Lower Eyelid Surgery in Houston
Lower eyelid surgery (aka a lower eyelid blepharoplasty) is a plastic surgery procedure that targets issues affecting the lower eyelids. A lower blepharoplasty is an umbrella term that refers to many surgical techniques plastic surgeons use to correct the lower lids. While lower eyelid surgery is a procedure to remove excess fat, muscle and skin.
The top plastic surgeons at Lift Plastic Surgery have a tissue preserving philosophy which means that after eyelid surgery there is no apparent loss of volume in the area beneath the eye. Read on to learn more about lower eyelid surgery in Houston.
What Is a Lower Blepharoplasty/Lower Eyelid Surgery?
Lower blepharoplasty is a form of eyelid surgery done only on the lower eyelids. It involves the surgical repair or reconstruction of the lower eyelid. The surgeon may remove excess skin and adipocyte fat. The surgeon may also reinforce corresponding muscle and tendon tissues. These changes should resolve any functional and cosmetic problems of the periorbita, which is the area from the eyebrow to the upper cheek.
When Is a Lower Eyelid Surgery Done?
Lower eyelid surgery is usually recommended for people with lower eyelid laxity. This eyelid characteristic occurs as a person ages. In addition, some genetic conditions (e.g., blepharochalasis) can cause the eyelid skin to become lax.
During the initial consultation, Dr. Patel will do a snap-back test. To perform this test, the surgeon gently pulls the patient’ s lower lid away from the eye and the surgeon determines the elasticity of the patient’s lid by observing the amount of time it takes for the eyelid to return to its normal position. If a person has to blink for the eyelid to return to its normal position, this demonstrates lax lower eyelids.
While performing the snap-back test, the surgeon also measures the distance the patient’s lower lid can be pulled away from the globe.
What Is Dermatochalasis?
Dermatochalasis is the medical term that refers to lax skin on the lower eyelid. Lax eyelid skin occurs as a result of overstretched collagen fibers.
The Anatomy of the Lower Eyelid
The normal anatomical position of the lateral canthal tendon which is located near the ear, is higher than that of the medial canthal tendon, which is positioned near the nose. When the opposite is true, the patient had a lax tendon.
The irregular characteristics of the lid may decrease the patient’s peripheral vision. When a patient has obstructions in the upper and outer areas of the visual field, his or her ability to drive or just read a book is negatively affected.
Addressing Lower Eyelid Laxity with a Blepharoplasty in Houston
The surgeons at Lift Plastic Surgery address lid laxity with lower blepharoplasty procedures.
After examining the patient’s medial and lateral canthal tendons, Dr. Patel determines which eyelid surgery will provide the patient with the beautiful, natural-looking results he or she desires.
The surgical techniques available at Lift Plastic Surgery include the lateral canthopexy or canthoplasty.
If the patient has any medial canthal tendon laxity, the surgeon performs a medial canthoplasty.
During a patient’s initial consultation, Dr. Patel provide the patient with highly detailed anatomical explanations. In addition, the surgeon also explains which eyelid surgery can correct or modify the eye issues he or she would like the surgeon to address.
Who Should Consider a Lower Blepharoplasty?
A lower blepharoplasty is a good option for individuals who have the following eye characteristics or issues:
- Lower eyelid laxity.
- Limited peripheral vision.
- Individuals with weak eye muscles.
- Multiple skin creases in the area beneath the eye.
- Lower eyelid asymmetry.
- Mounds along the cheek (i.e., festoons)
At Lift’s Houston office, the surgeon determines if an individual is a good candidate for a lower blepharoplasty in Houston. The surgeon also discusses alternatives for those who are not good candidates for this surgery.
An Initial Consultation in Houston for a Lower Blepharoplasty
During the initial consultation at Lift Plastic Surgery in Houston, Dr. Patel reviews the patient’s detailed medical and ophthalmic history. In addition, the surgeon examines the patient’s forehead, brows and lower eyelids.
The surgeon reviews the patient’s visual acuity, examines his or her pupils, as well as the movement of the various eye muscles. In addition, the surgeon evaluates the tear film and the ocular surface.
The surgeon notes the patient’s:
- Blink rate.
- Muscle strength.
- Natural defensive reaction of the eye (i.e., Bell’s phenomenon).
- Lower lid laxity.
- Ability to fully close his or her eyes.
- Skin quality around his or her eyes.
- Amount of eye hollowing.
- Globe position.
How Is a Lower Blepharoplasty Done?
Plastic surgeons can perform lower eyelid surgery at a surgical center, in a hospital or as an office-based procedure at a plastic surgery center.
During a blepharoplasty, to ensure patients remain comfortable throughout their procedure, patients receive twilight sedation or general anesthesia.
Immediately before the procedure at the Houston office-based surgical suite, Dr. Patel may mark the area of the skin incision. These markings are done with the person in a seated position. The borders of the excess skin or fat and any hollowing are drawn with a surgical pen.
Lower blepharoplasty is performed with local anesthesia or under monitored sedation. The local anesthetic consists of lidocaine and/or bupivacaine with epinephrine. In addition to this, topical anesthetic drops are instilled. A corneal shield is placed to protect the eye.
Incisions and Technique
At Lift’s surgical suite in Houston, Dr. Patel can use a variety of surgical techniques based on an individual’s needs identified during the physical exam. This could be a single procedure or a combination approach. Some of these approaches include the following.
The Transconjunctival Approach
This is a popular surgical approach that is used for individuals who do not have excess lower eyelid skin. They do have plenty of fat that can be removed via an incision through the conjunctiva. The conjunctival incision can be closed with absorbable sutures or they may heal without direct closure.
The Skin Approach
The surgeons create an incision about 1-2 mm below the eyelash line. A skin “pinch” is sometimes used to determine the amount of redundant skin. The surgeon removes a conservative amount of skin and asks the individual to gaze upward and open their mouth. This is to assess the amount of skin trim.
This infraciliary incision provides the surgeon with access to the orbicularis muscle and the orbitomalar ligament. If necessary, they can elevate or suspend the muscles and ligament to lift and support the eyelid. Lateral canthopexy can also be done using the same incision to maintain or elevate the position of the lower eyelid along with a lower blepharoplasty procedure.
The infraciliary skin incision is then closed with fine monofilament or absorbable catgut sutures.
- For individuals with significant lower lid laxity, plastic surgeons may suggest canthopexy or lateral canthoplasty.
- They may also use fat grafting techniques to add volume to the hollows below the eyes and the lid-cheek junction. Alloplastic orbital rim and malar implants are other alternatives to improve volume.
- Surgeons may also suggest laser skin ablative or non-ablative resurfacing or chemical peels to reduce rhytidosis and skin discoloration in appropriate candidates. This helps the skin of the lower lid look smoother and more even.
- Ligation, sclerotherapy, or laser treatment are other alternatives to reduce the appearance of prominent lower eyelid veins.
- Botox injections can also be used to minimize creases in the periorbital region and lower lids.
The choice of procedure depends on many factors including age, the condition of the skin, the cause of the lower lid laxity, and the person’s goals and expectations for the surgery. At Lift’s Houston office, Dr. Patel are open to helping you decide what’s best for you.
The Benefits of Lower Eyelid Surgery
There are many benefits to lower eyelid surgery. The first benefit is a reduction of under-eye bags. A person’s visual field also expands. As the skin appears tauter, an individual can look years younger with few shadows beneath the eyes.
The Cost of Lower Eyelid Surgery
The cost of lower eyelid surgery varies from person to person. For specific costs of the lower eyelid, you can send in a price request at their Houston office. If an individual needs a lower blepharoplasty to address a lax lower eyelid that is decreasing their field of vision and affecting their daily activities due to impaired vision, health insurance may cover a portion of the costs.
Before a Blepharoplasty Procedure
To ensure the procedure is smooth, it’s important to prepare before the surgery. Here are some steps to follow.
- Discontinue products that contain nicotine (e. g., chewing tobacco, e-cigarettes, traditional cigarettes).
- Discontinue some medications like (e.g., ibuprofen) and vitamins (e.g, vitamin E) for 10 days before and 10 days after surgery. These medications increase the likelihood of excess bleeding.
- For all other medications, inquire with Dr. Patel about when to stop them.
- Stock up with groceries, water, and medicines as needed. Going outside for two weeks after the surgery might be difficult, so stocking up would be helpful.
- Having someone during and after the procedure is helpful to ease any anxiety.
- Having some pillows to stay propped up and frozen gel packs to ease swelling is another good idea.
After the Procedure
After the lower blepharoplasty procedure, it’s important to visit the Houston office with Dr. Patel for the post-surgical appointment. This is to ensure that healing is taking place as expected. Here are some additional steps.
- Avoid activities that cause eye strain (e.g, working on a computer, surfing the web on a cellphone, and driving).
- Watch out for complications like bleeding, fever, and excessive tearing.
- Avoid contact lenses for two weeks.
- Use cold compresses to reduce swelling in the first 48 hours, followed by warm compresses.
- A steroid ointment or ophthalmic antibiotic (or drops) may be prescribed for the first postoperative week.
How Long Does it Take to Recover?
The recovery period varies depending on various factors such as a person’s age, the state of their skin, their general health, and the size of the incision. After the surgery, it is normal to experience some bruising and inflammation. Within six weeks, most of these symptoms resolve completely. Unlike upper eyelid surgery, lower blepharoplasty is a more complex procedure. By the end of 3 months, you should be able to see the final results of your surgery.
What Are the Side Effects?
A lower eyelid procedure can have some potential side effects. This includes:
- Minor bleeding
- Inability to close the eyes completely
- Blurred vision
- Suture cysts
- Risk of a blood clot
- Double vision
Most people are safely able to resume work within three weeks of surgery and have no visible signs of surgery two months after the surgery. At the earliest sign of bleeding or fever or any other side effect, contact Lift’s Houston office to schedule an immediate consultation with the surgeon.
Lift Plastic Surgery’s Approach to Patient Care
At Lift Plastic Surgery, Dr. Shitel Patel provides great care for those in and around the city of Houston. Once an appointment is scheduled, the surgeons meet with an individual to discuss their options. The surgeon creates a custom-tailored blepharoplasty procedure plan. An individual is allowed to take the time to think about their decision.
Once a decision is made, the surgeon will ask for laboratory tests to be done before the surgery. If the results are optimal, they will schedule a date for the surgery.
At Lift Plastic Surgery in Houston, the surgeons are open to questions. They are more than willing to address any concerns an individual has before surgery.
7 Frequently Asked Questions
Is Lower Eyelid Surgery Permanent?
Even after a lower blepharoplasty, you will continue to age. However, the bags or excess skin that was removed under the eyes do not return. Most patients do not have to repeat this procedure.
When can I Wear Contacts Again?
After lower eyelid surgery, you must be as delicate as possible with the incisions. Since wearing contact lenses requires you to lift and retract the eyelid, it’s best to avoid doing this for about two weeks. You can also speak to the surgeon, as the healing of your incisions will dictate your ability to wear contact lenses.
Are the Scars Visible?
In most cases, the scars of lower eyelid surgery are very well concealed. Immediately after the surgery, bruising is visible; the incision, not at all. Some sutures dissolve without the need for removal by a surgeon. In some instances, if the surgeon does not use dissolvable sutures, you will return to Lift Plastic Surgery in Houston, Texas, to have your doctor remove them. Suture removal is usually a pain-free procedure.
Can I have Lower Eyelid Surgery if I have had PRK or LASIK?
Yes. Often, people find that after their PRK or LASIK procedure, their eyelids get masked by spectacles. They are good candidates for lower eyelid surgery.
How Much Bruising Will I Have?
The bruising varies from person to person. Bruising is usually worse in the first 24-72 hours of the surgery. It occurs when blood pools behind the skin. After three or four days, the bruise looks purple and by 2 weeks it disappears completely. Some patients’ surgical bruises remain for an additional three to four weeks. This bruising can be minimized by placing frozen gel packs and sleeping with the head elevated.
Is there an Age Limit?
There are no age restrictions when it comes to lower eyelid surgery. Excess skin and fat are commonly observed as you age. Genetics also plays a role in collagen formation in the skin. If you are in good health with no major eye conditions, age is not a limiting factor. However, you can discuss this with Dr. Patel when you visit Lift’s Houston office.
When can I Return to Normal Activity?
Most individuals can watch TV and do their normal chores within two days after surgery. Reading and surfing the net might take longer as the eyes get fatigued quicker. You also want to avoid straining the eyes for the first week after the procedure.
Top Plastic Surgeons Accepting New Patients for Lower Eyelid Surgery in Houston
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Contact Houston / Webster, Texas Plastic Surgeon Shitel D. Patel, MD at Lift Plastic Surgery.
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