Springs Aesthetics offers eyelid surgery for men and women in Colorado Springs, South Denver, Castle Rock and other areas of Colorado. Dr. John Burroughs is an internationally-recognized expert in eyelid surgery for cosmetic and reconstructive cases.
What is Eyelid Surgery?
Eyelid surgery may be performed for cosmetic or reconstructive purposes. Being Board Certified and a Fellow of the American Society of Ophthalmic Plastic and Reconstructive Surgery and the American Academy of Ophthalmology demonstrates Dr. Burroughs’ commitment to remaining abreast of the latest advances in eyelid surgery and sharing his expertise with surgeons and patients around the world. Blepharoplasty refers to plastic “reshaping” of the eyelid.
What are Common Types of Eyelid Surgery?
Some of the most common types of eyelid surgeries that Dr. Burroughs performs are:
- Upper eyelid surgery for cosmetic and reconstructive purposes, primarily for anti-aging
- Droopy eyelid surgery to correct an upper eyelid that hangs low over the eyes
- Lower eyelid surgery to restore a natural eye shape and protect the tissues from irritation and infection
- Double eyelid surgery, also known as Asian eyelid surgery, to reshape the skin around the eyes
How Much Does Eyelid Surgery Cost?
The average cost of cosmetic eyelid surgery varies, based on the nature of the procedure and the degree of correction that is needed.
Dr. Burroughs is well-known for his expertise in blepharoplasty procedures.
- Eyelid Reconstruction
- Eyelid reconstruction may be recommended after trauma to the eye or as part of a skin cancer removal treatment plan.
- Skin Cancer Removal
- Dr. Burroughs performs eyelid and facial skin cancer removal that preserves or restores the aesthetics of the treatment area.
Does Eyelid Surgery Hurt?
Typically eyelid surgery does not hurt, and discomfort afterwards can be treated with tylenol and more rarely stronger medication for a few days. Dr. Burroughs cares about patient comfort and employs many techniques to improve patient comfort. This includes: “distractesia,” that reduces injection discomfort by such methods as tapping or vibration during injections; diluted and/or buffered local anesthetic prior to stronger anesthetic to make the first injections more comfortable; slowly injecting; employing Pro-Nox optional nitrous oxide (“laughing gas”), long-lasting local anesthetic; numerous alternative local anesthetics suitable to an individual patient’s need; and use of ice/coolness prior and during injections. Most cosmetic eyelid surgery is done by Dr. Burroughs in his office operating rooms under local with oral or IV sedation.
What is Recovery Like After Eyelid Surgery?
Recovery from eyelid surgery varies and may take several months for the final results. Most patients can comfortably go out in public by a week after surgery especially if LidLift goggles are used to reduce bruising and swelling. During the first week, you may have limited use of your eyes and be required to use special eyedrops or ointment. Many patients can drive within a few days, but much of this depends upon swelling that can avoided by carefully avoiding blood thinning medications, herbals, supplements, vitamins, and even alcohol prior to surgery. Antibiotics may be prescribed to protect against infection. We will outline before and after care prior to the time of your eyelid surgery to optimize safety and speed healing.
What Eye Conditions Can Be Treated At Springs Aesthetics?
- Entropion/Ectropion are disorders of the eyelid in which the lid turns inward or outward respectively. Both conditions typically develop in the lower eyelid. Oculoplastic surgeons, like Dr. Burroughs, are the most experienced in surgically improving these eyelid malpositions to avoid eye discomfort, eye damage, and even vision loss.
- Dry Eye may be a temporary or chronic condition that can lead to complications when left untreated. Dry eye can be managed with optimizing the best ocular surface lubricants, minimally invasive with punctal (tear drain) closure, IPL treatments to improve oil gland dysfunction providing healthier tears, BlephEx treatments to improve eyelid health and oil tear secretions, and surgical eyelid improvements to improve eyelid blinking and coverage of the eyes.
Does insurance ever cover eyelid surgery?
Insurance will often pay, less your specific copays and deductibles, for eyelid surgery that is performed to improve vision. For instance, if your upper eyelids are drooping and this is blocking your vision, your insurance company may pay for upper eyelid surgery. If the upper eyelids are blocking vision, insurance companies require a visual field test be obtained to demonstrate that the eyelids block the peripheral vision and that the vision is improved by elevating the eyelids. If your lower eyelids are droopy and this is causing eye irritation or watering of the eyes, your insurance company may pay for correction of this problem. Insurance companies typically require that the medical need be documented with photographs, which are reviewed by the insurance company during the preauthorization process. Some problems like bags in the lower eyelids do not affect vision and are never paid for by insurance companies. Other problems like excess skin in the upper eyelids that effect vision when severe enough are paid for by insurance companies when photographs and visual fields document a medical need for the surgery. Dr. Burroughs’ office can act as your advocate to help get your insurance company to pay for medically necessary procedures. Many of the procedures he performs are done only to improve appearances, and these cosmetic procedures are not paid for by your insurance company. During you consultation, Dr. Burroughs will determine what procedures will offer the most functional (medical) and cosmetic benefit and discuss the range of options.
Where is the incision made when performing upper eyelid blepharoplasty surgery?
In nearly all cases of upper eyelid blepharoplasty surgery, there is excess skin in the upper eyelids, so removal of extra skin is only possible with an incision. Fortunately, the skin of the upper eyelid is some of the thinnest skin in the body and typically heals with little to nearly invisible scarring. Further, the incision site can be hidden in the fold of the upper eyelid allowing the incision to be hidden while healing. The incisions usually have to extend to the lateral crows feet area to avoid unwanted excess skin at the outside corners of the eyes.
How is the upper blepharoplasty incision made?
Dr. Burroughs has used lasers, scalpel blades, bovie (electric needles), and radio frequency needles. His preference is to make the incision with a scalpel blade or with an electric (bovie) needle set at a low setting to optimize the wound shape and architecture while minimizing collateral heat damage that other modalities can cause. Once the initial skin incisions are made, then depending on the circumstance and patient needs, the other modalities can be used. One problem with lasers is they can easily become uncalibrated, causing the incision to be inaccurately placed, and they also can cause heat damage that leads to slower wound healing and, rarely, more scarring.
What kind of sutures does Dr. Burroughs use for blepharoplasty surgery?
Dr. Burroughs finds eyelid wounds heal cosmetically better and faster with non-dissolving sutures that are removed between 7-14 days after surgery. Dissolvable sutures “dissolve” by causing local inflammation and can sometimes leave the incisions looking more red and “bumpy” in the initial phases of healing. Dr. Burroughs also finds that performing a “running” suture to be easier for removal than a series of interrupted sutures that have to be individually removed.
Is fat or muscle removed during upper blepharoplasty surgery?
Aesthetically, the tendency is to leave as much fullness in the upper eyelids as possible. Removal of too much fat from the upper eyelids can give one a hollow appearance that is not desirable. Often the fat pad in the upper eyelid adjacent to the nose is bulging forward and is reduced in size at the time of upper eyelid blepharoplasty surgery. This is done conservatively to get rid of the bulge without causing a hollow appearance. Some patients benefit with removal of the superficial skin while leaving the underlying muscle, which can be helpful in older patients or those with pre-existent muscle weakness before surgery that can worsen eyelid closure after surgery. Others, most in fact, benefit with some eyelid muscle removal, which can help reduce the crows feet appearance and provide a subtle and pleasing brow lift.
Can the eyebrows be lifted or the lines between the eyebrows “11’s” removed with upper blepharoplasty surgery?
Yes. There are several options to include Wrinkle Blocker, filler, and surgery to improve these areas. Dr. Burroughs has published an article in the Archives of Facial Plastic Surgery journal, detailing an optimal technique to address these concerns at the same time as upper blepharoplasty surgery.
Can ptosis (drooping of the eyelid margin) of the upper eyelid or sagging of the lower eyelids be addressed at the same time that cosmetic eyelid surgery is performed?
Yes. It is very common for patients to have surgery done to improve function at the same time that cosmetic surgery is done. The portion(s) of the surgery that is done to improve eyelid function and eye comfort may be covered by your insurance company.
If I’m having upper eyelid surgery, what else can be safely done at the same time?
Many other procedures can be done just before, during, or after your upper eyelid surgery. This can include Wrinkle Blocker, chemical peels, and fillers. Additionally through an upper eyelid incision, Dr. Burroughs can gently raise the eyebrows, reduce the wrinkle lines between the eyebrow, improve frontal area headaches, raise the lower eyelids, and improve the crows feet areas.
Are there any special considerations if I am planning or have had eye surgery (laser or cataract)?
Yes. It is optimal when medically appropriate (you can see well enough to function) to have eyelid surgery first. Very rarely, eyelid surgery can change one’s vision and cause the need for glasses or an adjustment to one’s glasses prescription. Usually by 6-8 weeks, the eyes are stable and no further refractive (eyeglass) changes occur. It is quite rare for major shifts to occur, but because both laser and cataract surgery depend upon very accurate and stable preoperative measurements, it is best if one is thinking of doing eye surgery and eyelid surgery to do the eyelid surgery first. If you have already had laser (e.g., Lasik) or cataract surgery performed, then generally no substantial visual changes will occur, but is a slight risk. Patients that have had prior laser surgery are at a higher risk for dry eyes, which can be exacerbated following eyelid surgery and needs to be carefully monitored during healing.
Where is the incision made to lift a drooping cheek?
This varies from patient to patient, but it may be made either in the upper eyelid, the lower eyelid, or at the temporal hair line. You should discuss this with Dr. Burroughs during your consultation.
Do I need an upper eyelid lift or an eyebrow/forehead lift or both?
This varies from patient to patient and their desired goals. Generally, if the eyebrows are resting at or below the orbital rim, then some form of brow or forehead lifting will be required for the best result. Dr. Burroughs can discuss this during your consultation.
What is double eyelid surgery?
Asian patients have different anatomy than occidental patients. Some Asian patients are born with a fold in the upper eyelid and others are not. When the fold is present, it is called a double eyelid. The fold in the upper eyelid of Asian patients is much nearer to the eyelashes than it is in the occidental eyelid. It is often said that Asian patients wish to have their eyelids “westernized.” In our experience, Asian patients seeking double lid surgery want their eyelids to look like those Asian patients that are born with a fold in the eyelid and do not wish to have their eyelids look like occidental or “western” eyelids. This form of cosmetic eyelid surgery is performed by Dr. Burroughs. If you are considering this type of surgery, it is helpful to bring a photograph of a model with the appearance you hope to achieve, so that this can be discussed and decided if it may be safely and reasonably achieved. Dr. Burroughs’ stepmother is Korean, and while he was still in the Air Force, he performed many Asian blepharoplasties on Filipino and Korean patients. He has also surgically treated patients from Japanese, Chinese, Taiwanese, Cambodian, and Vietnamese descent.
Is it possible that I may have trouble closing my eyes after upper eyelid surgery?
Yes, but this is usually a temporary issue that improves greatly upon suture removal in most cases. The upper eyelids are central to form and to visual function. Removal of too much skin from the upper eyelids does not look natural and causes problems with lid closure. Dr. Burroughs is an expert in both ophthalmology and plastic surgery which is why he is acutely aware of the need for the lids to both look and function normally after cosmetic eyelid surgery. The most serious complications of facial cosmetic surgery occur with eyelid surgery. Some patients with medical issues such as weak facial muscles require an even greater concern for properly performed eyelid surgery to enable the best and safest result. In the early stages of healing, sometimes the eyelids will not completely close, but after the sutures are removed, generally the skin loosens up and muscle strength returns allowing full closure of the eyelids. During this time, utilization of artificial tears, gels, and ointments can improve eye comfort and vision.
What is eyelid surgery recovery like?
Recovery varies by the exact procedure(s) performed and the individual patient. Generally, eyelid surgery is minimally painful but results in bruising and swelling. Patients should plan on being home on the day of surgery and for two additional days. During these first few days, cool compresses are applied to the eyelids to reduce bruising and swelling. After the third day, most patients can drive a car and get about fairly easily. Postop patients should avoid heavy lifting and strenuous exercise for 10-14 days after their procedure. Most patients will wear sunglasses for 2-3 weeks to hide bruising and swelling. Dr. Burroughs will provide you with detailed written instructions prior to your procedure.
Are there potential complications from eyelid surgery?
Yes. All medical and surgical procedures carry some risk. You should discuss the risk of complications with your doctor prior to surgery so you can make an informed decision on how to proceed. Many patients select Dr. Burroughs for their surgery because of his ophthalmic background, and they believe the risk of complications with cosmetic eyelid surgery may be lessened when performed by a surgeon with special plastic surgery training of the eyelids and who is vastly experienced in performing these procedures. A careful ophthalmic history and exam is critical before any eyelid surgery. Each year, Dr. Burroughs has been the first to diagnose eye problems prior to surgery that could cause suboptimal results following surgery or even vision loss whether surgery is performed or not. Dr. Burroughs will appropriately refer you to the correct eye specialist if he detects a problem that needs to be addressed prior to eyelid surgery.
For more than 20 years, Dr. John Burroughs has helped men and women in Colorado Springs, South Denver, Castle Rock and other areas of Colorado, as well as internationally, by providing exceptional care in plastic surgery and eyelid surgery. At his practice, he also offers medical spa treatments that are performed by his aestheticians to complement results and speed healing. To learn more about eyelid surgery at Springs Aesthetics, contact us today to schedule a consultation.