Eyelid surgery, technically known as blepharoplasty, is a procedure that removes fat, excess skin and muscle from the upper and lower eyelids. The surgery can correct drooping upper lids and puffy bags under the eyes that make you appear old and tired and that sometimes interferes with your vision. Dr. Rohrich's philosophy is to rejuvenate the eyelids by restoring the eyelid shape and contour. He believes the old techniques of performing eyelid surgery by over-excising skin, muscle and fat only achieve in making the eyes look older more rapidly. "We shouldn't accelerate this process as surgeons by removing in excess what aging already takes away."

Dr. Rohrich is a *board-certified, world-renown, plastic surgeon and has spent over 15 years specializing in facial cosmetic surgery. He has written numerous articles for scientific journals and magazines and lectures internationally on plastic surgery. He is Chairman of The Department of Plastic Surgery at UT Southwestern Medical Center at Dallas.

The information provided will give you a basic understanding of the procedure but it can't answer all of your questions, since a lot depends on your individual circumstances. For more information, please view the "Frequently Asked Questions" or visit his "Resource Library" for related articles, websites and video clips.

Am I a good candidate for the surgery?

Your visit with Dr. Rohrich will determine if you are a good candidate. If you are in good physical and mental health with reasonable expectations you should be an appropriate candidate. Most candidates are over 35 years of age but if droopy, baggy eyelids run in your family, you may decide to have the surgery at a younger age. Many patients decide to have the surgery performed at an early age as it is one of the first features of the face to show signs of aging.

A few medical conditions can make this surgery more difficult. They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease and diabetes. A detached retina or glaucoma are also reasons for caution. Check with your ophthalmologist before you have surgery.

Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Rohrich.

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What should I expect from my consultation?

During your consultation, you will learn about the surgery, its limitations and risks, and discuss your needs and concerns. This will help Dr. Rohrich understand your expectations and determine whether they realistically can be achieved. Dr. Rohrich will carefully examine your eyelids to assess the shape of the lids and asymmetries to determine what type of procedure would best maximize your result.

After your consultation a photographer will take photographs for your medical record and you will meet with Dr. Rohrich's patient coordinator to discuss the surgery fees and scheduling dates. You may also schedule an additional consultation to view computer imaging so that you can visualize the results of the eyelid techniques that Dr. Rohrich has specifically designed for your surgery.

You should come to the consultation prepared to discuss your medical history. You should provide any relevant information from your ophthalmologist. Also provide information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries and medications that you currently take. It is important for you to provide complete information.

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How is the surgery performed?

In a typical procedure, Dr. Rohrich will make incisions following the natural lines of your upper eyelid creases and just below the lashes on the lower lids. Working through these incisions he will separate the skin from the underlying fatty tissue and muscle, conservatively remove a minimal amount of excess fat and trim the sagging skin and muscle if needed. Often Dr. Rohrich will perform a "lateral canthopexy" to tighten the outer part of the eye. This makes the eyes appear youthful and fresh. The incisions are then closed with very fine sutures.

If you have a small pocket of fat beneath your lower eyelids but don't need to have any skin removed, Dr. Rohrich may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid leaving no visible scar.

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What happens the day of surgery?

Your eyelid surgery will be performed at either one of our specialty hospitals or an accredited outpatient surgery facility.

Prior to the procedure, medications are administered for your comfort and to lessen the anxiety if need be. General anesthesia is typically used for patients undergoing eyelid surgery. The surgery usually takes 1 to 2 hours depending on the technique used and if any other procedures are done. After surgery, you will awake in a recovery area where you will be closely monitored. Eyelid surgery does not usually require an overnight hospital stay, and patients can be up and around within a few hours after the procedure is completed.

Be sure to arrange for someone to drive you home and stay with you to assist you the first couple of days while at home. The "Patient Care" section on this site gives you instructions to prepare for surgery, including guidelines on eating, medications to avoid, drinking and smoking. If you are a smoker, you will be asked to stop smoking well in advance of surgery.

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What is the recovery like?

It is not uncommon to have swelling and bruising for several days following your surgery. You will be given special cold compresses to wear for the first 48 hours after your surgery. You will be required to sleep with your head elevated on pillows to help decrease the swelling. Your vision can be blurry for several days as expected from your surgery and from the eye ointment you will apply. Your eyes may not close as they did prior to your surgery. This is normal and may take a few weeks to resolve before your upper and lower eyelids close normally. You will be given prescriptions for pain medication and antibiotics as needed.

You should be able to read and watch television after 2 to 3 days but you will not be able to wear contact lenses for about two weeks and even then they may feel uncomfortable for a while. You should be able to return to work in approximately 7 to 10 days depending on your occupation and the extent of your surgery. Your bruising will resolve in 10 to 14 days, as will most of the swelling.

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What should I know about my results?

You will see a noticeable difference in the shape of your eyelids soon after surgery. However, improvement will become even more apparent after two weeks when most of the swelling has resolved.

Whenever surgery is performed on your body a scar will result. The scars for this procedure may remain slightly pink, depending on your skin tone, for six months. Eventually they will fade to a thin, nearly invisible line.

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What does the surgery cost?

At the time of your initial consultation, you will be quoted a price that will include Dr. Rohrich's fee as well as hospital and anesthesia fees. Fees are due in full two weeks prior to your surgery. Checks, money orders, cash and credit cards may be used for payment. A $500.00 deposit will reserve a specific time and date for your surgery. Most insurance policies do not cover eyelid surgery unless you can prove that drooping upper lids interfere with your vision. Check with your insurer for more information.

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