Risks of Cosmetic Upper Eyelid Surgery, and How they are Minimized and Managed


what are the risks of cosmetic upper
eyelid surgery cosmetic upper eyelid surgery can be a highly effective way to
improve the appearance of hooded eyes and drooping eyelids specialized
procedures such as asian eyelid surgery can be done so you appear as if you were
born with a natural eyelid crease that reveals the beautiful shape of your eyes
successfully performed cosmetic upper eyelid surgery doesn’t draw attention
because it looks natural and fits with the individuals facial characteristics
what we do notice almost immediately are the eyes of people who had either
surgery and don’t look like themselves typically they look tired tight and even
surprised eye contact is the foundation of social interaction so having eyes
that don’t look natural can have a significant impact on so many aspects of
your life cosmetic upper eyelid surgery is a
complex art in order to achieve attractive and natural-looking eyes it’s
also a science requiring scientific precision to the point that the
difference between great results and complications can be measured in
millimeters I’ll discuss the risks involved in cosmetic upper eyelid
surgery and what I do to plan and perform procedures with a high rate of
successful outcomes I’m Dr. Amiya Prasad I’m a
Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic
and reconstructive surgeon I’ve been in practice in Manhattan and Long Island
for over 20 years I routinely perform cosmetic eyelid procedures every day in
my practice such as lower eyelid surgery for under-eye bags
upper eyelid blepharoplasty for hooded eyelids double eyelid surgery
to create an eyelid crease as well as specialized oculoplastic procedures such
as eyelid ptosis surgery I also specialize in revision eyelid surgery to
help people who’ve had complications from surgery originally performed by
other doctors a significant risk and concern for patients I see in
consultation for upper eyelid blepharoplasty is excessive skin removal
such that the person has difficulty with eye closure one of the most common
indications for upper eyelid surgery is called dermatochalasis dermatochalasis
is a condition where the upper eyelid skin stretches and thins resulting in
redundant folds over the eyes and creating a hooded appearance I find that
the shape created by this hooding essentially defines the shape of the
eyes and makes the eyes look like you’re tired or angry to treat the hooded
appearance eyelid skin needs to be removed a first impression to how to
address excess skin may be to just pinch the skin and remove what’s being paged
it’s actually not so straightforward the upper eyelid needs to move with ease
during blinking and in order to do properly distribute the tear film over
the eyes this means you need to leave behind enough skin to allow for this
action to take place in addition the skin below the brow may have descended
because of the eyebrows being in a lower position what is referred to as eyebrow
ptosis during the skin pinching process there may be recruitment of skin below
the eyebrow which can cause downward displacement of the eyebrow and keep the
eyes looking like they’re still hooded further the extent of skin removal can
actually drag the eyebrow closer to the eyelid which
is not a good look the skin elasticity is critical when determining the amount
of skin that’s needed to be removed for eyelid surgery if the skin has limited
stretch less concedes to removed if the skin is very elastic more skin needs to
be removed when too much skin is removed the eyelid function can be compromised
the patients with skin shortage after upper eyelid blepharoplasty will often
complain of their eye or eyes looking to open and feeling discomfort with
blinking they also report that their eyes don’t close even when they’re
sleeping it’s common for these patients to need dry eye therapies such as the
frequent application of artificial tears and lubricating gel or ointment to be
used at night for patients who come to me in this situation I typically have to
perform skin graft surgery in order to restore the skin needed for proper eye
function so what do I do to minimize the risk of skin shortage after surgery
well I factor in skin elasticity eyebrow position and I help when I draw my
design I spend a lot of time taking measurements the art is also in the
placement of the eyelid crease as well as where the skin removal should begin
and end relative to the inner and outer corners of the eyes I also provide some
estimation as to what the patient’s upper eyelids will look like by using an
instrument or a Q-tip to displace the skin inward to reveal a more defined
eyelid crease cosmetic upper eyelid surgery is not just about redundant skin
but also about fat located in two distinct areas the first is called
orbital fat there are two fat compartments and the
lacrimal gland within the space between the bone and the muscle that lifts the
eyelid called the levator muscle the volume and position of the prolapsed fat
as well as the lacrimal gland have significant effects on the appearance of
the upper eyelid this is why upper eyelid blepharoplasty is not just a skin
removal procedure as the surgeon you have to be able to anticipate the
appearance that will result when you are sculpting the prolapsed fat in the upper
eyelid if too much fat is removed during surgery it can cause the upper eyelids
to look hollow and even droopy the second area which is relevant to the
appearance of the upper eyelids is fat and soft tissue located below the outer
aspects of the eyebrow called the sub bra fat I focus on this area
particularly if the outer part of the upper eyelids look very heavily hooded
the result is a more open space on the outer aspect of the upper eyelid
revealing the true shape of the eyes I often see patients who had surgery
elsewhere and are concerned about having had too much fat removed they’re looking
for a solution to restore some fullness over their eyes
there are several surgical options which I have performed throughout my career
including fat grafting and dermis fat graft surgery the challenge is that in
this area particularly after surgery there can be a limited blood supply
limited blood supply could compromise the viability of a tissue graft I have
found that the placement of hyaluronic acid filler to restore fullness has been
highly reliable in cheating improvement which can be appreciated immediately the
technique I use allows me to place volume with great precision
and my patients don’t have to have a recovery time as a would after surgery
another common issue I see is not addressing the presence of eyelid ptosis
eyelid ptosis occurs when the margin of the eyelid is lower than it should be
the cause of eyelid ptosis is generally related to the muscle which lifts the
eyelid called the levator muscle like the word elevator without the letter e
in the beginning it’s been my observation that general plastic
surgeons choose not to address eyelid ptosis and if essentially hope that
removal of skin and fat will be enough for a good result as a cosmetic
oculofacial plastic surgeon I couldn’t disagree more with this had in the sand
approach when the upper eyelid is too low you look tired or sleepy
so when ptosis is not recognized and addressed the eyelids will still look
droopy after the surgeries performed a basic fact and point of differentiation
between the residency training of general plastic surgeons in comparison
to fellowship training of oculofacial plastic surgeons is as follows a general
plastic surgeon during a residency in a typical Hospital will have limited
exposure to eyelid surgery in comparison to their exposure to breast hand and
other body reconstructive procedures since residency programs receive support
from Medicare it’s unlikely for a general plastic surgeon to have
significant training in cosmetic eyelid surgery or specialty training in
cosmetic oculoplastic surgery otherwise the taxpayer would be paying for
elective cosmetic procedures which is not supposed to happen cosmetic surgery
in oculoplastic surgery training are examples of fellowship training
these are training programs for doctors after completing a residency as an
oculofacial plastic surgeon I first trained in ophthalmology or eye surgery
I then received specialized training through fellowship in order to learn
specialized procedures such as ptosis surgery if a patient has ptosis and is
going to have an upper eyelid blepharoplasty I can operate on the
levator muscle as well as the muscle behind the upper eyelid called Mueller’s
muscle these are not procedures typically performed by general Plastic
Surgeons brighter looking eyes after ptosis surgery with blepharoplasty can
be very gratifying for the patient there are always risks to any surgery but
risks can be reduced through the experience and expertise of the
operating surgeon eyelid surgery is one of the procedures you don’t want to
choose based on cost or by assuming that all eyelid surgery procedures are the
same as business and marketing and elective healthcare services become
increasingly commoditized for example think about ads for discounted
liposuction you as the patient have to be your own advocate eyelid surgery is
unique in that the results of a cosmetic procedure not only affects your
appearance but also affects your vision I hope you found this information
helpful thank you for your question

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