1206 Somerville Rd
Decatur, AL 35603
The basic goal of eyelid surgery is to improve the appearance of the lids to prevent people from having a "tired" look. The upper lid operation improves the appearance by removing the lax, excess skin that hangs down toward the eye lashes and obscures the eyelid itself and the natural eyelid crease. The upper lid operation also removes the fat pads that can create a bulge at the lid and nose junction. A crisp upper lid makes you eyes appear wider and less tired and also allows eyelid make up to be visible and more attractive. It must be remembered that the anatomy of the upper eyelids must be evaluated along with the position of the eyebrows and therefore sometimes a forehead lift will need to be discussed. More information on forehead lifts is available by reading the Forehead Lift section below.
The lower lid operation improves the appearance by removing and/or re-positioning the bulging fat in the lower lids that makes the lids look puffy or swollen. In most patients I do a specialized technique which does not remove all of the fat, but re-positions the fat in a special way to give a more youthful appearance to the anatomy of the lower lids. A small amount of skin is also removed to tighten the lids. In some patients the outer edge of the lid will also be suspended to tighten the lid and improve the appearance. Because of some of these specialized techniques I do not do the transconjunctival approach to lower lid blepharoplasty.
Lower lid surgery is never covered by insurance because it is strictly to improve the appearance of the lids. Most often upper lid surgery is also considered cosmetic surgery and is not covered by insurance.
Upper eyelid surgery can be submitted for insurance coverage if the degree of the deformity meets certain criteria. First, the patient must have legitimate claims of obstructed vision from the extra skin. It usual has more credence if the patient is actively employed and the obstructed vision affects their work. Second, close up photographs of the lids must show that the skin hangs over the front edges of the eyelashes. Third, visual field examination by an ophthalmologist or optometrist must show significant obstruction of the visual field that then improves to a large degree when the excess skin is held out of the way.
During your initial consultation we will discuss all of the aspects of the operation and how it relates to you. We will have a second visit that is the pre-operative visit where I will answer all of your final questions, write the prescriptions for the medicines you will need after the surgery and you will do your pre-operative visit at the hospital.
The upper lid operation is done as an outpatient procedure or day-surgery at Decatur Morgan Hospital using IV sedation anesthesia and local anesthesia. It is done in the main operating rooms at Decatur Morgan Hospital and takes just over 1 hour to perform. We do the operation in the morning and you will get discharged to home late in the afternoon. You will go home with supplies to do cool compresses to the eyes that evening.
When lower eyelids are done alone the operation is done as an outpatient procedure or day-surgery at Decatur General Hospital using general anesthesia. It is done in the main operating rooms at Decatur General Hospital. It takes just over 1 hour to perform a lower lid operation alone.
When the upper lids and the lower lids are done at the same time it takes just under 3 hours to do the operation. We do the operation in the morning and you will get discharged to home late in the afternoon. You will go home with supplies to do cool compresses to the eyes that evening.
It is crucial that for 10 days prior to your surgery you do not take any aspirin, arthritis or other muscle ache pain medicines. These medicines will make you bruise more and can lead to other complications. The ONLY pain or headache medicine that is safe to take is Tylenol (acetaminophen) because this does not affect blood clotting and bleeding.
Remember that eyelid surgery does not improve the fine wrinkles in the lids and the crow's feet area. Fine wrinkles need to be addressed separately, usually with laser skin re-surfacing. More information on laser surgery is available by going directly to the Laser Surgery page.
All patients are unique and the response to post-operative discomfort is variable. Most patients state that eyelid surgery is not that uncomfortable. Patients say that the eyes feel tight or heavy. Some patients take the narcotic medicine only for a day or two and then switch to Tylenol for pain. As I said, patients are all unique and their pain tolerance is very different. When the upper lids are done alone almost all patients feel normal by 2 weeks and when all four lids are operated on they feel normal by 3 to 4 weeks. I will remove the skin sutures in the office 5 days after the surgery. Removing the sutures pinches and sometimes can be uncomfortable.
For a desk job that does not require any heavy lifting you should expect to be away from work for 1 to 2 weeks for either type of lid surgery. For a job that requires physical exertion or heavy lifting you should expect to be away from work for 2 to 3 weeks depending on your exact job description. For a short time the surgery may have an effect on your abililty to do fine reading, either in print or on a computer screen.
By one week from the surgery you will have some minor residual swelling but no bruising. You will probably not feel comfortable in contact lenses for 2 to 3 weeks after the surgery. You may have some light sensitivity and intolerance to windy conditions outdoors. The recovery for doing surgery on all four lids at the same time is always a little longer then the recovery for just operating on two lids.