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Ask Dr. Barber

baberpicQ.  I am thinking about having an eyelid lift and would like to know how long it will take to heal and will it change the shape of my eyes?

A.  Rejuvenating the eyelids by reducing the redundant and heavy upper eyelid skin or tightening the lower eyelid skin is a surgical procedure that is done either with you asleep or under twilight anesthesia.  The surgery involves making an incision on the upper eyelid in order to remove the excess skin.  The incision is well hidden and after a few months following the surgery, it is difficult to find where the scar is located.  For the lower eyelid, the incision can be placed either just under the eyelashes, about where you would apply your eyeliner, or in some cases the incision can be placed on the inside of the eyelid so there is no visible scaring.  The inside incision is only used if the goal is to remove the fat bags in the lower lid but no skin.  The recovery time for eyelid surgery varies, but you can expect bruising and swelling that may last as long as three weeks.  A small amount of swelling will persist for up to three months, but typically not enough that others will notice, although you may be aware of the persistent swelling.  I tell my patients to expect about three months before you see the final results of the surgery.

As for whether the surgery changes the shape of the eyes, it should not, but it sometimes can.  Why might it change the shape?  In some patients, the lower eyelid is very lax, and in order to prevent a down pull of the eyelid after the surgery the corner of the lower eyelid must be tightened.  When this surgery is performed (canthopexy), the opening of the eye can appear to be slightly narrowed or in some cases rounded.  That  being said, in the vast majority of cases, there is not any noticeable alteration in the shape of the eyelids.  There are other potential risks of eyelid surgery and you should discuss the risks versus benefits of eyelid surgery with a board certified plastic surgeon.

 

Q.  I am 66 years old and seriously contemplating a facelift.  My biggest concern is looking different or fake after the surgery.  How do I avoid that look?  

A.  No one wants to look fake after a facelift and only rarely does a patient want to look like a different person (i.e. make me look like Jennifer Aniston).  Your expectations and goals should be discussed at length with your board certified plastic surgeon.  Let him or her know whether you are looking for dramatic changes (not advisable) or more subtle changes.  I love it when a patient brings a picture of herself or himself from about 20 to 30 years earlier so that I can see what this person looked like at a younger age.  The purpose is not to return the patient to that look, that would be quite impossible, but to see the shape and bone structure of the youthful face.  How full is the face and what lines are on the face that have been there since youth, but now may be interpreted as a sign of aging?  I am not a proponent of pulling the skin of the face so tight that it distorts the area around the mouth and changes someone’s looks.  To me, a good facelift is one that lifts the cheeks, tightens the neck, and fills any hollowness of the cheeks using fat grafts taken from the patients’ tummy area.  My goal is for patients to have a rested look but not an operated look.  Patients often tell me that their friends look at them curiously, knowing something is different but not sure what.  My response to that is that their good friends probably know exactly what she has done, but they are too timid to ask.

William Byron Barber II, M.D.

has been practicing plastic surgery in Greensboro for 20 years and is certified by the American Board of Plastic Surgery.  He is Chief of Plastic Surgery for Moses Cone Health System, and is an active member of numerous local, regional and national plastic surgery associations.

Visit his website at: www.BarberPlasticSurgery.com or e-mail him at: AskDrBarber@BarberPlasticSurgery.com

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