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Eyelid Surgery (Blepharoplasty)

As one ages, the eyelids undergo changes that can make one look tired and older. Many factors, including heredity and sun damage, can accelerate these changes. Dr. David Janssen and Dr. William Doubek, the board certified plastic surgeons of Fox Valley Plastic Surgery are able to brighten and restore the appearance of the entire face with eyelid surgery in Wisconsin. This procedure can be performed to remove those “bags” beneath the eyes as well as loose skin of the upper and lower eyelids.

Dr. David Janssen and Dr. William Doubek are experts in blepharoplasties. The Wisconsin plastic surgeons are helping women and men from places such as Green Bay, Appleton, Fond du Lac, and Sheboygan perfect their personal Renaissance. To learn more about eyelid surgery, request your consultation in either the Oshkosh or Appleton office using our online form or contact us at (920) 233-1540. The non-refundable $100 cosmetic consultation fee can be applied towards the cost of the procedure.

Your Improvements

Eyelid surgery, technically called blepharoplasty, can be performed on either the upper or lower lids, or both. The discreet placement of incisions helps ensure no visible scarring around the eyes. In addition to its aesthetic benefits, blepharoplasty can also be of medical benefit to those patients whose field of vision is impaired by excess, sagging skin. Eyelid surgery can treat:

• Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
• Excess fatty deposits that appear as puffiness in the eyelids
• Bags under the eyes
• Drooping lower eyelids that reveal white below the iris
• Excess skin and fine wrinkles of the lower eyelid

Pricing

In order for insurance to cover the cost of a blepharoplasty, patients need to take a visual field test.  The visual field test is an objective test, typically done in an ophthalmologists’ office, that confirms whether eyelid skin is responsible for blocking vision.  The test involves evaluating each eye separately.  There are brief flashes of light, and with each flash the patient is asked to push a button.  If the patient cannot see the flashes in the upper field of vision, and the ophthalmologist concurs that this is from excess skin, or from significant descent of the brow and eyelid skin, then an insurance carrier may consider surgical management as “medically necessary.”  Generally speaking, if the eyelid covers part of the pupil, a blepharoplasty may be covered by insurance.  Every insurance company has rigorous standards, so this needs to be pre-determined before surgery can commence.

For patients who do not qualify for insurance coverage, the procedure can be done as an elective procedure.  In general, a blepharoplasty costs $6150 for the upper lids only, $7200 for the lower lids only, and $10750 for both lower and upper lids at the same time. This does not include fat pad removal. The price includes the surgeon’s fee, the facility fee at the Theda Care Surgery Center, and anesthesia. The pricing is subject to change, and will change if the surgery is done at another facility, and if there are unique circumstances surrounding the surgery, etc.

The use of Strataderm® immediately after wound closure and for several weeks afterwards, is highly recommended for optimal healing. Stratamed is the first film-forming silicone gel-based wound dressing approved for the use on open wounds and compromised skin. Depending on the length of the incision, a tube of Strataderm® costs $32-$54.

Usually there are multiple procedure discounts for cosmetic procedures: 15% off the surgeon’s fee for the 2nd cosmetic procedure, and 30% off the surgeon’s fee for the 3rd procedure. The operating room fee is discounted 50% for the 2nd+ procedure, while anesthesia is based solely on time. Although there are zero interest financing options available through Care Credit and Alphaeon Credit, payment by cash gives an additional 5% discount. There may be additional discounts, which are too varied to be mentioned here.

The non-refundable $100 cosmetic consultation fee can be applied towards the cost of the procedure. The consultations for insurance covered blepharoplasties will be billed to insurance.

Best Candidates

In general, good candidates for a blepharoplasty include:

• Healthy individuals who do not have a life threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for eyelid surgery
• Individuals without serious eye conditions

The appearance of a drooping upper lid may be due to relaxation of the forehead skin and eyebrow. Sometimes a drooping eyelid is caused by stretching of one of the upper eyelid muscles. The plastic surgeon thoroughly evaluates the patients to determine the causes of the eyelid appearance, and recommends the best procedures to remedy them.

Preparing for Surgery

Patients preparing for surgery may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding

Preparing for surgery with a clear, complex-carb rich beverage will keep you strong and enhance your recovery. Drinking ClearFast PreOp prior to your medical procedure is a safe way to speed up recovery time, nourish your body, and reduce post-operative nausea and vomiting. It is available at Hometown Pharmacy on N. Sawyer Street, Oshkosh at $8 a bottle. The recommended dosage is one bottle the night before your surgery once you are in the fasting window, and a second bottle two hours before surgery. Consult with your anesthetist before taking the beverage. Afternoon surgery patients are encouraged to take this beverage.

Eyelid surgery may be performed in an accredited office-based surgical facility, outpatient or licensed ambulatory surgical center, or a hospital. Patients must arrange for someone to drive them home from surgery and to stay with them for at least the first night following surgery.

Procedure

Anesthesia is administered for the patient’s comfort during the surgical procedure. The choices include local, intravenous sedation or general anesthesia. The surgeon or anesthesiologist will recommend the best choice for the patient. The incision lines for eyelid surgery are designed so the resultant scars will be well concealed within the natural structures of the eyelid region. The upper eyelid can be corrected through an incision within the natural crease on the eyelid. This allows for removal or repositioning of fat deposits, tightening of muscles, and removal of excess skin.

Conditions of the lower eyelid may be corrected with an incision just below the lower lash line. Through this incision, excess skin in the lower eyelid is removed. Again, the excess fat can be repositioned or removed.

A transconjunctival incision, created on the inside of the lower eyelid, is an alternate but less common technique to correct lower eyelid conditions and redistribute or remove excess fat. With this technique, no skin is removed. Eyelid incisions typically are closed with removable sutures, skin adhesives, or surgical tape.

Are you ready to discuss eyelid surgery for yourself? Contact Fox Valley Plastic Surgery today at (920) 233-1540 to schedule a consultation.

Recovery

During recovery, lubricating ointment and cold compresses may be applied, and in some cases the eyes may be loosely covered with gauze, after the procedure is completed. Patients will be given specific instructions that may include how to care for the eyes, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site, and when to follow-up with the office.

Initial healing may include some swelling, bruising, irritation or dry eyes, and discomfort that can be controlled with medication, cold compresses, and ointment. Irritation at the incision sites is also possible.

Most patients can return to work at a desk job in 5-7 days. Depending on how comfortable patients are with going out with bruising and swelling, patients may be back on their feet earlier or later than the average time.  Moving the eyes around too much within the first two days following surgery puts stretch on the incision lines and tugs at the fragile attachments starting to form under the surface of the skin.  This can stir up various degrees of bleeding, which will cause more bruising and swelling. Keeping the eyelids closed as much as possible and keeping them fixated on something directly in front of them when they open their eyes, greatly improves recovery time.  Applying cold compresses and keeping the head elevated for the first 2 or 3 days, helps to keep the eyes at rest and minimizes bruising.

The majority of patients are able to get back to their social activities and work activities within a week of surgery.  Patients who are physically active will have to wait at least three weeks to resume activities. The final result is usually evident in 4-6 weeks with continued improvement over several months.  Life-long sun protection and a healthy lifestyle will help extend the results of the blepharoplasty.

Meet Our Surgeons

Dr. David Janssen and Dr. William Doubek combine experience, refined surgical techniques, and artistry to produce beautiful results for their plastic and reconstructive surgery patients.

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Potential Risks

Eyelid surgery risks include:

• Anesthesia risks
• Swelling and bruising
• Bleeding from the incision lines
• Dryness to the eyes
• Sensitivity to sun or other bright light
• Difficulty closing your eyes
• Ectropion, an outward rolling of the eyelid
• Infection
• Lid lag, a pulling down of the lower eyelid may occur and is often temporary
• Temporary or even permanent change in vision, and very rare chance of blindness
• Changes in skin sensation
• Pain, which may persist
• Poor wound healing
• Possible need for revision surgery
• Unfavorable scarring

These risks and others will be fully discussed prior to giving written consent.

Consultation

During the eyelid surgery consultation patients should be prepared to discuss:

• Surgical goals
• Medical conditions, drug allergies, previous medical treatments, and any problems with the eyes
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries

The plastic surgeon will also:

• Evaluate the patient’s general health status and any pre-existing health conditions or risk factors
• Take photographs
• Discuss eyelid surgery options
• Recommend a course of treatment
• Discuss likely outcomes of eyelid surgery and any potential risks
• Discuss the type of anesthesia that will be used

From Milwaukee to Madison, Green Bay and beyond, our plastic surgeons have opened eyes for many satisfied patients in Wisconsin. Contact Fox Valley Plastic Surgery at (920) 233-1540 or request your consultation online.  The non-refundable $100 cosmetic consultation fee can be applied towards the cost of the procedure.