What Happens During Eyelid Surgery?... And Other Eyelid Surgery Questions Answered

One of the first eyelid surgeries to gain attention in the medical world occurred in 1917. Walter Yeo, a 26-year-old sailor on HMS Warspite, suffered serious injuries to both the upper and lower eyelids while manning the warship's guns during the Battle of Jutland. Sir Harold Gillies, a man often referred to as the “father of plastic surgery,” took skin grafts from other areas of the body and used them to create new eyelids for Yeo. 

Today, eyelid surgeries accounted for more than 34,700 of the plastic surgeries performed by AAFPRS surgeons in 2012. It's a surgery that generally takes 45 minutes to complete, though it can take longer in more extensive cases.  

 What Happens During Eyelid Surgery?  

After the anesthesia takes effect, the surgeon makes incisions within the crease of the upper eyelid and/or along the eyelash line or inside the lid on the lower eyelid. Once the incisions are made, the surgeon is able to remove or reposition the fat, tighten muscle, and excise the excess skin. The incisions are sutured after the eyelid lift is complete.

What is the Recovery Like?   

 Within a few hours, you'll go home to recover. The most common complaints are swelling and bruising. Discomfort is alleviated with the pain medications your surgeon recommends. Cold compresses and resting with the head elevated help with swelling. Your eyes may feel dry and itchy, and artificial tears help with lubrication.
Within three days of the surgery, you should be able to resume light activities. Stitches are removed after five days. You do need to refrain from strenuous activities for a month.  

 

Will Blepharoplasty Get Rid of Crow's Feet?   

Blepharoplasty addresses bags and sagging skin on the upper and lower eyelids. If you have troublesome crow's feet, your facial plastic surgeon may recommend Botox Cosmetic to relax the muscle and alleviate the wrinkles and crow's feet.  

What Factors Are Considered During an Eyelid Lift Consultation?   

 

 Facial plastic surgeons consider three factors when determining whether an eyelid lift is the best option. The quality and quantity of the skin is important. If skin is too thin or crepe-like, C02 laser treatments are an excellent option. Prominent fat pads on the lower lid are another factor. If there is plenty of fat, you're likely a good candidate. Finally, the surgeon looks to see how much volume loss is present in the tear trough. Again, if there is noticeable volume loss, you may be a good candidate.

How Much Does an Eyelid Surgery Cost?

 

  It's hard to put exact figures on the cost of blepharoplasty without seeing the patient. In 2012, the American Academy of Facial Plastic and Reconstructive Surgeons placed the national average surgeon fee at $3,514. This is only the surgeon's fee. You should also expect additional fees, such as the fee charged by the anesthesiologist.

 Is Eyelid Surgery the Only Option?  

  

For folds in the upper eyelids, there is a non-surgical option that can help fill in the loss of volume. Dr. Robert Kessler, a Newport Beach facial plastic surgeon, can use Restylane to fill in the volume loss. Botox is useful in alleviating drooping eyelids related to muscle loss. Read more about Restylane on Dr. Kessler's website.

The best way to discuss your options for improving the eyelids is by scheduling a consultation and talking to Dr. Kessler. You can reach his Newport Beach office by calling (949) 644-6544.

The Aging Face: How Do You Know When It's Time for a Facelift?

No two people are alike. Some men and women begin seeing signs of aging in their 30s. Others manage to reach their 40s or even 50s before the tell-tale signs of collagen and elasticity depletion appear. This is why it can be hard for a facial plastic surgeon to give a specific age when a facelift becomes necessary. You are looking for key signs of an aging face, not a specific age.

Options for Improving an Aging Face

 

Some issues of an aging fact are corrected, albeit temporarily, with the use of injections like Botox or fillers. Botox relaxes the muscles responsible for dynamic wrinkles like frown lines and crow’s feet to help restore a more youthful appearance. Fillers add volume to areas where collagen stores have depleted and left hollows. The thing to remember with these non-surgical techniques is that they are temporary.

Botox lasts as little as three months with some patients, so you need to return to the doctor a few times a year for touch-up injections. Autologous fat transfers work by moving fat from another area of your body to the face. The body absorbs some of this fat over time, so again touch-ups may be necessary. Fillers like Restylane last longer than Botox, but even then the results tend to last six months to a year, so you'll need to go for new injections once or twice a year.

A facelift helps improve a number of signs of aging. It starts by tightening skin to help correct the creasing that often appears from the sides of the nostrils to the corners of the mouth. These creases, known as nasolabial folds, are easily corrected with a facelift, but that's not all. Loose skin that sags along the jawline creating jowls is another area targeted by a facelift. The facelift also helps tone the jawline to give it more definition. With a facelift, the surgery is long-lasting with most patients getting a full 10 years of improvements out of the one surgery.

With a facelift, you do undergo anesthesia. Incisions are made at the temples and extend around and behind the ears. Incisions are often made in natural skin folds or in the hairline to help hide any scarring. After the surgeon tightens the skin and corrects issues with muscle and underlying tissue, the incisions are closed. You'll return to the surgeon in approximately two days to have drains removed. Stitches are removed in 5 to 10 days. You need two weeks to recover before getting back to your normal activities.

Signs That You Need a Facelift Instead of Injectables

 

Perhaps the most important signal for a facial plastic surgeon is when a patient's aging skin has lost enough elasticity that jowls have formed. Once the skin sags from the jawline, non-surgical techniques will no longer work as effectively to correct the signs of aging. Only a facelift can significantly tighten the skin and eliminate jowls.

When the skin has lost elasticity and the neck is starting to show sagging skin, again a facelift is ideal. Through the incisions, the plastic surgeon can tighten muscle, reposition underlying tissue, and excise excess skin to create a tighter, younger appearance.

Watch the American Academy of Facial Plastic Surgery's an overview of Aging Skin video to learn more about aging. To discuss the benefits of a facelift versus non-surgical techniques, contact Dr. Robert Kessler, a Newport Beach facial plastic surgeon. Dr. Kessler will view your skin and walk you through the different options you have for restoring a more youthful look. Call (949) 644-6544 to schedule a consultation today.

Extreme Weight Loss: Choosing the Lower Body Lift Over Abdominoplasty

Weight loss of 10, 20, or even 30 pounds is impressive, but weight loss totaling 100 or more pounds is an astounding feat. After massive weight loss, however, many men and women have a hard time celebrating their new form due to all the excess skin that diet and exercise do not correct. These people may weigh less, but the sagging skin makes it hard to find clothing that fits well.

There are two surgical procedures that excise the rolls of loose, sagging skin, but only one is truly suited for extreme weight loss.While a tummy tuck will tone and shape the abdomen, it doesn't address the back, buttocks, hips, and thighs. For that reason, many plastic surgeons recommend that weight loss patients opt for the lower body lift over the tummy tuck.

Understanding the Lower Body Lift

With an abdominoplasty, the incision is made along the pubic line from one hip bone to another. With a lower body lift, the incision is more extensive in order to accommodate what is essentially three different procedures combined to tighten skin and improve the appearance from the waist to the knees. The abdominal and lower back incisions are connected across the top of the thigh oriented within garment lines.

The first step is performing the abdominoplasty. Excess skin is surgically removed, and the abdominal muscles are tightened. The incision continues around the hips to help lift the buttocks and outer thighs. If there are still fatty deposits that diet and exercise haven't addressed, liposuction is useful in removing those deposits. Excess skin is also removed from the lower back.

Due to the fact that the lower body lift is a more extensive surgery, patients must stay overnight in a surgical facility. A registered nurse is on hand to monitor your recovery. Some doctors ask you to spend a second night, too. After this point, you go home with pain medications in hand and strict instructions about taking it easy during the recovery.

You must wear compression garments while you heal. This helps to limit swelling and keep bruising to a minimum. You will return to the surgeon's office in two weeks to have drains removed. At that point, you should no longer need pain medications.

At the two-week mark, you should receive clearance to return to work, but you still need to avoid strenuous activities. It takes a month for the incisions to fully heal, so you will not be back to normal routines for five or six weeks following the lower body lift.

Other Procedures That Can Help

You may also have excess skin hanging from your upper arms or sagging breasts following extreme weight loss. To reshape the upper arms, you may want to undergo a brachioplasty, also known as an arm lift, to excise the loose skin and help bring new definition to the arms. Breast lifts and possibly implants restore the appearance of the breasts, creating a more uplifted and symmetrical appearance. 

As a body lift takes upwards of eight hours to complete, your plastic surgeon may schedule these procedures for another day. Remember that you didn't lose the weight overnight, so don't worry about needing a few months to recover from these surgeries.

Newport Beach plastic surgeon Dr. Robert Kessler specializes in body contouring after extreme weight loss. View before and after pictures of some of his lower body lift patients. Celebrate your weight loss by consulting with the doctor about the changes this surgery makes in terms of physical appearance and self-esteem. You can reach Dr. Kessler's California plastic surgery office by calling (949) 644-6544.

Creepy Eyelid Skin: Don't Turn to Eyelid Surgery Just Yet

 

Skin around the eyes that resembles crepe paper is a common occurrence in aging men and women. Depleting collagen stores are to blame. While some retinol creams can help to add moisture, a visit with a plastic surgeon with advanced training in facial aesthetics can provide superior, lasting results.

If thoughts of eyelid surgery have you shivering in fear, relax. Chemical peels and laser resurfacing treatments are often better solutions for crepey skin around the eyes. An eyelid lift is most beneficial when the skin and muscle are starting to sag.

A Brief Anatomy of the Eyelid 

The role of the eyelid is to protect the eyes from excessive light and injury. At the same time, the eyelids help to distribute moisture over the cornea. The top of the eyelid is the visible skin, but below that skin is subcutaneous tissue and muscle. Within the tissue is collagen that helps keep the skin plump and youthful-looking.

Comparing Laser Resurfacing, Chemical Peels and Ulthera

A chemical peel involves the application of a chemical solution over the problem skin around the eyes. There are different solutions ranging from light to deep. A light peel removes the outer layer of the skin to reveal fresher, younger skin below. A deeper peel removes wrinkles. The procedure starts with a thorough cleaning of the face and then protective measures are taken to keep the solution from getting into the eyes. Once the peel has been on the skin for the correct amount of time, the solution is removed. Most people need a day to two weeks to recover depending on the depth of the peel.

Laser resurfacing is a little trickier. It is a process in which the laser ablates the upper skin layers. Complications may include deep burns which can lead to scarring or hypopigmentation, so it is essential to choose a plastic surgeon who is skilled in laser resurfacing. With a qualified plastic surgeon, the treatment revitalizes the skin's texture and color.

Lastly, Ulthera with a 1.5mm depth can make very nice improvements in the lower eyelid.  This FDA-approved, non-surgical, non-invasive procedure uses ultrasound energy to tighten loose skin. The procedure takes just 60 to 90 minutes in the office setting and there is no downtime.

When is Eyelid Surgery Recommended? 

As collagen stores deplete and skin loses elasticity, the skin starts to sag and wrinkle. Skin that resembles crepe paper is one of the common signs of aging. On the eyelids, that upper eyelid skin may sag so much that it obstructs vision. When the eyelids obstruct vision, clearly you need to see a plastic surgeon. Crepey skin alone doesn't require an eyelid lift, but if the skin is sagging and making you look or feel older while also making it hard to see, surgery is the better option.

The Lowdown on Eyelid Surgery 

During an eyelid surgery, incisions are made in the natural creases or eyelash line on your upper and/or lower eyelid. Once the skin is tightened and the excess fat is removed or reshaped, the incisions are sewn or glued shut, depending on your surgeon's preferences. Ointment is placed in the eyes to keep them lubricated.

For the next week, your eye may feel dry and itchy. Bruising and swelling is normal, too. You can minimize the swelling by keeping your head elevated while resting and using ice packs. You'll be back to light activities within three days. Stitches are removed within the first week. You'll be back to strenuous activities after four weeks.

View the American Academy of Facial Plastic and Reconstructive Surgery's video on laser skin resurfacing. Your eyelid needs could be as quick and easy as a non-surgical procedure. Talk to Dr. Robert Kessler to discuss your concerns over crepe paper eyelids and discuss if non-surgical treatments are right for you. Call the Newport Beach plastic surgeon at (949) 644-6544.

Tight, Toned Arms: Plastic Surgeons See Increase in Brachioplasty

Many women dream of toned arms that they don't have to hide in longer sleeves, but many struggle to get their arms to cooperate with those dreams. You see toned arms mentioned in magazines ranging from Self to Shape and give the exercises a shot. Many times, you end up with muscle, but that flabby skin and fatty tissue doesn't go away without surgical removal.

Between 2011 and 2012, the American Society for Aesthetic Plastic Surgery reports the number of upper arm lifts increased by 4,260. That same surgery saw an increase of more than 812 percent between 1997 and 2012, according to the same report. Brachioplasty, also known as an upper arm lift, isn't meant to replace diet and exercise, but it does help tone arms when other measures fail.

What to Expect During a Consultation

One of the things your plastic surgeon needs to check is how much excess skin and fatty tissue are present. Where the sagging skin is minimal, a mini brachioplasty may be all you need, otherwise a full brachioplasty is necessary. The benefit to a mini brachioplasty is that the incision is much smaller. For a full brachioplasty, the incision can run from your armpit to your elbow.

You will need to discuss any current or past health issues and surgeries. Your plastic surgeon must know everything about you to prevent complications during or after the surgery. Make sure you are honest about your alcohol intake, smoking, medications, and any vitamins or herbal supplements you take. If you've had past reactions to anesthesia, that is also important information for your surgeon.

Steps Taken During an Arm Lift Surgery

Brachioplasty is performed in either a surgical suite, outpatient surgery center or hospital. Your doctor will use one of two anesthesia methods: general anesthesia or IV sedation and local anesthesia. After you are asleep, an incision is made in the predetermined place on the underarm. If there is excess underarm fat, liposuction is used to remove that first.

During the surgery, the plastic surgeon trims and shapes the underlying tissue. Excess skin is excised and then the incision is closed. If drains are necessary to collect excess fluids, they are placed. Dressings are put in place to cover the incisions, and compression garments are added to minimize swelling and support the arms as they adapt to their newly toned shape. Plan for the surgery to take upwards of two hours, and then you'll stay in recovery for a short while before being released.

Healing After Arm Lift Surgery

Expect some mild discomfort for the first few days. Your plastic surgeon will prescribe prescription pain relief to keep you comfortable. Plan to return to your surgeon to have the drains removed and ensure things are healing properly. Many plastic surgeons use dissolving stitches, but if your surgeon used regular stitches you will return to have them removed in one or two weeks. Swelling takes up to two weeks to fade.

Provided that you're healing well, you will be able to return to work after five days of rest. It takes about 14 days before you can get back to exercise routines.

Are your sagging arms embarrassing you? Do you hide them behind long sleeves, even in warmer weather? You're not alone. Watch this video from the American Society of Plastic Surgeons to see how arm lift surgeries are on the rise. Dr. Kessler specializes in Newport Beach arm lifts. Schedule a consultation with his office to find out how you can feel comfortable in sleeveless shirts again. Call (949) 644-6544 or complete Dr. Kessler's online contact form.