Lower Blepharoplasty

The eyes can show a great deal of emotion, which may be the reason that upon meeting someone new or carrying on a conversation people tend to focus on the other person’s eyes. Since the skin surrounding the eyes is extremely thin, it is also very delicate. For this reason, these areas are frequently the first places to show the signs of aging. Signs of aging can include loose skin, wrinkles, fat deposits, and creases.

At ME Plastic Surgery in Atlanta, Dr. Gabriele Miotto performs lower eyelid surgery (aka a lower blepharoplasty), to address the signs of aging in the skin beneath the eyes. If the signs of aging are apparent in the upper eyelids, patients can have an upper blepharoplasty (aka upper eyelid surgery) or a combination procedure in which Dr. Miotto performs eyelid surgery on the patient’s upper and lower eyelids during the same surgical session.

Dr. Gabriele Miotto is an internationally recognized and highly experienced plastic surgeon who is dedicated to helping her patients attain the refreshed, more youthful appearance they desire.

Before and After Photos

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Patient story

This is a female patient in her 60’s who wanted to improve the tired look and puffiness in the upper and lower eyelids. We did an upper and lower blepharoplasty (eyelid surgery) to remove excess skin and bags and to tighten the eyelid muscles. We also restored the eyelid shape and brightness with a lateral “scarless” brow lift and an eye corner lift, or canthopexy.

Initial consultation

The first step towards more youthful-looking eyes is scheduling an initial consultation for a lower blepharoplasty with Dr. Miotto at ME Plastic Surgery. During this consultation, individuals need to be prepared to talk about their medical history, current medication, vitamin and herbal supplement use, as well as any chronic medical conditions (e.g., diabetes, hypertension, glaucoma, etc.) they have. Patients who have allergies to certain medications or to latex products should provide details about these allergies during their initial consultation.

Dr. Gabriele Miotto also asks the patient what he or she would like to accomplish with a lower blepharoplasty. Patients are always encouraged to be candid with their surgeon because this is the only way that Dr. Miotto can work towards providing a patient with his or her desired result.

After reviewing the patient’s medical information, answering the patient’s questions and finding out what the patient’s motivation for lower eyelid surgery is, Dr. Gabriele Miotto examines the patient’s eyes.

The eye examination

The surgeon needs to determine what is causing the patient to experience the issues that lower eyelid surgery addresses; therefore, patients should expect their eyes to be examined. This examination may include measurements and checking tear production.

Procedure recommendations

Once the examination is complete, Dr. Miotto will recommend the treatments and procedures that she believes will provide the patient with the results that he or she desires.

If the patient is interested in any of the procedures or treatments recommended by Dr. Miotto, she will answer any questions the patient has and provide information about these services. Should the patient decide to move forward with any of the recommended procedures, Dr. Gabriele Miotto may begin preparing for these additional procedures. This preparation may include taking more measurements and photographs of the areas the patient is having addressed. Dr. Miotto uses this information as she creates the patient’s custom-designed surgical treatment plan.

Can any other procedures be performed during a lower blepharoplasty?

Yes, there are other procedures that Dr. Gabriele Miotto can perform at the same time she performs the patient’s lower eyelid surgery or combination upper and lower blepharoplasty.

These other procedures include

Preparing

Prior to surgery, there are a few things that Dr. Miotto asks her patients to do

• It is vital that patients who smoke cigarettes or use any other product that contains nicotine discontinue using these items or smoking at least 4 weeks before surgery and 4 weeks after.
• 10 days before surgery, patients need to stop taking Vitamin E.
• 7 to 10 days before surgery, patients should stop taking medications that are known to increase bleeding, including blood thinners and aspirin.
• Since alcohol is known to increase inflammation, patients must avoid consuming alcohol for at least 7 days before their lower eyelid surgery in Atlanta.
• 5 days before surgery, patients must not take naproxen sodium and ibuprofen.
• Patients who need to take medication for pain within the 5-day timeframe leading up to surgery can safely take acetaminophen.
• If applicable, be sure to have any preliminary testing done no later than a week before surgery.
• Since a lower blepharoplasty is an outpatient procedure, patients need to ask someone to drive them to and from surgery.

10 days before their surgery, patients need to refrain from taking the herbal supplements listed below

• Valerian.
• St. John’s Wort.
• Saw Palmetto.
• Licorice.
• Kava-Kava.
• Goldenseal.
• Ginkgo Biloba.
• Garlic.
• Fish Oils.
• Feverfew.
• Ephedra/Phentermine (weight-loss drug).
• Echinacea.

Before their lower eyelid surgery in Atlanta, Dr. Gabriele Miotto requests that her patients take

About 14 days before a laser treatment or a chemical peel, Dr. Gabriele Miotto instructs her patients to begin using two products, tretinoin and hydroquinone. These products help the face heal quicker after chemical peels and laser treatments. Both hydroquinone and tretinoin are available at our Spa.

What to expect

Dr. Miotto has a couple of different lower eyelid surgery methods to choose from, the transconjunctival method or the lash-line method. While creating the patient’s personalized surgical treatment plan, Dr. Gabriele Miotto determines which of these lower blepharoplasty methods will serve the patient better.

Safety First Priority

ME Plastic Surgery’s main concern is always patient safety, which is why we do not permit our patients to use any of the for-hire driving services that are available following procedures requiring sedation. Therefore, on the day of their procedure, patients must arrive at least 15 minutes before their scheduled procedure with a licensed driver. The licensed driver must be present with the patient when he or she arrives, otherwise, the procedure will need to be rescheduled until such a time when the patient can bring a licensed driver to the surgery center.

Pre-op

As the patient prepares for surgery in the pre-op area, Dr. Gabriele Miotto will visit the patient. She will create several markings around the patient’s eyes, which she uses as a guide while performing the lower eyelid surgery in Atlanta. Dr. Miotto wants her patients to feel as comfortable as possible before their procedure, which is why she encourages her patients to ask any last-minute questions they have at this time.

Anesthesia options

Anesthesia options include IV sedation or local anesthesia with oral sedation.

Surgical techniques

The procedure Dr. Miotto chooses depends on the issues she is addressing for the patient.

The Lash-Line Incision

This technique involves the creation of an incision along the patient’s eyelash margin. Through this incision, Dr. Gabriele Miotto removes excess fat and any extra skin that is causing the eyelid to droop.

She closes the lash-line incision using very fine sutures.

Although she creates the lash-line incision outside the eye, its visibility fades quickly.

After a lower blepharoplasty using a lash-line incision is complete, the patient enjoys a smoother transition from his or her lower eyelids to the cheeks.

The Transconjunctival

This eyelid surgery method involves the creation of an incision inside the lower eyelid. Using this incision, Dr. Gabriele Miotto removes the excess fat that is present in the lower eyelid.

Since the incision used during this procedure is created inside the lower eyelid, sutures are not required.

Lower eyelid surgery

A canthopexy is a procedure that can be performed during the same surgical session as the lower blepharoplasty.

The canthopexy procedure addresses the outer corner of the eye and is designed to provide the lower eyelid with additional support to prevent it from drooping.

After this combination procedure, very fine sutures are placed. These sutures are visible, but they will be removed within a week’s time.

Treating Hollow Eyes with Fat

If the area beneath the eyes appears sunken-in or hollow, Dr. Gabriele Miotto can harvest the patient’s own fat to use as a filler. After she fills these areas, the patient’s eyes will look more youthful.

Autologous fat grafting

During this procedure, Dr. Miotto harvests fat from an area of the body where excess fat has accumulated. Common areas used for fat harvesting include the hips, abdomen, and thighs.

The fat being used for injection is harvested via liposuction.

After harvesting the fat, Dr. Gabriele Miotto prepares it for injection. During this preparation process, the stronger fat cells are separated from the weaker ones. Dr. Miotto uses the stronger cells for injection.

She strategically injects the fat cells into the hollowed areas to provide the patient with even, natural-looking volume.

It is likely that some of the injected cells will die; however, many of the fat cells will survive. The cells that survive remain within the areas where Dr. Gabriele Miotto injected them, indefinitely.

Post-surgery Expectations

Directly following surgery, the patient’s eyes need to remain moist. For this reason, while in recovery, the patient’s eyes will have lubricating ointment in them. In addition, the patient’s eyes are covered with cold compresses. These compresses help reduce inflammation, which decreases bruising.

The patient remains in the recovery room being monitored for some time. Once the patient is awake and Dr. Miotto is happy with how well the patient is progressing, he or she is released to the driver that arrived with the patient. Before the patient leaves, ME Plastic Surgery’s Patient Care Coordinator schedules his or her first post-surgical appointment. This appointment is scheduled for the following day and patients are not permitted to drive for a full 24 hours after their eyelid surgery; therefore, patients will need a driver for this follow-up appointment.

Recovery

Dry eyes following eyelid surgery are common. This side effect typically lasts approximately 2 weeks. Should this continue past the 2-week mark, patients need to contact the office at (404) 850-5851 to discuss this issue with our team.

Patients taking narcotic pain medication after their blepharoplasty must have transportation until they have completed taking this type of medication.

Sluggishness is expected and usually lasts for a few days after a lower blepharoplasty.

Bruising and swelling are common. These side effects generally resolve within two weeks’ time.

Temporary side effects

Generally, these side-effects subside within 10 to 14 days. Nonetheless, visible incisions can take several months to fade. As any incision heals, avoiding sun exposure is imperative to ensure that the incision does not darken and fades well.

Restrictions and self-care

Restrictions

If stitches were placed, Dr. Miotto removes them within 7 days of surgery.

Patients must avoid any type of strenuous activity (including intercourse) for the initial 2 weeks after surgery.

It can take from 6 to 8 weeks to fully recover from lower eyelid surgery in Atlanta.

Caring for the eyes after lower eyelid surgery

Ice packs help reduce inflammation and should be used for the initial 48 hours after eyelid surgery. Use ice packs wrapped in a towel on the eyes in 10-minute intervals every hour on the night of surgery. The next day, use the ice packs wrapped in towels in 10-minute intervals every six hours

Use the prescribed ointments or eye drops to gently clean the eyelids. If the patient received lubricating eye drops, these drops may be used for up to two weeks.

Wear dark sunglasses.

It is important for the patient to elevate his or her head with two or three pillows while sleeping.

Patients need to avoid

Unless the patient is taking a prescribed pain medication, acetaminophen (Tylenol) can be used to control pain.

When to Seek Help

The patient needs to seek medical attention right away if he or she is experiencing

Lower blepharoplasty results

The results from lower eyelid surgery in Atlanta can continue to improve for 6 months.

After lower eyelid surgery, Dr. Gabriele Miotto’s patients have eyes that appear more youthful and refreshed. The results achieved during a lower blepharoplasty can last 10 years, sometimes longer.

Potential complications

Every complication is troubling; however, there are some complications that are considered more concerning than others. Knowing the potential risks and complications before any procedure is important.

Possible complications following a lower blepharoplasty include

More serious potential complications following blepharoplasty procedures are rare; however, they must also be acknowledged

If a patient experiences a complication listed above, he or she needs to contact the surgeon’s office right away.

How much does it cost to have lower eyelid surgery in Atlanta?

Everyone is unique, and since all surgical plans at ME Plastic Surgery are designed to meet the needs of a particular patient, the only way to determine how much an individual’s surgery costs is with an initial consultation.

Choose an Experienced Surgeon

If you are thinking about having a lower blepharoplasty, or any other procedure, make sure to choose a plastic surgeon who has experience performing the procedure or procedures you are considering.

Choosing an experienced plastic surgeon like Dr. Gabriele Miotto greatly reduces the likelihood of a complication following a cosmetic treatment or plastic surgery procedure in Atlanta.

Dr. Gabriele Miotto performs upper and lower eyelid surgery for people who reside in, or around Atlanta. She is an internationally recognized plastic surgeon who has more than two decades of experience performing cosmetic treatments and plastic surgery procedures. Dr. Miotto enjoys helping her patients with achieving their aesthetic goals.

Dr. Gabriele C. Miotto is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, nose, breast and liposuction. Call (404) 446-0738 for your consultation.

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