14 days before surgery. You'll need to make sure that you've got somebody that can drive you to and from the surgery center, because you'll get some sedation in an IV to where you don't feel any pokes, or sticks, or any discomfort, but where you're able to breathe on your own.

This is not a general anesthesia. This is something that's just to keep you good and comfortable during your surgery. After surgery you'll spend about 30 minutes to an hour in the recovery room, where they'll get you ready to go home. If you don't feel good, if you feel sick to your stomach or anything like that after surgery they won't let you go home until you feel better. Once you get home, we'll ask that you use some cold compress on and off for about 24 to 48 hours. This is to help with the bruising and swelling. Everybody gets some degree of bruising and swelling, but it varies from person to person. Some people swell and don't bruise. Some people bruise and don't swell, and some people do a whole lot of both.

You'll have an incision that's on the inside of your eye. You'll have some prescription eye drops that you'll be using three times a day, morning, noon, and night. Those drops are to help that incision heal in by itself. There are no stitches there. You will however have stitches on the outside of the eyelid, along the eyelash line, where you will be using a prescription ointment to those stitches three times a day for a week. That's to ensure that the stitches stay nice and moist, helps the wound edges to heal well together, and it helps us to remove the stitches, and it makes it more comfortable for you. We'll ask that you don't do any heavy bending or lifting for that first week after surgery, nothing where your head goes below your heart.

You will have, like I said, some swelling and you don't want to add any increased pressure along that stitch line. You can shower the day after surgery. We'll ask that, maybe, you put a little bit of that ointment on before you get in the shower. That way it helps to repel some of the water away from those stitches. It's not going to hurt anything to wash your face. If they do get a little bit wet that's okay. We just don't want to really saturate it. We'll ask that you, for that first week, don't fly, don't swim in any swimming pools, no hot tubs, lakes, ponds, anything like that. No dusty, dirty activities where you run the risk of getting any dirt or anything in your incisions, while you are healing.

Pain is usually not something that people complain about a lot. Pain levels vary from person to person, but overall people have very little discomfort. Usually Extra Strength Tylenol takes care of this. You will get a prescription for something stronger, in case you need it, but overall people typically do very well with little discomfort. We'll see you back here in the office after one week, to have any stitches that need to be removed at that time, and then your activity restrictions will be lifted from there.

What is Lower Eyelid Surgery?

Doctor Brian Biesman's team discusses Lower Eyelid Surgery.