PLANNING

During your initial consultation with Dr. Kolker, he will thoroughly discuss your desires and expectations for blepharoplasty and rejuvenation around the eyes. After a careful discussion of your health history and previous treatments, he will conduct a thorough examination of your eyes and face, including your skin tone, texture, and elasticity, facial soft tissue relationships, bone structure, and muscle dynamics of the areas around the eyelids in particular. Dr. Kolker will carefully review the blepharoplasty procedure, or combination of procedures, that suit you best. Dr. Kolker will answer all questions that you might have regarding any step of the eyelid lift or blepharoplasty process. When there are moderate or severe fine lines or wrinkles within the skin of the lower eyelids and crows-feet areas in particular, an eyelid resurfacing treatment, frequently with an ablative laser (such as CO2 or erbium) or fractional laser (such as Active FX) may be recommended prior to, as the sole treatment for, or during, your blepharoplasty and eyelid rejuvenation procedure.

PROCEDURE

The eyelid lift or blepharoplasty procedure is performed through inconspicuous incisions; an upper eyelid lift, or upper lid blepharoplasty, is performed with incisions hidden within a natural crease of the upper eyelid, and a lower eyelid lift, or lower lid blepharoplasty, with incisions immediately beneath the lash line, or completely concealed within the lower eyelid. Excess skin is directly removed from the eyelids. Dr. Kolker removes fat only when it is truly excessive. Most often, the prominent fat of the lower eyelids is "repositioned" by returning it from whence it came (within the orbit) by tightening the support of the lower eyelids. In this restorative portion of the blepharoplasty procedure, the muscle surrounding the eyelid (the orbicularis oculus muscle) and septum are tightened to a more youthful position, "pushing" any bulging fat back where it belongs, and minimizing the need to remove fat at all. As we age, we tend to lose volume in our faces; therefore, in blepharoplasty or eyelid lift surgery, Dr. Kolker advocates fat removal only when absolutely necessary. In selected eyelid lift cases, Dr. Kolker may recommend adding fat with fat transfer (autologous fat grafting), particularly in the area called the "tear trough" (the dark circles between the lid and nose). Tightening or refreshing of the skin of the lower eyelids can also be achieved with laser treatments combined with blepharoplasty surgery. Treating the lower eyelids with a CO2 or erbium laser, or with fractional photothermolysis (such as Active FX) will remove fine wrinkles and tighten the skin without the need for skin removal during blepharoplasty. Dr. Kolker will recommend the individual eyelid lift or blepharoplasty technique, or combination of blepharoplasty techniques, which suit you, and your lifestyle, best. A blepharoplasty in New York is performed in Dr. Kolker's office-based surgical suite, accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF). An upper lid blepharoplasty, or upper eyelid lift, takes less than one hour. A lower lid blepharoplasty, or lower eyelid lift, takes approximately one and one half hours, and together, an upper and lower eyelid lift, or bilateral upper and lower lid blepharoplasty, takes approximately two hours. The addition of fat transfer, or autologous fat grafting, or laser treatments to your blepharoplasty may confer an additional thirty minutes to one hour.

RECOVERY

Following eyelid lift or blepharoplasty, you will go home on the same day with a friend or family member. Mild swelling and bruising are expected after a blepharoplasty, and generally resolve after four to seven days, although the period of swelling and recovery will be slightly longer when fat transfer (autologous fat grafting) or laser procedures are performed at the same time as your blepharoplasty. Cold compresses will be applied for comfort and to minimize swelling. Sutures will be removed three to five days following blepharoplasty. Dr. Kolker suggests taking seven days off following a blepharoplasty, however many are able to return to work after four or five days. Following a blepharoplasty with fat and/or laser treatments, Dr. Kolker recommends taking fourteen days for recovery, although it is indeed possible to return to work as early as ten to twelve days after your blepharoplasty with fat transfer or laser treatment (provided there is no strenuous activity or heavy lifting involved). Light aerobic activity (elliptical or Precor, light treadmill walking, stationary bicycle, recumbent bicycle) may be resumed as early as four or five days following blepharoplasty, and more strenuous activity is begun at two to three weeks. Your relationship with Dr. Kolker does not end after blepharoplasty surgery; he will see you often through the first weeks and months following your eyelid lift, and will advise you on all matters in your recovery including skin fitness and health including diet, skin care, retinols, antioxidants, and sun blocks to maximize and preserve the rejuvenative effects of your eyelid lift procedure.

RELATED PROCEDURES

Eyelid lift or blepharoplasty surgery is frequently combined with other facial rejuvenative procedures. Blepharoplasty is often performed along with fat transfer (autologous fat grafts), laser resurfacing procedures, or chemical peels. For those individuals who have excess upper eyelid skin in addition to a drooped or settled position of the brow, blepharoplasty is often combined with a forehead lift procedure, such as an endoscopic brow lift, temporal brow lift, or a coronal brow lift. For those individuals who desire additional plastic surgery enhancements, particularly geared toward achieving and maintaining a youthful balance of all parts of the face, your blepharoplasty may also be combined with a facelift. Eyelid lift or blepharoplasty can also be combined with breast and body contouring procedures such as liposuction, tummy tuck, breast augmentation, and breast lift.

If you would like to learn more about having a blepharoplasty in New York, and about the blepharoplasty, eyelid lift, or eyelid rejuvenating techniques that will suit you best, we invite you to meet with Dr. Kolker for a private consultation at our office, located at Park Avenue and 70th Street, by calling 212-744-6500, or by scheduling an appointment online.