Eyelid Surgery

• To get rid of excessive skin, wrinkles and crow’s feet surrounding the eyelids.
• To remove skin folds hanging over your eyes.
• To remove fat bags and excessive fullness protruding through the eyelid skin.
• To alleviate a tired appearance and puffiness and obtain more alert and youthful look.
• To soften the appearance of dark circles from under the eyes.
• To improve vision in patients with documented visual field obstruction.

Plastic surgeon Dr. Rayham performs blepharoplasty (eyelid procedures) in his offices or hospital setting in Manhattan/NYC, Brooklyn or Staten Island, New York. The eyelid surgery generally lasts from thirty minutes to 2 hours. It is usually done under local anesthesia with twilight sedation. Sometimes general anesthesia is utilized, especially if eyelid surgery is being performed in conjunction with other procedures and prolonged operative time is anticipated.

The upper eyelid surgical procedure starts with placing small incisions in the natural folds of your upper eyelids. This prevents significant visible scarring later. Excess skin and sometimes a thin strip of muscle and fat is removed. Incision is then closed with fine sutures to form a barely visible scar. Sometimes this incision can also be used to perform a concomitant brow lift procedure for a more visible aesthetic enhancement of upper face.

When addressing the lower eyelids the choice of incision is based on the amount of excess skin. If excess skin is minimal to mild, Dr. Rayham prefers to place an incision on the inner surface of the eyelid in a so called trans-conjunctival blepharoplasty approach. This approach is used to alleviate a need for external scar and to prevent any visible signs of operation at the completion of the procedure. Puffiness or the “fat bags” are decompressed through those small incision. In some instances, laser skin resurfacing is added to the procedure to smooth lower eyelid areas. In addition this incision can also be used to elevate the cheeks to a higher position to fill the “tearthrough “and to blend the transition gap between the cheeks and the lower eyelids. This procedure is called Trans-Blepharoplasty Incision Mid-Face Lift.

There are circumstances when the excess fat protruding through the lower eyelids can be used to fill the hollow circles around your eyes. This procedure has an advantage of taking your own eyelid fat from the areas where it is excessive and gently repositioning it to the area where it is beneficial.

Upon completion of the operation you incisions will be covered by antibiotic ointment. Several fine sutures may be present which will be removed within a week. Sometimes a small suture may be required to hold your lower eyelid lifted and healing in a higher position for a better aesthetic result. If incision was placed on the inner surface of your lower eyelid, there will be no sutures to be removed. The amount of swelling that you may get is variable, but you can resume most normal activities within a week and should show very few signs of your procedure by two to three weeks. Although some minor pain is usually associated with immediate postoperative period, it can be effectively treated with oral medication. While complications are rare, patients can minimize potential problems by carefully following the directions given after the procedure. Special eye drops will be prescribed for the immediate postoperative period. Dr. Rayham encourages his patients to refrain from smoking for several weeks before and after the surgery. Also, if you wear glasses, we will show you how to position and tape them in such a way to prevent undue pressure that may negatively influence your healing process.

If you live in New York or nearby, you can go home the day of your eyelid procedure. Our out of town patients normally stay overnight in one of our recommended hotels and can be driven home or fly home the next day following their postoperative check-up with Dr. Rayham.