Atlanta
Eyelid Surgery (Blepharoplasty)

Eyelid Surgery FAQs

Eyelid Surgery in Atlanta, GA with Dr. Miotto

The eyelids frame and protect the eyes, bringing beauty and expression to the face. The eye region (periocular area) plays a crucial role in our daily interactions with each other and aging in this area can be very noticeable. As we get older, the eyelid tissues become thinner and the skin loses elasticity contributing to a “tired” or aged appearance. It is also common to notice more puffiness around the eyes and visible dark circles and wrinkles.

Aesthetic eyelid surgery, known as blepharoplasty or eyelid lift, is a common procedure used to rejuvenate the periocular area and treat excess skin, puffiness and dark circles, with the purpose of make the appearance of the eyes more vibrant and less tired. During a blepharoplasty, the surgeon removes the excess skin, loose muscle and fat from the eyelids and tightens the tissues for a rejuvenated look. If the eyelids are sunken or hollow, fat grafting can be added to the eyelids for a great rejuvenating tool. Modern eyelid surgery includes not only removing excessive tissue but also adding tissues, such as the patient’s own fat to restore the youthful anatomy. There is no cookie cutter procedure when we talk about aesthetic surgery, specially the eyelids. Individuality, patient’s race, facial shape, aging patters, they all count when making a surgical plan.

A blepharoplasty can be done for the upper and lower eyelids depending on the individual needs. Small incisions are placed inside the eyelids (in the conjunctiva – called transconjunctival blepharoplasty) or in the natural creases of the lids where the scar can be hidden (skin pinch blepharoplasty or skin-muscle blepharoplasty). Blepharoplasty is an outpatient surgery done under local anesthesia and sedation or under general anesthesia. After the procedure, there will be visible fine skin sutures in the incisions (for skin pinch or skin muscle blepharoplasty) or no sutures (for transconjunctival blepharoplasty) .

Eyelid surgery is not a painful procedure, but mild discomfort around the eyes is expected. Bruising and swelling are usually the cause of the discomfort. However, it can be treated with preoperative and postoperative medication and supplementation, ice and anti-inflammatories. Swelling can be minimal or more intense depending on how many procedures need to be done in surgery to make the results the most beautiful and natural possible. Frequent combined procedures with a blepharoplasty or eyelid lift include: fat grafting to the eyelids or to the face, endo browlift  or lateral brow lift, laser resurfacing or resurfacing with a chemical peel to treat the skin aging, facelift or neck lift…there are many options for us to use to achieve the best results.

Sutures are removed between 5-7 days after the blepharoplasty. Expect at least two weeks for committing to major social events as residual bruising and more visible swelling can be prominent during the first 2 weeks after surgery. We are all different, so it is hard to predict who will get more or less swelling and bruising. Therefore, we usually recommended that you perform a blepharoplasty 2-4 weeks before any major social events.

There are non-surgical options to a blepharoplasty. For patients with hollowed eyelids, temples or deep dark circles we can use hyaluronic acid fillers or your he patient’s own fat to rejuvenate these areas. Aging causes facial deflation or loss of fatty tissue around the eyes which contributes tremendously to a tired and aged appearance.

Hyaluronic acid fillers are recommended as temporary but effective nonsurgical options and can be repeated every year or as needed. Fat is a more permanent solution but is partially reabsorbed and more than one injection session may be needed.

Hyaluronic acid injections are done in the office using topical anesthetic. Fat grafting requires the use of local anesthesia for numbing of the fat harvesting area. Fat can be harvested from any fatty deposit in the body, it is prepared as microfat and injected in depleted periocular areas – it is the patient’s own natural filler. Expect some swelling and bruising for a few days after any injection of hyaluronic acid fillers or fat.

Our goal is to provide individual beautiful and natural results. Always!

General preoperative recommendations for blepharoplasty / eyelid lift surgery:

What to avoid before surgery:

1. DO NOT take any aspirin for 7-10 days before your scheduled procedure. Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before surgery. You may take Tylenol (Acetaminophen) if needed for aches or pains. Please contact the office at if you have any questions about any medications that you are taking or if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP).
2. Discontinue Vitamin E 10 days before surgery.
3. Avoid the following herbal supplements for 10 days before surgery: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
4. Stop Smoking. The harmful effects of smoking can cause tissue death, infection, and open wounds. It also makes you age faster!
5. Alcohol can promote swelling of the surgical area and it is best to avoid alcohol intake for at least one week before surgery.

What to take before surgery:

1. Before a chemical peel or laser treatment, Dr Miotto will instruct you to begin using tretinoin (retin-a) and hydroquinone two weeks before your procedure to speed up the healing process. We carry these products at our Spa for your convenience.

General postoperative recommendations after blepharoplasty / eyelid surgery:

1. You MUST have a responsible adult to transport you home and stay with you for a full twenty-four hours after your surgery. If general anesthesia is used, the medications used during the procedure directly affect the nervous system, and for your safety, we will not allow you to drive or be home alone immediately after surgery.
2. You will be unable to drive if you are taking narcotics.
3. It is common to feel sluggish for a few days as the anesthesia works its way out of your system.
4. It is recommended to elevate the head with two to three pillows after all facial procedures.
5. Your initial post-operative appointment will be scheduled by your Patient Care Coordinator; please make arrangements to have reliable transportation for these appointments as you will not be permitted to drive until twenty-four hours after your surgery and when you are no longer taking narcotic pain medications.

Activity:

1. For your safety, we require that you have a responsible adult stay with you for twenty-four hours after your surgery for general help, as you may find your balance and judgement impaired.
2. Please refrain from physical activity that will increase your heart rate or blood pressure for two weeks after surgery. However, bed rest is NOT recommended, and you should be walking at normal pace after the procedure.
3. Frequent walking will decrease the risk of post-operative blood clots (mostly after general anesthesia).
4. Sexual activity can safely be resumed one to two weeks following surgery. Please discuss with Dr Miotto as needed.

Bathing:

1. You can shower twenty-four hours after surgery. You may clean the incisions as instructed by Dr Miotto or her nurses after the procedure.
2. Do not submerge yourself into a tub/pool until all wounds have healed (usually in three weeks).
3. Do not scrub the surgical sites, however you can allow soapy water to run over them.
4. Avoid lotions on the surgical sites for two weeks, but you can moisturize any other areas as desired.

Returning to Work:

1. Recovery time will vary; however, most patients return to work within one to two weeks after the procedure, within one week you will have a feel for your specific limitations and will be able to determine how comfortable you will be with resuming your daily activities and workload.

Diet:

1. Immediately following surgery, it is best to eat bland, easily-digested food and avoid excess sugar and salt. Healthy proteins (eggs, lean meat, beans, nuts), rice, fruits and cooked vegetables (broccoli, peppers, sweet potatoes) will provide your body with nutrients essential for healing.
2. Eat a few bites of food before taking pain medications as these can cause nausea.
3. A diet low in sodium will help minimize swelling and water retention.
4. Drink plenty of water! Drinking low sugar sports drinks and protein shakes are recommended.

Final Results:

1. Keep in mind that our goal in aesthetic surgery is improvement and not perfection. You will be followed closely after surgery to assure that you heal well and have the best possible results.
2. It can take months for the very final results of your surgery be apparent. After twelve weeks, you can expect your results to be mostly permanent. Expect subtle changes in swelling and healing (including the appearance of scarring) to continue to appear for up to twelve months.
3. It is important for you to keep open communication with your physician and return for your follow up visits. We will take pre and post pictures along the way and look at the final results together.

Eyelid Surgery (Blepharoplasty) Before & Afters

Eyelid Surgery (Blepharoplasty) in Atlanta, GA. Eyelid Surgery performed by Dr. Miotto

Atlanta Eyelid Surgery (Blepharoplasty) Specialists

Eyelid surgery is also referred to as a blepharoplasty or an eyelid lift. This plastic surgery procedure is designed to rejuvenate the eye and provide the patient with a more refreshed, youthful-looking appearance. A blepharoplasty can be performed on the upper or on the lower eyelids. A blepharoplasty can also be performed on both sets of eyelids during the same surgical session. At ME Plastic Surgery in Atlanta, Dr. Gabriele Miotto and Dr. Felmont Eaves perform blepharoplasty procedures to help people regain a more youthful appearance.

What Issues Can Eyelid Surgery in Atlanta Address?

Issues that can be addressed with a lower blepharoplasty include a sagging lid as well as the bags and puffiness beneath the eye.

An upper blepharoplasty can be used to correct upper lids that descend and cover a portion of the patient’s eye, which may obstruct his or her vision.

During an upper or lower blepharoplasty, the surgeon can also improve the shape of the eye.

Who Should Consider Eyelid Surgery in Atlanta?

The ideal candidates for blepharoplasty procedures are people who would like to address:

• sagging lower eyelids.
• drooping upper eyelids.
• excess fat and skin on the eyelids.

The blepharoplasty patient should:

• be healthy.
• have realistic expectations about what a blepharoplasty can accomplish.

Most blepharoplasty patients are at least 35 years of age, however, there are people who choose to have this procedure before they turn 35. These patients are usually those who have inherited certain eyelid characteristics that can be addressed with a blepharoplasty.

Before having a blepharoplasty, patients should consider their goals and discuss these desires with the doctor during the initial consultation. At ME Plastic Surgery in Atlanta, Dr. Miotto and Dr. Eaves have years of experience performing eyelid surgery for men and women. Their extensive experience allows them to determine whether a blepharoplasty can accomplish the goals of the patient.

What Causes Eyelid Ptosis?

Determining the reason an individual has eyelid ptosis is essential to correcting the problem. It is the cause of the ptosis that determines the specifics of a patient’s custom-designed surgical plan, which is why choosing an experienced plastic surgeon with the ability to correctly diagnose the cause of the ptosis is vital to achieving a successful eyelid surgery result.

Potential causes of eyelid droopiness:

• A decrease in the production of collagen and elastin – with time, the body naturally decreases its production of elastin and collagen, which are the proteins responsible for giving the skin its ability to stretch and its plump appearance. The decrease in the level of these proteins in the body can lead to eyelid ptosis. Eyelid ptosis is characterized by an upper eyelid that droops.
• Detached fibers – a drooping upper eyelid can also occur when the fibers connecting the muscles that are used to open the eye detach (eyelid ptosis). This detachment may happen as an individual ages and is referred to as blepharoptosis. At ME Plastic Surgery in Atlanta, Dr. Gabriele Miotto and Dr. Felmont Eaves can address this issue with eyelid surgery.
• Excess skin – The lack of elasticity and the continuous gravitational pull results in the collection of excess skin on the upper and the lower eyelids. When there is excess skin on the upper eyelid, a fold of skin develops. This fold hangs over the eyelashes, interrupting the patient’s field of vision.
• Fat breaking through into eyelid – if the connective fibers in the eyelid weaken, fat can herniate into the upper eyelid, this fat causes the eyelid to consistently appear swollen and droop.
• Brow ptosis – another issue that could cause a drooping eyelid is a brow that has fallen. To correct this issue, instead of eyelid surgery, a brow lift needs to be performed.

The Importance of Correctly Determining the Cause of Eyelid Ptosis

When a patient has eyelid ptosis, the doctor needs to determine what is causing the condition. Correctly determining the reason for the ptosis and then addressing the cause accordingly is the only way to correct this problem.

An inexperienced surgeon may have difficulty determining the cause, which is why choosing an experienced plastic surgeon is of utmost importance.

Eyelid Surgery (Blepharoplasty) Before & Afters

Eyelid Surgery (Blepharoplasty) in Atlanta, GA. Eyelid Surgery performed by Dr. Miotto

Blepharoplasty Limitations

A blepharoplasty is unable to completely eliminate dark circles beneath the eyes, facial wrinkles or crow’s feet, however, at ME Plastic Surgery, blepharoplasty procedures can be performed along with other plastic surgeries and treatments that are designed to address these issues.

Some of the other treatments frequently performed with blepharoplasty procedures include forehead lifts, dermal fillers, fat grafting and laser resurfacing.

Hollow-Looking Eyes can be Addressed with Fat Grafting

Individuals with eyes that appear sunken in can add volume to these areas using their own fat.

Personalized Eyelid Surgery Plans in
Atlanta

Although most of the time patients need a traditional upper blepharoplasty to address multiple issues, there are times when a more specialized procedure is required. For example, if excess skin is the only reason a patient needs an upper blepharoplasty, his or her custom-designed blepharoplasty plan will reflect that the surgeon is only removing the excess skin.

An Initial Consultation for Eyelid Surgery in Atlanta

During the initial consultation at ME Plastic Surgery, patients should be prepared to discuss their medical history with the doctor. The doctor needs to know about any medications the patient is currently taking, treatments and chronic conditions (e.g., diabetes, hypertension, etc.) as well as information about previous surgical procedures. In addition, please let doctor know if there were any issues related to anesthesia. Allergies to medication and latex should be included on the patient’s registration information.

The doctor needs to know what the patient would like to accomplish with eyelid surgery. Depending on the issues being addressed, certain eye tests will be performed.

Since each patient is unique, at ME Plastic Surgery, every surgical plan that Dr. Miotto and Dr. Eaves creates is designed to meet the needs of a specific patient.

While creating a patient’s unique surgical plan, Dr. Gabriele Miotto and Dr. Felmont Eaves consider the patient’s:

• Aging patterns.
• Race.
• Facial shape.
• Goals.

Photos May be Taken

If the doctor believes that the patient is a good candidate for eyelid surgery and he or she chooses to move forward with the procedure, pictures of the patient’s eyes may be taken. These photos are taken from different angles. The surgeon uses these pictures while creating the patient’s personalized surgical plan for a blepharoplasty.

Prior to surgery:

• STOP SMOKING. The nicotine found in tobacco is a vasoconstrictor, which means it causes the blood vessels to contract, thus, making it difficult for the nutrient-rich, oxygenated blood to reach the incision site as it heals. This slowed response can lead to the development of an infection and necrosis (i.e., tissue death) as well as open wounds. In addition, smoking hastens the aging process.
• AVOID ALCOHOL. Since alcohol is known to promote inflammation, patients should avoid these products for at least 7 days before their surgery.
• DO NOT take these herbal supplements for at least 10 days before the blepharoplasty procedure – Valerian, Feverfew, Echinacea, Saw Palmetto, Garlic, Phentermine/Ephedra, Fish oils, Goldenseal, Licorice, Ginkgo Biloba, St. John’s Wort and Kava-Kava.
• DO NOT take Vitamin E for at least 10 days prior to eyelid surgery.
• DO NOT take any type of NSAID within 5 days of surgery. NSAIDS include Motrin, Aleve and Ibuprofen. If pain medication is required at some point during this 5-day period, patients can take Acetaminophen (Tylenol).
• DO NOT take aspirin or products that contain aspirin for at least 7 days before eyelid surgery.
• If a patient’s general practitioner or cardiologist has prescribed aspirin, please call ME Plastic Surgery at (404) 850-5851.

Keep in mind that patients should never decrease their dosage or discontinue taking any prescription medications without speaking with Dr. Eaves, Dr. Miotto or the prescribing physician.

What Patients Should Take Before Their Eyelid Surgery in Atlanta

Some vitamins, supplements and products can help with the healing process. Taking these before surgery as recommended by Dr. Gabriele Miotto and Dr. Felmont Eaves can speed up a patient’s recovery time.

Before eyelid surgery in Atlanta, patients should:

• Hydroquinone and retin-a (tretinoin)- patients who are having a laser treatment or chemical peel should also begin using hydroquinone and retin-a (tretinoin) 14 days before the procedure. These products help the body heal, thus, speeding up the healing process. For the sake of convenience, these products are available at our Spa.

Preparing for At-Home Recovery Following a Blepharoplasty

Preparing ahead of time can make the recovery process much smoother.

Preparing for a blepharoplasty:

• Take a week or two off work.
• Since patients are unable to drive following their eyelid surgery, they need to find someone they trust to serve as their chaperone on the day of their procedure.
• Patients also need someone they feel comfortable with to remain with them for at least 24 hours after their procedure.
• If a patient is taking narcotics, he or she is not permitted to drive. Therefore, the patient will need a chaperone until the narcotics are no longer required.

Items patients should have readily available at home:

• Two or three extra pillows.
• Cold gel packs.
• Crushed ice in a Ziploc bag (if not using a gel pack). Although ice cubes can be used, after eyelid surgery, crushed ice and gel packs are more comfortable options.
• Artificial tears or eye drops.
• Gauze pads (small).
• Over-the-counter pain medication, however, Aleve, Naproxen, Motrin, Advil and aspirin need to be avoided as these medications could increase the likelihood of excess bleeding.
• Prescription medications, including any that were pre-ordered by Dr. Miotto or Dr. Eaves.
• Clean towels and washcloths.
• Hand wipes.
• Facial tissues.

ME Plastic Surgery’s Patient Transportation Policy:

At ME Plastic Surgery, after having a procedure that involves the use of any type of sedation, patients are not permitted to use public transportation or for-hire transportation (e.g., Uber, a taxi, etc.) to return home. This policy is designed to protect our patients at a time when they may be vulnerable.

Eyelid Surgery in Atlanta – The Procedures

Patients must bring their driver with them on the day of their blepharoplasty, otherwise, the procedure will be rescheduled.

Pre-Op

During pre-op, Dr. Gabriele Miotto or Dr. Felmont Eaves visits the patient. Several markings are created around the eyes. These markings are used as a guide during surgery. At this time, patients are encouraged to ask any last-minute questions they have.

Anesthesia

Patients may receive local anesthesia with oral sedation or IV sedation.

Eyelid Surgery (Blepharoplasty) Before & Afters

Eyelid Surgery (Blepharoplasty) in Atlanta, GA. Eyelid Surgery performed by Dr. Miotto

Upper and Lower Eyelid Surgery at ME Plastic Surgery in Atlanta

When an upper and lower blepharoplasty are performed simultaneously, the procedure takes about two hours. The upper eyelids are usually addressed first.

An incision is created on the upper eyelid. This incision runs along the new eyelid crease, which resulted from the excess skin. This technique may be referred to as a skin-muscle blepharoplasty or a skin-pinch blepharoplasty.

Through this incision, the surgeon separates the skin from its underlying tissue and removes the excess fat, skin and, if indicated, loose muscle.

The tissues are tightened.

Using extremely fine stitches, the surgeon closes the incision.

These stitches remain intact for 5 to 7 days.

The resulting scar remains hidden within the crease of the eyelid.

Lower Eyelid Surgery in Atlanta

This procedure can be performed using several techniques. The technique that Dr. Miotto or Dr. Eaves chooses depends on the characteristics of the patient’s lower eyelid and his or her desired result.

The Transconjunctival Method

With this method, an incision is created inside the lower eyelid. The surgeon uses this incision to access and remove fat that has accumulated in the lower eyelid.

Since the transconjunctival incision is created on the inside of the lower lid, it is not visible.

At this time, if the patient is also having a laser treatment, the laser is used to soften fine lines.

A lower blepharoplasty using the transconjunctival method does not require stitches.

Eyelid Surgery Lash-Line Incision Method

With this technique, an incision is created along the eyelash margin. Using this incision, the surgeon removes loose muscle as well as excess fat and skin.

The incision is closed using a very fine suture.

Although this incision is created on the outside of the eyelid, it fades relatively quickly, becoming nearly invisible.

Once this procedure is complete, the patient has a smooth transition from the lower eyelids to his or her cheeks.

Canthopexy with a Lower Blepharoplasty

A canthopexy and lower blepharoplasty can be performed at the same time. The canthopexy is performed at the outer corner of the eye.

A canthopexy procedure is designed to provide additional support to the lower eyelid, preventing it from sagging.

Following this procedure, there will be fine sutures visible which will be removed within a week.

Addressing Hollow or Sunken-in Lower Eyelids with Autologous Fat

When a patient has eyelids that look hollow or sunken-in, the patient’s own fat can be harvested to use as filler.

Once the hollow areas are filled, the patient’s eyes look rejuvenated.

Preparing the Harvested Fat for Injection

Autologous fat grafting is a procedure that is used to harvest the patient’s fat. Once the fat is harvested, it is prepared for injection.

The preparation process involves centrifuging or straining the fat cells to separate the stronger cells from the weaker ones.

Once the separation is complete, the viable fat cells can be collected and injected into the hollow areas.

Although some of the fat cells will die, many will survive. Those that do survive remain in the areas where they were injected, indefinitely.

Other Procedures Frequently Performed with Eyelid Surgery in Atlanta

Many patients choose to address multiple issues at the same time.

Some of the procedures that are frequently performed during the same surgical session as a blepharoplasty include:

• Fat grafting to fill in hollow areas of the face or eyelids.
• An endoscopic or lateral brow lift.
• A neck lift or facelift.
• Resurfacing using a chemical peel.
• Laser resurfacing.

At ME Plastic Surgery, highly experienced plastic surgeons Dr. Gabriele Miotto and Dr. Felmont Eaves help their patients attain the youthful-looking, rejuvenated appearance they desire.

In the Recovery Room

Patients should expect to have ointment put in their eyes, which helps keep the eyes moist. The eyes will also be covered with cold compresses, which help to alleviate inflammation, ultimately reducing the amount of bruising a patient experiences.

Initially, patients may experience blurry vision, which is due to the ointment. Their eyes may also be very sensitive to light.

The patient’s eyes might be watering or they may feel dry.

The Patient Care Coordinator at ME Plastic Surgery schedules the patient’s first post-operative appointment. Since patients are unable to drive for 24 hours following surgery, they need to have reliable transportation to and from their first post-operative appointment.

Recovering from eyelid surgery in Atlanta:

• Patients who take narcotic pain medications need to have reliable transportation set up until they are no longer taking this medication.
• Some patients experience dry eyes after their blepharoplasty. This side effect usually only lasts about 2 weeks. If this side effect continues beyond the 2 weeks, please contact ME Plastic Surgery at (404) 850-5851 to speak with our team.
• Patients should expect to feel lethargic. This side effects lasts for several days following their blepharoplasty procedure in Atlanta.
• Patients need to keep their heads elevated using two or three extra pillows.
• The fine stitches in the lids are removed within 5 to 7 days.
• Ice packs should be used for the first 48 hours after surgery.
• Patients may receive lubricating eye drops to use for a week or two after surgery.
• Inflammation and bruising can last a week or two.
• Strenuous activities, including intercourse, must be avoided for the first 2 weeks.
• Full recovery can take from 6 to 8 weeks.
• The results attained with a blepharoplasty can continue improving for up to 6 months.

Blepharoplasty Results

After eyelid surgery in Atlanta, patients enjoy a more refreshed, youthful-looking and rejuvenated appearance. The results attained during this procedure can last up to 7 years.

Potential Complications Following a Blepharoplasty

While all complications are troubling, some are more concerning than others. Knowing the possibilities is important.

Some potential complications include:

• Infection.
• Excess bleeding.
• Dry eyes.

Although serious complications following eyelid surgery are rare, there are times when an issue arises, for this reason, they must be addressed.

Potential complications include:

• The inability to fully close one’s eyes.
• Eyelid skin inconsistencies (e.g., folding in or out)
• Abnormal coloring on the skin of the eyelid.
• Vision loss.
• A pulled-down lower lid.

Patients experiencing any of these complications need to contact their plastic surgeon.

The Cost of Eyelid Surgery in Atlanta

Each patient is unique, therefore, the only way to determine how much an individual’s blepharoplasty procedure will cost is with an initial consultation.

Contact ME Plastic Surgery Today

At ME Plastic Surgery, Dr. Gabriele Miotto and Dr. Felmont Eaves create beautiful, natural-looking blepharoplasty results for men and women in Atlanta, and its surrounding areas. If you are considering eyelid surgery, or any other cosmetic procedure, contact ME Plastic Surgery today at (404) 850-5851. With more than 20 years of experience performing plastic surgery procedures and cosmetic treatments, Dr. Gabriele Miotto and Dr. Felmont Eaves have the skill, knowledge and vision to help you attain the more-youthful appearance you desire.

ME Plastic Surgery, 3200 Downwood Circle Northwest, Suite 640, in Atlanta.

Eyelid Surgery FAQs