Eyelid Surgery

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Blepharoplasty is the medical term for eyelid surgery. Excess skin and puffiness (fat) in the upper or lower eyelids can be modified by blepharoplasty surgery. The results are natural-looking and achieve a more rested, lighter and more aesthetically preferred appearance.

The incisions, made in the upper eyelid, are hidden in the natural crease of the eyelid where they are essentially invisible. Dr. Neufeld utilizes the most technologically advanced laser to perform this surgery. There is virtually no bleeding during the surgery with this technology which makes recovery easier and faster than more traditional methods. Patients rarely have any discomfort following this surgery. All patients are given medication for pain, but most don’t even get the prescription filled.

The lower eyelids are also treated with the laser during the eyelid surgery. Excess fat causes bags to appear under the eyes. Surgery to correct this is can be done without cutting the skin or placing any stitches in the lower eyelid, so there is no scar. Dr. Neufeld, our Atlanta blepharoplasty expert, uses the laser to sculpt and modify the excess fatty tissue. To schedule your appointment with Dr. Neufeld, please call 844.ATL.RENEW!

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Your Surgical Experience:

Your surgery is performed in an outpatient setting – our Atlanta blepharoplasty patients are able to go home directly following their procedure.

Patients are usually given mild sedation from IV medication in a vein in their arm. This will ensure that patients are totally comfortable and will not be aware of or remember any part of their surgery. Local anesthesia is then applied to the operative area to further ensure total patient comfort. There is usually no need for general anesthesia or a breathing tube or breathing machine. The length of the procedures varies from person to person, however, on average, surgery for the upper and lower eyelids takes approximately 30 minutes each to complete. (One hour for both upper and lower.)

After Eyelid Surgery

Following the procedure, patients are observed for a short while before they are allowed to go home. The first two days following surgery should be spent relaxing with the head elevated, applying antibiotic ointment several times per day and applying ice packs (frozen peas work great). This will help keep swelling to a minimum.

Initially, the eyelids may feel tight. This usually resolves over the first week or so. All patients are given prescriptions for pain killers. However, rarely do patients report the need to use them. On average, by one week after surgery, approximately 70-80% of the swelling will have dissipated and after two weeks, close to 90% of the swelling will have dissipated. The remaining 10% will decrease over the next few weeks to perhaps a month. Occasionally, all swelling takes several months to resolve.

Upper eyelid blepharoplasty is sometimes covered by insurance if certain criteria are met.

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Eyelid Retraction Repair

Eyelid retraction can affect the upper or the lower eyelid. Eyelid retraction occurs when the eyelid is pulled away from the eyeball, either too far up in the case of the upper eyelid or too far down in the case of the lower eyelid. Common causes of eyelid retraction include thyroid eye disease, trauma, or previous surgery to the eyelids. Although it may not cause discomfort, the patient may want eyelid retraction for aesthetic reasons.

The repair of the eyelid retraction depends on the cause and the degree of severity but may include eyelid retraction surgery. Releasing the eyelid itself may correct the problem or sometimes placement of grafts into the eyelid may be necessary. The specific treatment is determined after a detailed consultation with Dr. Neufeld, our Atlanta eyelid retraction surgery expert.

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Eyelid Weight Implantation

The eyelids were designed to close completely. Tears that are resting along the lower eyelid need to be distributed to the eyeball to keep the eye healthy. When we blink, the upper eyelid dips down into this "tear lake" and distributes the tears onto the surface of the eyeball. There are times when the upper eyelid does not close properly and this process is inefficient. This can occur after a stroke, Bell's palsy, surgery, or simply because of a weakness of the eyelid closure muscles.

To help the eyelid close better, Dr. Neufeld can use an eyelid implant, usually made out of gold or platinum, to help it close better. This also better maintains the healthy surface of the eye itself.

This procedure is done by making a fine incision in the eyelid fold with the laser. A small pocket is created to receive the eyelid weight and the incision is closed. The procedure takes approximately 15 minutes. Swelling and bruising are minimal. Many of our patients use this for aesthetic reasons as well.

Eyelid Malpositions

The eyelids can occasionally assume unnatural or incorrect positions and may require oculoplastic treatment. When the eyelid turns out, it is called ectropion. When the eyelid turns in, it is called entropion. When the eyelid turns in, the eyelashes can rub on the cornea and cause great discomfort and the potential for infection and ulceration of the cornea. When the eyelid turns out, constant irritation may result from the eye being too exposed. In both cases, the tears may not be able to find their way to the drains in the eyelid. Both of these problems can be corrected with simple surgical procedures.

The eyelid malposition surgery for correcting this issue is done under local anesthesia and involves tightening and repositioning while restoring balance to the muscles and tendons. There are several tiny stitches that are placed that will dissolve over the first one to two weeks. These procedures are usually covered by insurance. Thomas Eye Group provides this treatment at many of our locations.

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Droopy Eyelids (Ptosis)

Drooping of the eyelids is usually due to a loosening of a muscle and tendon that normally holds the eyelid in position. This results in the eyelid margin (the area where the eyelashes grow) crossing the eyeball at a point that is too low. This often blocks part of the visual field and limits how much a person can see. This can be repaired by surgically reattaching the tendon to a more appropriate position, thereby elevating the eyelid to a more appropriate and natural position.

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Droopy eyelid treatment is performed as outpatient like most oculoplastic procedures. Patients are awake, but with mild sedation. Local anesthesia is placed delicately into the eyelid to ensure total patient comfort. There may be an incision made on the skin surface to access the muscle and tendon. If there is an incision made, it is made in the fold of the eyelid. As a result, any scar is well hidden. Sometimes, the procedure can be performed without making any skin incision at all. The specific approach will depend on your consultation with Dr. Neufeld and the severity of the drooping eyelid.

The incision is made with the laser beam and, as a result, bruising is usually less than if the incision is made with a scalpel. Also, healing is quicker with the laser. It is normal to have some bruising and swelling, most of which is gone within the first two weeks following surgery. The eyes may feel tight and slightly dry after ptosis surgery. This is normal and will usually resolve once the initial swelling subsides.

These procedures enable patients to see more of their visual field while, at the same time, give patients a more rested and youthful appearance. The procedures are often covered by insurance.

If you would like to consult with our eye care specialist about ptosis or any of our other cosmetic procedures please contact us at any of our convenient locations. 

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Children with Ptosis

It is important that we follow children with ptosis to ensure the normal development of their vision. Children with ptosis will often raise their eyebrows to raise the eyelid, and may also hold the head back to see out from under the eyelid. This allows them to see normally, despite the droopy lid.

To correct the ptosis, the lid that is drooping is raised to match the level of the other lid. In addition, the curve of the drooping lid is carefully matched to the curve of the other eye. If both eyes have ptosis, then we correct both eyes. This is done as an outpatient procedure, under general anesthesia, and the child goes home the same day. We usually consider correcting the ptosis when the child has reached the age of 3 1/2 to 5 years old. By this age, children have grown, and their eyelid structures are more developed, which gives us a much better result. Thomas Eye provides treatment for ptosis as part of our Aesthetics & Oculoplastics services. Contact us about droopy eyelid surgery in Atlanta today to learn about the ptosis treatment options available for adults and children.

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Eyelid Cancer

Skin cancer can occur anywhere on the skin, but usually on sun-exposed areas. The face is a common area for sun exposure. Eyelid skin cancer occurs less frequently in the general population, but Dr. Neufeld sees a lot of patients who have eyelid cancer.

Too much exposure to sunlight is the single most common cause and fair-skinned people develop skin cancers more frequently than dark-skinned people. Skin cancers could also be hereditary. Skin cancers usually appear as painless bumps or nodules, and occasionally eyelashes are distorted or missing. There may be ulcerations of the area, bleeding, crusting and distortion of the skin. Oftentimes, cancer can masquerade and appear very benign. This often leads to undue delays at diagnosis and treatment. As a result, it is prudent to have any suspicious areas biopsied to determine the presence of skin cancer.

How Is Eyelid Cancer Treated?

Treatment of skin cancer on or near the eyelids involves the complete removal of cancer. Following the removal of cancer, the eyelid will need to be reconstructed. This is imperative not only for the area to look normal, but to function normally as well. The area surrounding the eyelids is an area with complicated structures that lie beneath the skin surface such as tear ducts, muscles, tendons and support structures for the eyelids. The goal of surgical reconstruction is to preserve the function of the eyelid, to protect the eye and to obtain the best cosmetic appearance possible.

Sometimes cancer can extend under the skin surface, and its true borders can be much larger than they appear. It is very important to remove all of the cancerous tissue to decrease the likelihood of a recurrence or spread of cancer. There is a surgical technique called Mohs surgery that is often used to eradicate skin cancers. Dr. Neufeld works very closely with the Mohs surgeon to ensure the cancer is completely removed and the area is reconstructed properly. Early detection of skin cancer is an important factor in its treatment. Be sure to discuss any eyelid lesions, no matter how “normal” they may seem with your doctor.

If you would like to consult with our eye care specialist about eyelid cancer or any of our aesthetic oculoplastics treatments, please call us at any of our convenient locations including Atlanta.

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