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Eyelid | Blepharoplasty

About Lower Blepharoplasty

blepharoplasty 01 updated lowerThis is a procedure that corrects two major features responsible for the appearance of aged lower lids; lax or wrinkled lower eyelid skin and bulging or puffy bags.

Correct preoperative evaluation is required to determine the degree to which these features are present and to determine the optimal procedure to correct the problem.

A recent concept in rejuvenation seeks to address the region as a whole – the mid-face. This includes the lower eyelid, the depression (tear trough deformity) below the lower eyelid and the drooping of the cheek fat pad and naso-labial fold. See also mid-face rejuvenation.

Length:

Approximately one to two hours.

Anesthesia:

Local anesthesia with sedation or rarely general anaesthesia.

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About Upper Blepharoplasty

blepharoplasty 01 updated upperThe appearance of “tired eyes” with overhanging upper eyelid skin has led patients to seek correction, most often by removing the excess. This is a relatively simple procedure with minimal discomfort, short ‘down time’ and favorable outcome.

Occasionally, drooping of the outer part of the eyebrow (brow ptosis) may contribute to this appearance and where necessary correction may be indicated. Aggressive treatment by excision of excess upper eyelid skin alone for the treatment of tired eyes in the presence of brow ptosis is inadequate, counterproductive, and seldom leads to any marked improvement in the condition.

In this case an upper blepharoplasty should be performed in conjunction with a lift of the outer part of the eyebrow to achieve the best results.

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POST-OPERATIVE INSTRUCTIONS

MOBILITY

During the first week, you will sleep on your back. Get out of bed every 2-3hrs and walk a little bit, thenback to resting. Avoid any strenuous movements and heavy lifting.

Heavy exercise or straining can cause bleeding or swelling during the first few weeks. Return to normal activity should be a gradual process and should never cause discomfort. Stop if you areuncomfortable!

  • First 3 weeks: You may take a gentle walk within a few days, “short Sunday stroll”. You may drive whenyou are comfortable and have discontinued all medications, typically 10 days post operatively.
  • Weeks 4-6: Legs & light cardiovascular exercise only (lower body movement, no arms)
  • Week 7-12: Gradual increase in cardio exercise & light upper body training( abdomen, biceps - no peck exercises for first 3 months )

ICE

Cold compresses help minimize swelling and bruising. Use a bowl of ice cubes with gauze at the bed side to soothe sore areas during the first 2 days. It is more important to sleep than to have ice on the eyelids,so don’t ‘stay up’ in order to ice. When you do awaken, apply some ice before going back to sleep.

DO NOT BEND FORWARD

ARNICA & LIGHT THERAPY

Optional - You may take Arnica which is a homeopathic remedy to aid in reducing your bruising and swelling post-operatively. Light Therapy can assist in the healing process.

OINTMENT

Cleanse your eyes with cooled boiled water and apply your prescribed eye ointment with cotton tips 4 times daily to suture lines.

SWELLING & BRUISING

Difficult to anticipate as this differs from person to person, but we find that with upper eyelids most settles after 2 weeks, healing of the lower lids tend to take longer & bruising may last up to 6 weeks.

EYE DROPS

Use the refresh plus eye drops as required to soothe irritated eyes.

BLEEDING

If you bleed from one of the suture lines, apply pressure with gauze for 10 – 20 minutes, and it will almostcertainly stop. If dried or clotted blood is stuck in the suture line, we advise gentle cleansing with cleanwater using a cotton bud or gauze.

SUTURES

Removal of sutures at 5-7 days after surgery. The application of your prescribed eye ointment can then beapplied during the day until the tube is finished.

BATHING & SHOWERING

Take care when washing your hair and face or applying makeup/sunscreen/moisturizer not to get any product on the eyelids until the day after the sutures are removed.

SUN

Scars take at least one year to fade completely. During this time, you must protect them from thesun. Even through a bathing suit, a good deal of UV radiation can reach the skin and causedamage. Wear a sunscreen with a skin-protection factor (SPF) of at least 30 at all times when in theoutdoors.

SCAR MANAGEMENT

The incisions will be covered with Bactroban ointment for about 2-3 weeks after surgery, then topical Vit Aor Silicone for 8-12 weeks. ( this will be explained to you after surgery )

MEDICATION - Take medications as directed

Contact Dr Geldenhuys if you develop nausea, heartburn, diarrhea, constipation or bloating. If pain persists despite pain medications please contact Dr Geldenhuys.

DIET

Have 3 meals a day with plenty of fiber, protein & carbohydrates. Hydrate yourself with plenty of noncarbonated drinks: water & freshly squeezed juices.

CALL ROOMS (021) 424 5218 IF YOU HAVE

  • A temperature greater than 37’C.
  • Excessive bleeding from your eyes or incision sites
  • A sudden increase in pain, or swelling.
  • Any questions regarding your care.

DAY OF SURGERY

On arrival at the clinic you will be offered a pre-med, this is to ensure you are relaxed & calm for the procedure. Prior to surgery, Dr. Geldenhuys & your anesthetist will see you in the ward. You should have nothing to eat or drink for 6 hours before your operation. If you are required to take chronic medication during this time please do so with a sip of water.

WHAT TO BRING WITH YOU

  • Any current medicines and those which have been prescribed.
  • Medical Aid membership card
  • ID Document
  • Credit Card or other agreed means of payment
  • Toiletries if required.

WASHING

Medicated soap will be provided to be used on the morning of your operation.

PRODUCTS

Do not apply make-up, perfume/deodorant, nail polish or hair products after washing.

JEWELRY

Remove all jewelry.

CLOTHING

Wear loose, comfortable clothing and footwear. Front opening garments with buttons or zips are ideal.

BEFORE YOUR SURGERY

Arrange to have a responsible adult over 18 years of age stay with you the first evening after surgery. The procedure will be cancelled if you do not have support.

SMOKING

Smoking increases the risks of complications significantly and should be ceased 4 weeks prior to surgery.

ALCOHOL

No alcohol 48 hours before surgery.

DIETARY REQUIREMENTS

Be well nourished, hydrated and rested before your surgery.

MEDICATIONS

A script will be issued for antibiotics and pain tablets. You will need to purchase them from a chemist and bring them with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over the counter products and prescription medicines can cause complications before and after surgery.

They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. These include medications containing aspirin & anti-inflammatories (Voltaren, Brufen etc) they should not be taken 2 weeks prior to your procedure. Avoid Vitamin C & E supplements and red wine 3 days before your operation.

Stop all herbal medications 1 week before surgery. These include Echinacea, Ephedra, Garlic, Ginseng, Ginkgo, Kava, St. John’s Wort, and Valerian. *(Please ask us for a more comprehensive list if required.)

Please consult Dr Geldenhuys before ceasing any chronic medications. Arrange to have someone fetch you on discharge & stay with you for 2 nights.

ADDITIONAL PRECAUTION & ADVICE

Report any signs of a cold or infections; skin (boils, bites scratches etc) dental etc within two weeks of your surgery. These may increase the risk of surgical infections and may require delaying your surgery for a few days/weeks.

Obtain any desired “comfort items” for after surgery e.g. music, comfortable clothing, pillows, healthy prepped meals, anything that will facilitate a pleasant environment for your recovery. Avoid sun/UV exposure for two weeks prior to surgery. Any evidence of sunburn will result in your surgery being cancelled.

Do not save questions for the morning of your surgery. This is a busy time for us and it should be a relaxing time for you. Please contact the office PRIOR to your surgery if you have any questions.