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FAQ Videos – Upper Eyelid Surgery

Inflammation that occurs after an eyelid surgery is often influenced by the following elements:

  1. Method of anesthesia
  2. Surgical technique
  3. Aftercare received after completion of surgery at home aftercare
  4. The existence of other disorders such as sinus problems and allergies.

To help lessen post-surgery puffiness and swelling, Dr. Amiya Prasad developed his own sedation method—a light local intravenous sedation method that lets patients recuperate from blepharoplasty and return to work sooner. This type of sedation technique is so effective that patients are able leave the clinic and go home after surgery, without feeling that heavy characteristic fatigue that accompanies general anesthesia.

Eye shape is mainly reliant on genetic features, such as the dimension, prominence, and shape and position of bones, tissues and ligaments of the eye. All these features are different for each person, thus it is essential to discuss with your surgeon the best approach that will yield the most natural-looking results for you.

In Dr. Amiya Prasad’s practice, blepharoplasty is performed with intravenous LITE™ IV sedation, which permits patients to experience speedier recovery periods. Upper eyelid blepharoplasty addresses problems of the eyelid crease, as well as extra skin that may be present on the eyelids. In some cases, fat and soft tissue can be added and sculpted into the area to improve the overall appearance of the eye. Lower eyelid blepharoplasty deals with droopy, swollen and tired-looking skin under the eyes. This procedure can be executed either from a transcutaneous approach (from the outside) or a transconjunctival approach (from the inside).When contemplating which type of procedure to have, make sure you choose a surgeon with advanced eyelid surgery skills as lower eyelid surgery can adversely affect the lower eyelid if not done properly.

Aside from the typical risks associated with surgery, such as bleeding and infection, there are risks involved in eyelid surgery that can affect the function and health of the eyes and could lead to complications. These complications may include:

  1. drooping of the upper eyelids after surgery
  2. skin shortage that prevents full eyelid closure,
  3. unwanted scarring,
  4. lower eyelid retraction
  5. ectropion.

Other complications may also include dry eyes and corneal ulceration.

Before having eyelid surgery, make sure to have a full proper medical and physical examination of the eyes in order to lessen the risk of complications. A full examination should include a proper diagnosis of any existing eye issues such as ptosis or lacrimal gland prolapse.

To minimize any post-operation scarring, detailed planning, a minimally traumatic surgery and immediate post-operative care are necessary. When performing lower blepharoplasty, Dr. Amiya Prasad favors the transconjunctival approach, so as not to create any external incisions on the skin. A certain level of artistry is required when addressing excess skin on the upper eyelid, as these incisions need to be positioned in such a way that even when the eyes are closed, they are scarcely noticeable. At the end of the surgery, Dr. Prasad chooses an optimal suturing technique and makes use of an advanced wound healing mixture (platelet-rich plasma or PRP), in order to speed up the healing process. This combination, along with proper home aftercare, helps patients recover quicker with less scarring.

Ptosis is a type of eye disorder wherein the margin of the eyelid is positioned lower than normal, due to the weakening or thinning of the levator muscle. This condition often results in droopy or heavy-looking eyelids. In other cases, these symptoms can be caused by dermatochalasis, which is basically the presence of extra skin weighing over the eyelid. Having ptosis surgery can fix the orientation of the levator muscle and can be performed together with an upper eyelid blepharoplasty.

The end results of eyelid surgery can last for up to 5-10 years, depending on the following conditions:
  • the patient’s age at the time they had the surgery,
  • the patient’s overall health
  • the state of one’s skin.
In order to foster realistic expectations of what surgery can do for them, Dr. Amiya Prasad strives to help his patients gain an understanding of the way the face ages over the years and how this affects the appearance of the eyes and the effects of surgery.
In preparation for eyelid surgery, patients must remember to disclose the following information to their surgeon:
  • the patient’s overall health (prevailing conditions, ailments, prescriptions or supplements) and
  • if they have or had any eye ailments such as dry eyes or blepharitis.
It is important to first address these conditions before undergoing surgery in order to prevent any further complications. Keep in mind that the more detailed you are about your medical history, the more beneficial it will be for both you and your surgeon.
Although eyelid surgery is a popular type of cosmetic surgery, many people still end up with undesirable results due to poor surgery jobs. Many of these unwanted results include
  • droopy upper eyelids
  • skin shortage that hinders the eye from closing properly
  • lower eyelid scleral show
  • lower eyelid retraction
  • ectropion.
To avoid these complications, it is extremely important to seek out the services of a surgeon who specializes in this particular type of eye surgery, as this requires a deeper and more extensive level of training and specialization. It also helps to seek out a surgeon who displays a meticulous dedication in studying your medical history and who will be committed to understanding your aesthetic goals, as well as the kind of results you want.
The best way to determine the right doctor for you is by doing research. Proper eyelid surgery is a very complex procedure that requires skills and knowledge that most general surgeons do not possess; therefore it is essential to take a look at a doctor’s training background and area of expertise. Another important value to consider is the amount of experience a doctor has, as this speaks volumes about the skills of a surgeon. As a cosmetic Oculofacial plastic surgeon with over 20 years of experience, Dr. Amiya Prasad makes it his duty to educate patients about the different aspects of eyelid surgery so they can make informed choices.
As a practicing cosmetic Oculofacial plastic surgeon with over 20 years of experience, Dr. Amiya Prasad prefers using local anesthesia with IV sedation. This type of method puts the patient in an extremely relaxed and drowsy state, while still being conscious during the procedure. In Dr. Prasad’s experience, this type of method is less demanding on the body compared to general anesthesia wherein the patient is unconscious and placed on a respirator.

Downtime after surgery is sometimes viewed as an inconvenience, and because of this, Dr. Amiya Prasad has developed his own system that allows him to treat patients quickly and effectively, with minimal downtime. All surgical procedures are done in his own licensed operating facilities, with the attendance of a dedicated team of nurses who he regularly works with. In Dr. Prasad’s experience, having a consistent team contributes to quicker and smoother surgery procedures. After the surgery is completed, speedy aftercare is given in the recovery room. This immediate attentive care given to the patient after surgery plays a substantial role in how fast a patient recuperates. Because of this, they are typically able to return to work within 1 week.

As a practicing Oculofacial plastic surgeon that was also initially trained as an eye surgeon, Dr. Amiya Prasad frequently comes across dry eye cases. Patients must keep in mind that before having eye surgery, they must be examined in order to gauge the optimum position of the lower eyelid to facilitate better lubrication of the eyes. In the past, Dr. Prasad has effectively performed successful eyelid surgery on severe dry eye cases, and even on patients with Sjogrens syndrome, rheumatoid arthritis and thyroid eye disease.
When addressing hooded eyes, the goal of laser and radio frequency devices is to heat the skin of the forehead and raise the brows by slow contracture. However, people with hooded eyes often have excess skin to be contracted, thus needing numerous sessions spanning several months. To add to that, hooded eyes usually have areas of fat which requires sculpting, and can only be accomplished through surgery. Surgery permits the surgeon to control and position the tissues and fat more precisely, leading to better results.
The layer of fat under the facial skin is responsible for giving the face the volume and glow that are distinguishing of supple and youthful-looking skin. In order to regain this youthful appearance, people often turn to high heat radiofrequency devices, which tend to burn or even “cook” that essential layer of fat, rather than tighten it. This results in the speeding up of the aging process of the skin. Keep in mind that more heat does not necessarily mean more tightening of the skin. It is therefore more advisable to have upper eyelid blepharoplasty for hooded eyes, in order not to further damage the quality of your skin.
The position of the eyelid relative to the pupil is a key factor in determining whether you need blepharoptosis repair or blepharoplasty. Blepharoptosis pertains to the eyelid margin being lower than it should be and can be addressed by blepharoptosis repair. Dermatochalasis denotes excess skin over the eyelids, which causes that hooded, tired-looking appearance which can be corrected by undergoing a blepharoplasty procedure. Unfortunately, it is common for ptosis to be overlooked because a plastic surgeon assumes that performing blepharoplasty will automatically improve the look of drooping eyelids. This leads to the eyelids still looking droopy, in spite of just having the surgery. On the other hand, it is not unusual for some people to have both dermatochalasis and blepharoptosis, which can sometimes pose a challenge when formulating a proper diagnosis and surgical plan. During a preliminary checkup, Dr. Amiya Prasad determines whether a patient has ptosis by lifting up the excess skin to see if it improves the eyelid margin or not. If the eyelid margin is still low, then it is safe to assume that the patient has eyelid ptosis, which can be easily fixed with the proper surgery.
Eyelid lifts are done to address extra skin and fat around the eyelids. Blepharoplasty is a surgical procedure performed on the upper and lower eyelids to address extra skin, fat, and other structural issues. A patient may decide to undergo either an upper or lower eyelid blepharoplasty, or both. Ptosis surgery is a surgical procedure specifically performed to fix the position of the eyelid margin relative to the pupil. Other procedures may also include levator muscle advancement, levator resection, and frontalis sling.
If you have excess skin over your eyes, the first step is to determine what is causing it. When assessing a patient who is concerned about excess skin over the eyes, Dr. Prasad looks for descent of the eyebrows (brow ptosis), and excess skin over the eyelids or (dermatochalasis). Usually, if brow ptosis is present, then it is likely that dermatochalasis is also present. Blepharoplasty can be the sole solution for sagging eyelids, or it can be part of the solution. Brow lifts, on the other hand, can only become a possibility if brow ptosis is present. The defining factor will depend on the source of the sagging skin, as well as the patient’s desired look.
Correcting drooping eyelids is a procedure that Dr. Amiya Prasad is comfortable and familiar with. If a patient’s drooping eyelids are caused by excess skin, or “dermatochalasis”, then blepharoplasty is performed. If the drooping eyelids are caused by ptosis, then ptosis surgery is done. It is always essential for a patient to meet with a specialist and get a thorough diagnosis to define which procedure is right for their case.
Ptosis refers to the position of the eyelid margin relative to the pupil. Sometimes, excess skin above the eyelid can weigh it down and affect its position; a condition called “mechanical ptosis”. During a preliminary examination, Dr. Amiya Prasad will raise the extra skin to see where the eyelid margin is situated. If the margin remains low, it is possible you have ptosis. If that is the case, you will require ptosis surgery to correct it, as it cannot be fixed by blepharoplasty alone.
Blepharoplasty refers to upper and lower eyelid surgery wherein the main goal is to improve the appearance and function of the eyes, and to sculpt extra skin and protruding fat pockets around the eyes. As practicing oculofacial plastic surgeon with 20 years of experience, Dr. Amiya Prasad firmly asserts the importance of performing blepharoplasty with a profound understanding of eye health, as well as having the technical expertise to successfully accomplish the goals of the surgery. Many of Dr. Prasad’s patients come to him to get revision surgery for surgeries that were improperly done by other surgeons. He treats patients in his Joint Commission-certified operating facilities, typically using local anesthesia with intravenous or IV sedation. Most of his patients are able to return to work within a week without experiencing much discomfort during the healing process.
Complications that can occur during or after a blepharoplasty procedure may include the following:
  1. Excessive bleeding
  2. Infection
  3. Undesirable scarring
  4. Vision loss
  5. Double vision
The issue of excess skin and displaced fat pockets around the eyes are not considered “complications” but “enhancements”. Dr. Amiya Prasad often receives patients seeking corrective surgery to fix bad results from an earlier surgery done by a different surgeon. One of the most recurrent reasons why people seek out revision surgery is to address retraction after lower eyelid surgery. This is a complication wherein the eyes become irritated because areas that were once protected and covered are suddenly exposed. It is best to evaluate these complications with your surgeon in order to determine how to manage them.