Plastic Surgery In Beverly Hills

Today, many people who are considering eyelid surgery are asking if full anesthesia is really necessary. They wish to avoid the risks and side-effects that are often associated with sedation or general anesthesia.

There are major advantages to remaining awake during any procedure on the eyelids. The most obvious advantage is that patients can avoid the risks that are most commonly associated with anesthesia, such as nausea, vomiting, sore throat, prolonged lethargy, breathing difficulties, interference with vital functions and even death in rare cases. Moreover, many people just do not want the down time that full-fledged anesthesia requires. They want to feel alert and ready to return to their routine as quickly as possible. Many people say that it takes them a full day or two to ‘come back to themselves’ following general or sedation type anesthesia.

Blepharoplasty, or cosmetic eyelid surgery, can often be done under “local” anesthesia, especially when the CO2 laser is used to perform the procedure. A small amounts of numbing medicine is injected directly into the location being worked on, such as is commonly done for routine dental work. This avoids the need for any sedation or general anesthesia. The CO2 laser aids in this process as it transmits far less pain stimuli to the tissues than does the more common methods used for surgical coagulation of blood vessels. Los Angeles Plastic Surgeon, Dr. Warren Lent, has been a long time advocate of the many benefits and advantages of laser eyelid surgery.

Following local anesthesia, patients are able to clearly comprehend all instructions, converse normally, and return home shortly after the completion of the procedure. Blepharoplasty is rarely associated with much post-operative discomfort, thus little to no analgesia is required once the local anesthetic wears off. Most patients require little more than Tylenol following these procedures.

Additionally, the use of local anesthesia is less costly. The services of an Anesthesiologist are not required, thus this fee is avoided. The procedure can often be performed in an outpatient setting, thereby reducing hospital or surgical center charges.

General or sedation type anesthesia is an option for those who cannot or are unwilling to tolerate any form of discomfort, including that which is associated with local anesthesia. This method of anesthesia may also be best suited for those patients who do not wish to be aware of any aspect of the ongoing procedure.

Any of these anesthesia techniques are reasonable options for anyone considering Blepharoplasty, cosmetic eyelid surgery or other types of eyelid procedures. The sole use of local anesthesia, combined with CO2 laser eyelid surgery, however has become an extremely popular option for those considering the most advanced type of eyelid surgery.

Treatment of the lower eyelids is most commonly directed at the fat pad, which causes the shadowing and appearance of dark circles, which give one that persistent tired appearance.  Dr. Lent, the Beverly Hills Plastic surgeon says, “there are several ways to perform this procedure, but the safest way is to approach the problem from behind the eyelid with, what is called a “Transconjunctival” approach”.  This technique helps prevent scarring from getting into the actual eyelid mechanism, thus preventing that terrible pulled down appearance that so often affects the lower eyelid when the ’old fashion’ method is used which requires an incision on the outside of the lid.

By removing the excess fat, you remove the cause of the bulging and eliminate the shadowing and its’ associated tired appearance.  Patients often worry about whether the skin will tighten or sag afterwards.  This is usually not a problem as the skin has a natural elastic quality, which allows it to shrink into place and therefore sagging is not an issue.

Treatment of the upper lids is directed at removing the excess skin and muscle, which is causing the tired or aged appearance. Any protrusion of excess fat can be removed at the same time. The treatment will take away the tired appearance, possibly improve vision and allow women to apply make-up easily and cleanly.

The procedure requires an incision, however this can be placed in the eyelid’s natural crease, which makes the healed scar well camouflaged and nearly impossible to see when the eyes are open. By placing the incision in this location, Dr. Warren Lent, a Beverly Hills Plastic surgeon says “we can achieve the best possible healing”. In general, the eyelids heal better than just about any other location of the body.

What is a Blepharoplasty?

A Blepharoplasty is a procedure performed on either the upper or lower eyelids to improve ones appearance around the eyes.  There are many reasons to consider a Blepharoplasty including a perpetually tired appearance, wrinkling, too much fat around the eye, shadows or dark circles and even obstruction of vision due to the excess skin blocking ones field of vision.

Are the problems affecting the upper and lower eyelids the same?

No.  There are many differences between the upper and lower eyelids and treatment requires different approaches for each.

The problems of the upper lids are generally one of stretched, loose or excess skin and muscle, which can hang down onto the eyelashes and below causing a tired and aged look as well as blocking a portion of the visual fields.

The problem of the lower eyelids is most commonly one of too much fat behind the eyelid, which pushes outward.  This creates a mound or pillow under the eye and since most light comes from above us, this causes a shadow beneath that fat pad.  This gives the appearance of dark circles under the eyelid, which is perceived as making one look tired.  Fatty accumulation can also affect the upper lids as well.