Upper Eyelid Surgery

 

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Upper Eyelid Surgery in New Jersey

Upper & Lower Eyelid Surgery (Blepharoplasty) Before & After Photo. Surgery by Dr. Baljeet K. Purewal (Oculoplastic Surgeon) in New Jersey.

Upper & Lower Eyelid Surgery (Blepharoplasty) Before & After Photo.


 



 



 


Patient Testomonial: Eyelid Surgery (Blepharoplasty)


 


FAQ: Upper Eyelid Surgery


Am I a candidate for Upper Eyelid Lift (Blepharoplasty) Surgery?

If you have heavy folds, wrinkles, sagging upper lid skin or puffiness that continues to bother you, you may be an excellent candidate for upper eyelid lift.

How is the surgery performed? Where is the incision?

The incision is made in the natural crease of the upper lid. After careful markings are made of the upper eyelid crease and the amount of skin to be excised, local anesthesia is used to numb the area. Excess skin and fat responsible for puffiness in the inner corners of the eyelid is removed with electrocautery. Stitches are then used to close the wounds and ointment is placed over the incision. There are no bandages, however, your vision may be slightly blurry from ointment.

How long does the surgery take?

Approximately 45 minutes to an hour.

Where is the surgery performed?

We perform our upper eyelid surgeries in our office with local anesthesia.

Do I need to be asleep for the surgery? What type of anesthesia is used?

Most upper eyelid blepharoplasty surgery can be performed comfortably with local anesthesia. If desired, local anesthesia with sedation can be performed in a surgical center.

What is the recovery time and what should I expect to look like during my recovery?

We do our best to minimize swelling and bruising by preparing our patients ahead of time with supplements and with careful intraoperative technique and local medication. Regardless, it is best to prepare for downtime of 4-7 days and to “look like you had a procedure” for 1-2 weeks. Some of our patients return to working from home the next day, others choose to go to work after 4 days with the knowledge that they will still have stitches and some swelling. After one week, the stitches are removed and the swelling subsides significantly but is still present. Wearing glasses can camouflage some of this swelling and makeup can be worn except directly over the incision area. Heavy lifting and bending should be avoided for several weeks to avoid complications with wound healing.

How long do the results last?

Results should last on average 10-15 years.

Will the shape of my eyes look different after upper eyelid lift surgery?

The goal of the surgery is to rejuvenate your eyelids while preserving the shape of your eyes. During your consultation, photos of yourself when you were younger will be reviewed as well as your aesthetic goals to ensure a natural, rejuvenated look.

I am afraid of looking “done” or surprised. How can I be sure that I will avoid that look?

It is important to us that we restore a natural look. By reviewing photos from when you were younger and listening to your desired goals we can achieve a result that is soft while still making a significant improvement. Many patients who have had surgery note that their close friends or family comment on how rested they look and cannot directly discern that they underwent a surgical procedure.

How will my scars look once I am fully healed?

The upper lid incision is hidden in the eyelid crease. A small portion of it may extend outward to capture excess skin on the edges. This may appear pinkish in color several weeks after the sutures are removed depending on the skin type, and will fade over the next several months. Makeup may be applied 2-3 weeks after surgery.

Will I have dressings or bandages?

There are no patches or bandages placed over your eyes. Ointment will be placed over the incisions and in your eyes for lubrication. You may experience slightly blurry vision at this time from the ointment.

Should I avoid wearing makeup?

Makeup directly over the incision site should be avoided for approximately 2 weeks after surgery.

How long before I can return to my normal activities?

Your vision may be blurry for the first few days after surgery from the swelling and ointment. This may make it difficult to do extensive close up work or drive for four to seven days. Most patients take one to two weeks off of work. Avoid bending, lifting, straining or any aerobic activities for 2 weeks.

Is it painful after upper eyelid lift surgery?

Pain is generally minimal. Ice packs alleviate much of the discomfort the first couple of days. You may use an over the counter pain reliever such as acetaminophen (Tylenol). Avoid any medication that may increase bleeding such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve).

What are my non-surgical options for the heaviness of my upper lids?

If the heaviness is slight, botox placed strategically in the eyebrow area may be used to achieve a chemical browlift. This generally gives a 1-2mm lift of the brow and can make the eyes appear more open. The downside of the procedure is that the lift is minimal and additional botox in the forehead area can counteract this effect. It also must be repeated every 3-4 months.

Upper Eyelid Surgery (Upper Blepharoplasty) in New Jersey

Blepharoplasty is the term used when referring to cosmetic eyelid surgery. Upper eyelid surgery is designed to rejuvenate the eyes by addressing saggy or droopy upper eyelids. Dr. Baljeet K. Purewal is an Oculoplastics and Reconstructive Surgeon specializing in cosmetic eyelid surgery and non-surgical facial rejuvenation techniques. She performs upper blepharoplasty procedures to revitalize her patients’ eyes. After their upper eyelid surgery at Fresh Face & Eye in New Jersey, Dr. Purewal’s patients enjoy a natural, refreshed and youthful-looking result.

Reasons Men and Women in New Jersey Choose to Have Upper Eyelid Surgery

Men and women choose to have this procedure for a variety of reasons. Many times, the reason an individual decides to have upper eyelid surgery in New Jersey is purely cosmetic, for example, to reduce the signs of aging and/or address excess tissue/skin on the eyelid.

Another reason people choose to have upper eyelid surgery is to address functional issues, such as overhanging skin/tissue on the upper eyelid that is obstructing their vision. During a functional upper blepharoplasty, Dr. Baljeet K. Purewal strategically removes redundant tissue on the patient’s upper eyelid, thus eliminating the obstruction.

The Natural Aging Process of the Eyelids

The skin surrounding the eyes is amongst the thinnest and most fragile on the human body. As our skin ages, collagen production decreases, which results in a lack of elasticity. The continuous gravitational pull in conjunction with this loss of elasticity leads to an accumulation of excess skin on both the upper and the lower eyelids.

When excess skin develops on the lower eyelid, wrinkles and bulges may result. If skin accumulates on the upper eyelids, the patient may develop an extra fold of skin. This extra fold may hang over the patient’s lashes, thus, obstructing his or her view.

The fat responsible for providing cushion between the eyeball and the skull may also bulge into the upper and lower eyelids. This occurs when the thin membrane holding this fat in place weakens, allowing the fat to come forward, repositioning itself in the lids.

Other Reasons the Eyelids Change

During the natural aging process, the muscles that support the eyelids begin weakening. These weakened muscles can lead to fat accumulation above and below the eyelids. Heavy upper lids may also result from a descending eyebrow, excess skin on the upper lid, or both. To solve these problems, an upper blepharoplasty can be performed to lift the eyelid and a brow lift may be used to elevate the eyebrow area. Furthermore, Dr. Purewal can perform a lower blepharoplasty to address issues related to the lower eyelid and the area beneath the eye. All three of these procedures can be performed during the same surgical session.

Recognizing Changes in the Upper Eyelids and Eyebrow Complex

As excess fat accumulates beneath the eyes and the upper eyelids; the upper lids begin to droop. In addition, the eyebrows may start to sag. At this point, due to this excess fat, an individual may notice that his or her upper eyelids feel heavier than they did before.

Who is a Good Candidate for Upper Eyelid Surgery in New Jersey?

The ideal candidate for an upper blepharoplasty is someone who is in good health. The potential candidate must want to rejuvenate and refresh his or her eyes.

Individuals who are interested in having this procedure should think about what they would like to accomplish. By visualizing their goals, patients can clearly verbalize their desires to Dr. Baljeet K. Purewal at their initial consultation.

Is There Anyone Who Is Not a Good Candidate for Upper Eyelid Surgery?

Yes, individuals who have chronic dry eye or eye diseases (e.g., glaucoma) are generally not considered good candidates for upper eyelid surgery. However, there are special circumstances when an upper blepharoplasty is performed despite these underlying conditions.

An Initial Consultation at Fresh Face & Eye in Chatham, New Jersey

As an experienced specialist in cosmetic eyelid surgery and non-surgical rejuvenation procedures, Dr. Purewal knows the importance of managing her patients’ functional and aesthetic concerns, which is why she performs a thorough clinical evaluation of the patient’s eyes during the initial consultation.

As she performs this clinical evaluation, Dr. Purewal determines how well the patient’s eyes are functioning. She is looking for eyelid irregularities that are affecting the patient’s vision. Dr. Purewal also takes note of any aesthetic issues the patient would like her to address.

If the patient is considering other rejuvenating procedures (e.g., lower eyelid surgery, facial fillers, etc.), Dr. Baljeet K. Purewal will examine the areas of the patient’s face and eyes that correspond to the procedures he or she desires.

Patients should:

Be prepared to discuss their medical history, including current medications and allergies.

Some patients choose to bring a list of their current medications with them to their appointment. Having everything written down before arriving can make filling out the registration paperwork much simpler.

This medication list should include the type of medication being taken, the dosage and the reason for the medication. Dr. Baljeet K. Purewal also needs to know if the patient takes any herbal supplements or vitamins: Some of these products are known to thin the blood, which can cause unnecessary bleeding and excessive bruising following eyelid surgery.

Dr. Purewal needs to know if the patient has any allergies to medications and/or to latex.

Explain what they would like to accomplish with upper eyelid surgery.

Patients need to be candid with Dr. Purewal regarding what they would like their final result to be. If patients do not share their goals with Dr. Baljeet K. Purewal, she is unable to provide them with the upper blepharoplasty results they desire. In addition, the patient may be able to address multiple issues during a single session. If Dr. Purewal is unable to visualize the patient’s goal, she cannot make recommendations to help the patient achieve his or her desired result.

Ideally, Dr. Purewal prefers that her patients are nonsmokers who do not use any other type of product that contains nicotine (e.g., e-cigarettes, chewing tobacco, etc.). However, as long as the patient agrees to stop using nicotine-containing products for at least four weeks before and then four weeks after his or her upper eyelid surgery, Dr. Baljeet K. Purewal is confident that the patient will have an uneventful recovery and natural-looking result.

The Importance of Avoiding Nicotine Before and After Surgical Procedures

Nicotine causes the muscles in the walls of the blood vessels to contract, which causes them to narrow. Nicotine usually affects the small arterioles and the large arteries (i.e., the oxygen-carrying vessels). Once the vessels become narrow, it takes longer for the oxygenated, nutrition-filled blood to reach the area of the body that is attempting to heal itself, thus, slowing the healing process and increasing the likelihood that the patient will experience a complication (e.g., an infection).

Issues Upper Eyelid Surgery in New Jersey Cannot Address

Although an upper blepharoplasty rejuvenates and refreshes the eyes, it cannot eliminate the dark circles that sometimes develop beneath lower eyelid. In addition, this procedure cannot address facial wrinkles or crow’s feet.

Many of Dr. Purewal’s patients choose to have other procedures to address these issues at the same time they have their upper blepharoplasty.

Common procedure additions include:

  • Lower eyelid surgery.
  • Forehead lifts.
  • Laser resurfacing procedures.
  • Dermal filler injections.

Preparing for Upper Eyelid Surgery in New Jersey

Patients who are having upper eyelid surgery should schedule their procedure at a time when they know they will be able to relax for at least a week, preferably two. Having this downtime is essential because during this first two weeks, it is vital that patients avoid performing strenuous activities, bending down and lifting heavy objects. Following these restrictions will help the patient avoid complications.

Patients who take medications to thin their blood need to discontinue those kinds of medications for two weeks before their procedure. However, prior to stopping any medication, patients need to speak with their prescribing physician.

Things to do before upper eyelid surgery in New Jersey:

  • Take several days off of work and/or school.
  • Patients who use products that contain nicotine must discontinue using them for at least four weeks before their procedure.
  • For the first few days following an upper blepharoplasty in New Jersey, patients must limit their physical activity.
  • Some of Dr. Purewal’s patients experience dry eye after they have their upper eyelid surgery, however, this symptom typically subsides within two weeks. Patients who experience dry eye for more than the usual two-week time frame should call Fresh Face & Eye at (973) 635-4000 and ask to speak with Dr. Baljeet K. Purewal.
  • An upper blepharoplasty is an outpatient procedure; therefore, the patient returns home several hours after surgery. Since patients are not permitted to drive after upper eyelid surgery, they must bring a driver with them on the day of their procedure. For safety’s sake, Dr. Purewal does not permit any of her patients who have been anesthetized or sedated to use public transportation, or any other type of ride-for-hire service (e.g., Uber, Lyft, etc.). Patients who arrive on the day of their procedure without a driver will need to reschedule their New Jersey upper eyelid surgery.
  • Dr. Purewal likes her upper eyelid surgery patients to have someone they trust remain with them on the night of their blepharoplasty procedure.

To make recovery as easy as possible, patients should purchase the items listed below before their procedure:

  • Small gauze pads.
  • Artificial tears or eye drops: Before using any product in or on the eyes after the blepharoplasty, patients need to make sure that Dr. Purewal approves.
  • Ice cubes.
  • An ice pack (e.g., frozen peas, corn or freezer bags filled with ice).
  • Clean towels and washcloths.
  • If necessary, patients can use over-the-counter medication for pain (e.g., Motrin, Advil, Aleve or Naproxen). Dr. Baljeet K. Purewal may recommend a pain reliever.
  • Due to an increased risk of bleeding, patients should avoid taking aspirin.

A Custom-Designed Upper Blepharoplasty in New Jersey

Each patient is unique, therefore, the technique Dr. Purewal uses during the upper eyelid surgery depends on the needs of the patient receiving treatment. She uses her experience, skill and artistic vision to provide her patients with the youthful-looking, rejuvenated appearance that they desire.

Procedure Steps for an Upper Blepharoplasty in New Jersey

Upper eyelid surgery usually takes an hour or two. Patients who choose to have multiple procedures during the same surgical session should expect to spend more time in the procedure room.

1. Pre-Op: A Visit from Dr. Baljeet K. Purewal

While the patient is in pre-op, Dr. Purewal usually stops in to see if the patient has any questions about the upper blepharoplasty procedure. If multiple procedures are being performed, patients should feel free to ask questions about those procedures as well.

2. Administering the Anesthesia

Upper eyelid surgery can be performed with just local anesthesia or twilight anesthesia. General anesthesia is rarely used for upper blepharoplasty procedures.
Once the patient receives local anesthesia and/or sedation, Dr. Purewal waits for the medicine to take effect.

3. Creating the Incision

Dr. Purewal creates an incision within the natural upper eyelid crease or at the location where she is creating a crease. Placing the incision here ensures any scarring that results remains well hidden.

4. Specially-Designed Instruments Allow Dr. Purewal to Adjust and Remove Tissue

After creating the incision, Dr. Purewal uses specially-designed surgical and microsurgical instruments to adjust and remove tissue.

5. Excess Skin and Tissue Are Removed

Dr. Purewal will identify the upper eyelid crease on both of the patient’s eyes. She will carefully remove excess skin. If too much skin is removed, the patient will have difficulty closing his or her eyes.

Sometimes, to attain optimal results, Dr. Purewal needs to remove part of the orbicularis oculi muscle.

Fat that is over the middle of the eyelid is frequently preserved, however, there are times when removing a portion of this fat improves the aesthetic contour of the upper eyelid.

6. Reviewing the Results

Once Dr. Purewal is happy with the shape and structure of the patient’s eyelids, she uses sutures to close the incisions. She also uses the sutures to reconfigure and smooth the eyelids.

7. Dr. Purewal Uses Very Fine Sutures to Close the Incisions

The sutures that are used to close the incisions during upper eyelid surgery are finer than a strand of human hair.

Suture Removal

To attain the best results possible, these sutures need to be removed within five to seven days of the upper blepharoplasty.

Recovering from Upper Eyelid Surgery in New Jersey

Inflammation and/or mild bruising around the eyes is common following upper eyelid surgery. These side effects last from 10 to 14 days.

Patients should ask Dr. Purewal before wearing makeup.

Glasses can be worn directly after the procedure, however, patients who wear contacts must avoid wearing them for several weeks while their eyes heal.

Patients should expect their eyelids to look normal within a week or two.

Results

Upper eyelid surgery can improve a patient’s self-image because once recovery is over the patient will feel better about the way he or she looks, which ultimately increases self-confidence. This newfound confidence may spill over into other areas of the patient’s life, making it easier to interact with others. With their brighter, fuller eyes, patients can now express themselves better.

Are the Results Attained with Upper Eyelid Surgery Permanent?

The results of an upper blepharoplasty can last up to seven years. A lower blepharoplasty rarely needs to be done again. That said, the body continues to go through the natural aging process, which means the eyes will still continue to age.

Potential Risks and Complications Associated with an Upper Blepharoplasty in New Jersey

Although unwanted results and complications stemming from upper eyelid surgery are rare, they can occur.

Potential risks, complications and undesirable results can include:

  • Inflammation.
  • Pain.
  • Infection.
  • Scarring.
  • Bleeding.
  • An adverse reaction to the anesthesia.
  • Abnormal eyelid pigmentation.
  • Excessive tearing.
  • Whitehead formation (i.e., milia) following suture removal. This condition is typically treated post-operatively.
  • Difficulty keeping the eyes closed and/or completing a full blink, resulting in chronic dry eye.
  • Chronic dry eye that causes the patient to experience a burning sensation. This side effect can be addressed with artificial tears.
  • If a patient experiences difficulty keeping his or her eyes closed just while sleeping, this complication is usually temporary.
  • Injury to the levator muscles causing eyelid droop.
  • An asymmetrical result.
  • Blurred vision.
  • Double vision.
  • Eyelid skin that abnormally folds in or out.
  • Vision loss (extremely rare).

Understandably, one of the main issues that concerns most patients is the accidental removal of too much skin from the upper eyelid, making it difficult to close the eye all the way. As an experienced Oculoplastics and Reconstructive Surgeon who specializes in cosmetic eyelid surgery, Dr. Purewal is very conservative during the skin excision process.

Preventing Complications and Reducing Risk

Serious complications following any surgical procedure are usually influenced by the skill of the surgeon and a patient’s individual response to the surgery itself. There are some severe complications that patients can help prevent by choosing a surgeon who is qualified to perform upper eyelid surgery and working hand-in-hand with their surgeon by following the surgeon’s instructions, restrictions and recommendations.

How Much Does an Upper Blepharoplasty in New Jersey Cost?

Each patient is unique, therefore, to determine how much an upper blepharoplasty will cost can only be accomplished with an initial consultation. During the consultation, Dr. Purewal will examine the patient’s eyes and find out what issues he or she would like Dr. Purewal to address.

Will Insurance Cover Upper Eyelid Surgery?

Insurance does not cover eyelid surgery for individuals choosing to have this procedure for rejuvenation purposes, as this surgery is considered cosmetic. However, when a patient has a droopy eyelid that is affecting his or her vision, the insurance will usually cover a portion of the procedure because when the surgery is performed for this purpose, it is no longer considered cosmetic, but functional.

If a patient is experiencing vision problems due to his or her drooping eyelid(s), Dr. Purewal recommends that the patient contact his or her insurance company to find out if they will cover part of the procedure.

If you are interested in learning more about upper eyelid surgery, and you reside in the New Jersey area contact Fresh Face & Eye today by clicking here or calling 973-635-4000 to schedule an initial consultation with Dr. Baljeet Purewal.

Dr. Purewal is a board-certified, Oculoplastics and Reconstructive Surgeon who specializes in non-surgical facial rejuvenation procedures and cosmetic eyelid surgery. She has been serving the New Jersey area for 10 years. Fresh Face & Eye is located in Chatham, New Jersey, at 82 Main Street.

 

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