Eyelid Surgery

Blepharoplasty surgery (eyelid tuck) is performed to cosmetically and functionally rejuvenate the eyelids and associated structures. As we age, the skin and muscle associated with eyelids become loose and baggy. This produces a sad and saggy look that makes us look old and tired. In addition, tissues that separate the cushioning fat around the eyeball become weak and fat protrudes into the eyelids forming bags under the lower eyelids and making the upper lids appear thick.

The excess tissue can also obstruct vision and by having cosmetic eyelid surgery, patients don't only look better, but oftentimes see better as well.

Aging changes of the upper eyelid gives a tired appearance and can obstruct vision.

Fat that normally cushions the eyeball protrudes and causes bags of the lower eyelids.

Aging changes of the eyelids can begin in the third decade and it is not uncommon to perform cosmetic eyelid surgery on patients in their 30's and 40's. Many people watch what they eat, they exercise and they pay attention to their appearance. Although they feel young, a complaint from many patients is when they look in the mirror they see a person that looks much older than they feel. Their friends are asking them if they are tired and they have lost that happy, refreshed look. Droopy and baggy eyelids simply make patients look older and tired. By rejuvenating the eyelids, patients look more alert, awake and refreshed.

Blepharoplasty surgery is performed in our fully accredited office surgery center with light IV anesthesia. If desired, the surgery can usually be performed with local anesthesia as well. This surgery takes about 15 minutes per eyelid and the recovery time is usually about a week. During this time, the patient must refrain from any heavy activity and lifting. The eyes may swell or bruise for several days after surgery. Most patients that have eyelid surgery on Thursday or Friday can recover over the weekend and get out of the house by Monday or Tuesday with sunglasses to cover the surgery.

Dr. Niamtu uses the newest technologies of laser and Radiowave surgery for eyelid surgery. This produces less bleeding and tissue damage which means faster recovery,  less bruising, faster healing and less post operative pain.

Radiowave and laser technology allows faster surgery with virtually no bleeding. This means less bruising, less post operative pain and faster healing.

Dr. Niamtu also uses the transconjunctival approach for lower eyelid surgery. This method allows the incision to be made inside the lower eyelid so there is no visible surgical scar. This approach is also less likely to cause a pulling down of the lower eyelid that is frequently seen with external incision techniques.

Older style external incisions (on the outside of the lower eyelid) can cause retraction of the lower eyelids and an unsightly pull down of the lower eyelid. This also causes exposure of the sclera (the white of the eye) and these changes are telltale signs of improper surgical technique. This can also result from excessive skin removal on the lower eyelid.

To avoid problems associated with lower eyelid malposition and excessive scleral show, Dr. Niamtu frequently treats the excess lower eyelid skin with laser resurfacing. This allows dramatic skin tightening without cutting away skin. No incisions are required. When performing laser resurfacing of the eyelid skin the patient will be red for a week and then pink for another several weeks. Makeup can be used to cover the pinkness until it resolves. For minor to moderate lower eyelid wrinkling, chemical skin peel can be performed and heals in about a week.  The results are not quite as dramatic as the laser treatment, but the recovery is faster.

The above patient underwent blepharoplsty by Dr. Niamtu with CO2 laser resurfacing of the lower eyelids.  The improvement of the non surgical laser procedure is dramatic and does not require an incision scar of the lower lids.

For patients that do not desire laser or chemical peel skin tightening, Dr. Niamtu utilizes a conservative procedure called a "skin pinch".  This small procedure is done with a mini incision hidden under the eyelashes and can tighten the wrinkles without adversely affecting the normal eyelid position.

The yellow area in the image above indicates the small strip of excess skin that is removed with the conservative "skin pinch' procedure.

The patient shown above had minimal lower eyelid wrinkling and desired a very conservative procedure with short down time. She was treated with a "skin pinch" blepharoplasty only and was back at work in several days.

Dr. Niamtu has performed thousands of cosmetic eyelid procedures and it is one of his favorite procedures.  Hundreds of Dr. Niamtu's before and after pictures can be seen by clicking on the floating Mona Lisa icon on the right of the page.

The images below show the rejuvenation possible with the simple laser assisted cosmetic eyelid surgery

One of the biggest problem with aging female upper lids is the in ability to wear eye makeup because the excess skin lies on the lashes.  The after image above illustrates the restoration of the youthful upper eyelid.

The patient shown above had aging changes of the upper and lower eyelids and was treated with laser assisted cosmetic blepharoplasty.  Aging lids can make a patient look much older and cosmetic blepharoplasty can make reverse years of aging.

When considering cosmetic eyelid surgery it is important to inform your surgeon of any abnormalities of your eyes, vision, or general eye health. You should also schedule your surgery when you can relax for a week. Eyelid surgery is very safe but complications can occur when patients over exert themselves. When using laser and radiowave techniques like Dr. Niamtu does, patients often feel great shortly after surgery and can have a tendency to over due activities such as sports, gardening, exercise, etc. It is truly important to refrain from strenuous activities that require bending or lifting for a week after surgery to avoid complications. In addition, any drugs that increase bleeding such as aspirin, some vitamins and herbs and some over the counter medications need to be discontinued 2 weeks before surgery. The standard of care is to have minor blood work performed before eyelid surgery to make sure the patent's clotting system is functioning properly.

The position of the forehead and eyebrows also effects upper facial aging. Endoscopic and mini open brow lifting are newer procedures that are used to address this problem. Brow position should always be considered before undergoing Blepharoplasty. If you consult a cosmetic surgeon for eyelid surgery and they do not mention brow position in the first minute, you should probably see another surgeon!

Insurance Coverage and Eyelid Surgery

Dr. Niamtu does not participate with insurance plans.  He performs purely cosmetic eyelid surgery with extreme precision and attention to skin, muscle, fat and wrinkles.  There can be a huge difference between cosmetic eyelid surgery and insurance covered procedures that simply remove some excess tissue to improve vision.

Dr. Niamtu and Blepharoplasty Education

Dr. Niamtu lectures frequently on cosmetic eyelid surgery and is a regular speaker at the prestigious Cosmetic Eyelid and Brow Course at St. Louis University, Department of Oculoplastic Surgery.  He is shown in the anatomy lab with cosmetic eyelid icon and guru, Dr. Alan Putterman.

Dr. Alan Putterman and Dr. Niamtu teaching eyelid and browlift surgery at St. Louis University

St. Louis July 2010

Dr. Niamtu continues to be invited as guest faculty for the St. Louis Oculoplastic and Cosmetic Blepharoplsty course and Facelift Course.

Dr. Niamtu is a regular lecturer at the Cosmetic Eyelid & Brow course at St. Louis University for the Department of Oculoplastic Surgery.  Click on above to enlarge.

The above brochure is from an oculoplastic surgery meeting in Cervia Italy where Dr. Niamtu lectured on eyelid and brow lift techniques. Click on the image to enlarge.

The above brochure is from a multispecialty cosmetic facial surgery course at the University of St. Louis in July of 2006 where Dr. Niamtu lectured on eyelid and brow surgery. Click on the image to enlarge.

The above brochure is from a multispecialty cosmetic facial surgery course at the University of St. Louis in February of 2007 where Dr. Niamtu has been a regular lecturer on eyelid and brow lift techniques. Click on the image to enlarge.

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Actual before and after picture of one of Dr. Niamtu's patients

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