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Eyelid Surgery (Blepharoplasty) with Dr. Jugenburg

A Rejuvenated Appearance Around the Eyes

The eyes are the first place we look when talking with someone. And nothing gives away the effects of age and gravity than droopy, tired eyes or bags under the eyes. Excess fat, wrinkles and hooded lids creates a fatigued and older look.

With eyelid surgery, medically known as a blepharoplasty, Dr. Jugenburg can help rejuvenate the appearance surrounding the eyes, improving the appearance of the upper eyelids, lower eyelids or both. This provides patients with a more youthful, rested and more alert look.

Dr. Jugenburg can perform both upper and lower blepharoplasty:

  • Upper Blepharoplasty
    Surgery on the upper eyelid involves the removal of excessively stretched skin that can cause multiple wrinkles or hooding on to the eyelash line. If there is an underlying droopiness of the lid, a muscle repair can be performed through the incision at the same time.
  • Lower Blepharoplasty
    During surgery on the lower eyelid, Dr. Jugenburg will redistribute the fat within the lower eyelid, which removes the appearance of bags and under-eye puffiness.

    The most suitable form of blepharoplasty will depend on where stretched skin and excess fatty deposits are located around the eyes. As an expert in facial anatomy, Dr. Jugenburg will determine the best approach during your consultation.

Asian Blepharoplasty Surgery

Approximately 50% of Asians are born without a visible upper eyelid crease – a fold in the area just above the eyelashes. Dr. Jugenburg offers an “Asian eyelid” blepharoplasty procedure that helps create a natural looking crease on the upper eyelid, creating an improved shape. This surgery is also called double eyelid surgery.

It’s important to note that there is a difference between Asian and Caucasian eyelids, both in size and in shape. The Caucasian lid crease is about 20% larger than an Asian eyelid crease, and also tapers closer to the eyelashes as the fold goes outward. Dr. Jugenburg’s goal with Asian eyelid surgery is not to give a westernized appearance to an Asian face; but rather, to create a crease that looks completely natural.

There are two types of surgery that will create an eyelid crease:

  • Closed thread/suture technique:  This uses sutures to create a crease in the eyelid by creating a depression in the skin, by attaching the skin to some of the deeper structures located within the eyelid.
  • Open incision technique:   In this procedure the skin is cut and a new skin crease is made by attaching the cut edges of the skin to the deeper structures of the eyelid.

The most common method of creating the crease is known as the double sutures and twisting method, or DST. The DST procedure involves creating a fold by pinching together the underside of the eyelid skin and stitching it in place. The doctor may also trim the web of skin that overlaps the corner of the eye. This skin is more prominent in patients of Asian descent.

Dr. Jugenburg will determine the best type of surgical procedure for your Asian eyelid surgery at the time of your consultation.

Why Eyelid Surgery?

There are various reasons for having eyelid surgery, and Dr. Jugenburg has extensive experience creating revitalized and rejuvenated upper and lower eyelids for patients. The reasons for wanting blepharoplasty include:

  • Hooded eyelids:  Having excess upper eyelid skin can lead to hooded lids, which give the appearance of tiredness and fatigue. At the extreme, hooded eyelids can even obscure vision.
  • Bags under the eyes:  As we grow older, we often develop bags underneath our eyes. It is usually caused by excessive stretching of the lower eyelid layers, and is a problem that is easily reversed with blepharoplasty.
  • Sagging skin and wrinkles under the eyes: Laxity of the skin and tissue under the eyes gives an aged appearance, and blepharoplasty is used to smooth the wrinkles.
  • Heavy, droopy eyes: Eyelids that have excessive amounts of fat can make you look tired all the time. This fat can be extracted during the surgery, leaving you with a more alert appearance.

Are You a Candidate for Blepharoplasty?

Eyelid surgery with Dr. Jugenburg will leave you with a more youthful appearance. It’s a common procedure for both Asian people, as well as patients age 30 and older, used to repair the effects of aging skin. As we get older, the skin loses it’s elasticity, and when you add in the effects of gravity, excessive skin begins collecting in the upper eyelids, which causes drooping eyelids. For lower eyelids, age causes loosening of the skin and the underlying muscle.

Good candidates for eyelid surgery are adult men and women who have healthy facial tissue and muscles. In addition, candidates for this procedure should have realistic goals as to what the surgery can accomplish.

Candidates for eyelid surgery include healthy patients who have:

  1. Puffiness around the eyes that make you look older than you actually are.
  2. Hooded eyelids that make you look permanently fatigued, even if you are full of energy.
  3. Hooded eyelids that are affecting your eyesight and your ability to see

In addition, you should:

  1. Be physically healthy
  2. Have no serious eye conditions
  3. Stop smoking at least two weeks before your procedure

Complementary Procedure: Eyebrow Lift

Some patients have a forehead, or eyebrow lift, at the same time as eyelid surgery. The eyebrow lift helps to minimize the creases that occur across the forehead, or those that appear high on the bridge of the nose. It also helps to reposition low or sagging eyebrows.

Unlike eyelid surgery alone, the brow lift offers the patient a more youthful appearance of the eyebrows, along with a more rested appearance of the upper face and eye area. There are several types of eyebrow lifts procedures available, including:

  • Open brow lift:  This procedures uses one continuous incision, that begins at the level of your ears and goes up and around the hairline.
  • Endoscopic lift:  This is a minimally invasive procedure that uses small incisions in the scalp, resulting in minimal scarring.
  • Browpexy: A procedure that adjusts the brow position using an eyelid incision.  This is a great procedure when done at the same time as the upper eyelid surgery.
  • Direct brow lift:  A procedure which involves making a small incision directly above the eyebrows and is ideal for older patients with wrinkles on their foreheads.

Most patients recover within two weeks, and it may take several weeks to see the final results of an eyebrow lift. Dr. Jugenburg will discuss the procedure with you, and determine if you’re a candidate to have this surgery along with eyelid surgery.

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What Can You Expect With Blepharoplasty

The best way to determine if a blepharoplasty (and any complementary procedures) is right for you is to have an initial consultation with Dr. Jugenburg. You will have an opportunity to discuss your goals and expectations about the surgery with the doctor, and ask any relevant questions that you may have.

During your initial consultation, Dr. Jugenburg will:

  • Review your medical history and any medications you are taking
  • Discuss the procedure and any related procedures
  • Provide recommendations that are based on your needs and goals

The most suitable form of blepharoplasty will depend on where stretched skin and excess fatty deposits are located around the eyes. As an expert in facial anatomy, Dr. Jugenburg will determine the best approach during your consultation.

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How The Surgery is Performed

The surgery is performed using local anesthesia, or under general anesthesia, depending on your specific needs.

Upper Eyelid Blepharoplasty

Dr. Jugenburg will make incisions in the natural creases of the upper eyelid. The excess skin and fat are removed and the incision is closed. By performing the procedure this way, the scars are well hidden when the eyes are open.

Lower Eyelid Blepharoplasty

In this procedure, an incision is made just below the lower lash line. Excess skin in the lower eyelid is removed using this incision, and fat will be redistributed to remove the appearance of puffiness and bags. At times, Dr. Jugenburg may also make an incision that is hidden inside the lower eyelid, known as a transconjunctival incision, to correct lower eyelid conditions or to redistribute or remove any excessive fat.

If the doctor uses the transconjunctival approach there will be no visible incision. In many middle-aged individuals the lower eyelids are lax. If you have this condition, Dr. Jugenburg may recommend tightening the lower eyelids in addition to removing excess skin and fat.

The procedure takes approximately two hours if both the upper and lower eyelids are completed at the same time. If complementary procedures are added, such as an eyebrow lift, it will change the amount of time the surgery will take.

You will see Dr. Jugenburg the day after your surgery and at specified intervals during the weeks following your surgery. This is done so that the doctor can personally monitor your recovery process, and to ensure that you have the best results possible.

The Recovery Process

With most blepharoplasty procedures, patients experience fast and uncomplicated recoveries. Immediately after the surgery, you will have an ointment and paper tape strips applied to your eyelids to reduce swelling and discomfort. Cold compresses, icing and rest are also encouraged.

We recommend that patients use moisturizing eye drops during the first few days after surgery in order to reduce swelling. Some bruising and swelling around the eyes is common and to be expected following the procedure, and will last anywhere from 1 to 3 weeks.

To expedite recovery, patients should:

  1. Keep their head elevated while sleeping
  2. Use ice or cold compresses to reduce swelling – especially during the first two days following surgery
  3. Drink plenty of water
  4. Avoid exertion and get plenty of rest
  5. Avoid wearing contact lenses for at least 72 hours

Most patients will take a week or so off of work following the procedure.

Eyelid Surgery FAQs

  • You will discuss your medications with Dr. Jugenburg during your initial consultation, and the doctor may have you stop taking certain medications prior to your surgery. Do not smoke for at least two weeks before the procedure, and at least two weeks after. Be sure to drink a lot of water in the days leading up to your surgery.

  • If you have upper eyelid surgery, the doctor will remove excessively stretched skin that can cause multiple wrinkles or hooding using an incision on the eyelash line. If there is an underlying droopiness of the lid, a muscle repair can be made. For lower eyelid surgery, Dr. Jugenburg will redistribute the fat within the lower eyelid, which removes
    the appearance of bags and under-eye puffiness.

  • Asian blepharoplasty is a type of eyelid surgery that creates a crease in the upper eyelid when the crease is absent. About 50% of Asians are born without an upper eyelid crease, and these men and women opt for this surgery to provide additional sharpness to the eye, creating an improved shape.

  • The eyelid surgery is not painful. Most patients can manage their pain following the procedure using over the counter medications.

  • There will be some bruising and swelling after the surgery, which is managed with cold compresses or icing. The bruising and swelling will last for approximately 1 to 2 weeks. Keeping the head elevated and getting plenty of rest will help expedite the healing process. Patients usually return to work within 1 to 2 weeks after the surgery.

  • The most common complementary procedure done with eyelid surgery is the eyebrow lift. This brow lift helps to minimize the creases that occur across the forehead, or those that appear high on the bridge of the nose. It also helps to reposition low or sagging eyebrows, helping to give the patient a more youthful appearance. You may also ask Dr. Jugenburg about a face lift, “mini face lift” and other procedures.

  • Scarring will be minimal, and the scars usually disappear when the eyes are open. Depending on the type of blepharoplasty you have, the incision may be hidden inside the lower eyelid. This procedure, known as a transconjunctival incision, is used to correct lower eyelid conditions or to redistribute or remove any excessive fat.

  • It is important to rest and avoid strenuous activities for the first several weeks following the surgery. Most patients are able to resume exercise three weeks after their procedure.

  • The benefits of eyelid surgery will last indefinitely. Revision surgery for this procedure is very rare. Understand, however, that following your surgery your body will continue to age and so will the results of the surgery

  • As with all cosmetic surgeries, there are some risks involved. These risks include bleeding, infection, swelling, scar irregularities and blood clots, but they are rare. Our operating suite is state-of-the-art, and we do everything we can to minimize the risks associated with surgery. Most importantly, Dr. Jugenburg and his team have various protocols in place to prevent complications from occurring.