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  • Cosmetic Eyelid Suregery

  • Cosmetic Eyelid Surgery

    The eyes are said to be the window to the soul. The first point of contact when interacting with an individual is invariably through the eyes. The eyes can project an array of emotions including happiness, anger, sorrow, anxiety and fear. Yet in themselves, they are virtually expressionless structures. It is the shape and contour of the skin, bony structure, soft tissues (muscle and fat), as well as the hair and lashes around the eyes, that convey expression. The eyes are often the first structure to show signs of aging. Over time, the skin of the eyes loses it elasticity and becomes thinner. As well, the muscles and fat around the eyes tend to lose their firmness, and the underlying bony support also becomes less prominent, slowly erasing youthful features. Wrinkles, deep lines and puffiness of the lids begin to develop with the passage of time. Exposure to the sun and genetic predisposition can also be contributing factors. The result can be marked changes in expression causing a tired and/or older appearance.

    These physical changes can produce concern and actual visual impairment. Thankfully, eyelid surgery (Blepharoplasty) is a simple and low-risk procedure that can reduce or eliminate the unwanted changes of premature aging of the eyes.


    Blepharoplasty (eyelid surgery) can correct excess skin and sagging pouches ("bags") beneath the eyes and excess folds around the eyes. This surgical procedure involves the removal of excess skin, and occasionally fat, on upper and lower eyelids.

    It can often be done in conjunction with other surgical procedures, including face-lift, eyebrow lift and forehead lift. Brow and forehead lifts are designed to raise eyebrows and reduce ridges and furrows on the forehead, thus creating a smoother, more youthful appearance. Trends in plastic surgery do evolve, and the newer techniques involve less cutting and more filling. Fat around the eyes and droop and create bags. Whereas in the 1990's, surgeons were removing this extra fat, it was found to often create a hollowness, or a surgical look. Newer techniques involve transposition of the fat (rotated to an adjacent area), thereby turning older looking eyes, with hollowness and bags underneath them, to a smooth, youthful eye.

    Before Eyelid Surgery

    Prior to eyelid surgery, a complete medical history is taken in order to evaluate your health. Dr. Kayem will conduct a thorough examination of the eyes and face to determine if you are a good candidate for eyelid surgery. This exam is made to determine the most effective surgical approach. The amount, distribution and type of excess skin to be removed are carefully noted. Dr. Kayem will describe the anesthesia to be used, the procedure, what results might realistically be expected, and possible risks and complications. An examination by an ophthalmologist may be recommended. Preoperative directions may include the elimination of certain drugs that contain aspirin, in order to minimize the possibility of increased bleeding. The areas to be excised are marked and photographs are usually taken before and after surgery in order to evaluate the final results.

    The Procedure

    Eyelid surgery can be done under general anesthesia with the patient asleep, or under local anesthesia in which the area is numbed and the patient remains awake. Prior to surgery, premedication to relax you is often administered. Anesthesia is undertaken, and incisions are created in preexisting natural creases, so that they are virtually undetectable within a week of the procedure. Small sutures are used to close the incision and special ointments and dressings may be applied. The procedure can take from one to two hours depending upon the extent of the surgery.

    Transconjunctival Blepharoplasty

    This type of blepharoplasty may be performed for patients that have significant fatty pockets below their lower eyelid but do not need skin removed. All incisions are made on the inside of the lower eyelid and the fat is then removed, or more often repositioned. In most cases, no sutures are required to close the incision and no scar is left. This Transconjunctival Blepharoplasty procedure is usually performed on patients with more elastic skin.

    Use of Fillers In and Around the Eyes

    Dr. Kayem has extensive experience in the use of fillers around the eyes. Often, patients who consult for eyelid surgery are found to be excellent candidates for fillers only. Fillers are also a good adjunct after surgery, replacing volume around the brow, and returning youthful highlights to the eyes.

    Following Eyelid Surgery

    Some swelling and bruising is expected, but is usually minor and subsides in a few days. Sensory changes such as numbness and itching may occur during the healing process, but usually resolves quickly. Women may use eye makeup within a week to two weeks after surgery, but are cautioned to cleanse the area thoroughly after each use. Dr. Kayem will determine when normal activities can be resumed; however, strenuous exercise must be avoided for several weeks following blepharoplasty surgery. Complications connected with eyelid surgery are relatively few and minor; however, there can be certain inherent risks connected with every cosmetic and plastic surgery procedure, which should be thoroughly discussed with the physician. Patients can minimize complications by carefully following directions given by the physician.