Blepharoplasty

Lower Eyelid Blepharoplasty

Lower eyelid blepharoplasty is a great option for patients dissatisfied with unsightly eye bags.Heredity and aging are the main culprits, but medical conditions as well as smoking can contribute.  This area is often the first aspect of facial appearance that is noticed, as a result, surgery of the lower eyelid bags offer dramatic results.

In developing a customized surgical plan, Dr. Perman will not only discuss your lower eyelid issues, but potential contributing factors, namely, upper eyelid, eyebrow, mid-face, and skin tone quality.

Past medical history is crucial in discussing any oculofacial plastic procedure. Medical conditions, medications and past surgeries may be an influence in the proposed procedure.

Whether your consultation takes place in the D.C., Maryland (Bethesda)  or Virginia (Fairfax or Gainesville ) office, the surgery will be performed at the ambulatory surgery center (ASC) in either Bethesda or Haymarket, under the watchful eye of a board-certified anesthesiologist. You will require a driver the day of surgery.

 Ice compresses are the key to managing swelling and bruising during the post-operative period. The degree of swelling and bruising vary from patient to patient, but with aggressive use of ice compresses, it is manageable. Make-up and strenuous exercise are to be avoided for 2-3 weeks post surgery. Tylenol is effective in managing any post-operative discomfort.

Aspirin and all anti-inflammatories (NSAIDs) and other medications/supplements that  promote bleeding risks must be avoided before and after surgery.  A list will be furnished when surgery is scheduled.

For certain lower eyelid blepharoplasties there are no sutures (trans-conjunctival), for others, the sutures are dissolvable.

The beneficial results of the surgery should last ten to fifteen years.

As an oculofacial plastic eyelid specialist,  Dr. Perman evaluates patients where there are functional considerations in addition to the cosmetic lower eyelid issues. In such cases, the patients health insurance may cover the functional component, apart from the cosmetic.

With decades of experience, Dr. Perman’s staff will navigate these issues for you.

As always, the better informed the patient, the happier the patient.

Upper Eyelid Surgery

The upper eyelids are among the first parts of the face to show age.  Just as much as age, your heredity is even a greater influence; just look at your family album; you have someone’s eyelids.  The descent (sagging) of these upper eyelid  tissues results in patients reporting a sad, tired, aged appearance. 

Fortunately, upper eyelid blepharoplasty offers one of the highest satisfaction rates, and Dr. Perman will share his over thirty five years of experience as an eyelid surgery specialist in getting you the best result possible.  During the initial consultation, he will evaluate not only your eyelids, but other possible contributing factors, such as, surrounding tissue (brow and midface), as well as skin tone and skin quality. Certainly, your past medical history as well as present medications (with and without prescription) will be covered as potential contributing factors as well.

During your consultation, you will discuss the procedure itself, the surgical facility, the sedation to be delivered by a board-certified anesthesiologist, the recovery process, the post- operative restrictions, and  the risks of surgery.  Dr. Perman feels strongly that the best informed patients and the happiest patients. Your consultation will occur in one of Dr Perman’s four offices, located in Washington D.C., Bethesda MD,. Fairfax or Gainesville, Virginia.

Dr Perman performs eyelid surgeries at one of two federally-approved ambulatory surgery centers (ASC), located in either  Bethesda,  Maryland or Haymarket, Virginia,.

You will require a driver on the day of surgery and someone to remain with you after surgery..  Tylenol is almost always more than adequate for post-operative discomfort. Aspirin, all anti-inflammatory (NSAIDs) ans all other medications / supplements that promote bleeding must be avoided, before and after surgery.   A list will be provided along with details for your pre-surgical clearance and evaluation.

You will be asked to use ice aggressively to manage post-operative swelling over the first 4-5 days following this procedure.  Sutures will be removed approximately 7-10 days after the blepharoplasty.  Although you may return to the office after a handful of days, bruising may persist longer.  Bruising varies from patient to patient, but is usually measured in a handful of weeks.You may not engage in any aerobic activity for 2-3 weeks following this surgery; restrictions on bending or heavy lifting for this period as well.  You may not wear contact lenses or  use of make-up around the eyes for 2-3 weeks as well.

There are some instances where an issue of visual obstruction(functional) exists in addition to the need for blepharoplasty (cosmetic). In such cases, the patient’s health insurance may cover a portion of the surgery, and some of the anesthesia and operating room costs.  Dr. Perman’s staf,f with decades of experience, will help you navigate both the functional and cosmetic components of the surgery.

Upper eyelid surgery is one of the most durable facial cosmetic procedures, and results should last twelve to fifteen years