Blepharoplasty (Eyelid Surgery) in Philadelphia, PA

Dr. Allan Wulc of W Cosmetic Surgery® is pleased to offer blepharoplasty in Philadelphia to patients who are ready to look more refreshed and rejuvenated by improving the look of their eyelids.

We tend to notice signs of aging around our eyes far sooner than in other areas. Puffiness, sagging skin, and wrinkles around the upper and lower eyelids may make us appear tired and unhappy when in reality we are well-rested and joyful. The good news is that blepharoplasty may resolve these issues and resolve sagging eyelid skin and allow our eyes to open more fully.

The Goal of Blepharoplasty Surgery

Dr. Wulc performs eyelid surgery to improve the appearance of the upper and lower eyelids. This procedure is often performed to treat loose or sagging skin that causes folds or disturbs the natural contour of the upper eyelids. It may also resolve excess skin and wrinkles of the lower eyelid, drooping lower eyelids, under eye bags, and fatty deposits that lead to puffiness. The main goal of upper blepharoplasty is to resculpt the upper eyelid, and in women, to create an eyelid crease. The main goal of lower blepharoplasty is to smooth the transition between the lower eyelid and the cheek

Good Candidates for Blepharoplasty

Patients who are tired of always looking tired and searching for a way to rejuvenate their upper and lower eyelids may benefit from blepharoplasty. This procedure may also be a good option if droopy eyelids obstruct your vision and make it difficult for you to see.

We recommend eyelid surgery to patients who are in good general health. Eye health is also important and a consultation with your eyecare professional to rule out an extremely dry eye is important.

No one particular age is ideal for this procedure. In some cases, patients in their early 20s might see the benefit of blepharoplasty. More often, however, men and women in their mid-30s and 40s –and later–who are bothered by the appearance of their eye region opt for eyelid surgery.

Custom Blepharoplasty

No one can lie, no one can hide anything, when he looks directly into someone’s eyes.
― Paulo Coelho

I understand that there are thick, dark circles under my eyes. I have grown to appreciate them.
― Leandra Medine

Being born with a pair of beady eyes was the best thing that ever happened to me. Bad guys have always been my bag… I look mean without even trying.
― Lee Van Cleef

Nature gives you the face you have at twenty. Life shapes the face you have at thirty. But at fifty you get the face you deserve.
― Coco Chanel

What is custom blepharoplasty?

Your eyes are your eyes. They visually interpret our world in all its colors and richness. To others, your eyes are supposed to betray a myriad of emotions and to be “windows to your innermost being”.

You can have eyes that supposedly make you look angry, tired, hostile or beautiful, alert and outgoing.

But your eyes are spherical balls that have colored irises and when healthy, don’t betray much. Its your eyelids, your brows, and the cheeks that envelop the eyes that define the true beauty of the eyes. Skin excesses, wrinkles, bumps, changes in eyelid shape over time—all these factors influence our decisions on how to restore the area around your eyes. Old photographs help us understand these factors and we take how time has affected you personally into account.

Bespoke eyelid surgery—custom blepharoplasty– is designed particularly to suit your individual needs. Maybe you’ve aged and your brows have dropped onto your eyelids. Maybe you’ve gained volume under your eyes but your cheeks have sunk. Maybe the fold above your eyelid has changed or needs to be sharpened. Maybe your eyelids have stretched and droop. Maybe your eyes were always beady and they never had the beauty that could have been brought out. These details are addressed with you at the time of your consultation and then implemented at the time of your surgery.

Some patients are happy with some of the changes associated with aging. Some say they like their wrinkles—they’ve earned them. Others, like Lee Van Cleef above, no that their look has become off-putting (he made a career out of it!).

But we always ask the question “what are your eyes saying?” and help you find a way to say something softer and more eloquently.

Procedural surgeons—those that know the operation but not the nuances—can produce a uniformly good result but often miss these details. As a consequence, the patients who undergoes a surgery emerges looking like they had the operation but not looking like they did in the past.

Even after a previous blepharoplasty, the elements that were not addressed at the prior surgery can be refined. But it is better to get it right the first time.

Custom blepharoplasty, is performed in an ambulatory surgery center, either with sedation or under general anesthesia per your preference.

At the time of surgery, we comprehensively treat any or all of these details as necessary:

• drooping of the upper eyelids
• set eyelid crease position
• remove all skin redundancy
• remove or reposition fat pads and “puffs”
• remove any lumps, bumps, and lesions
• reposition the lower lids if they have drooped.
• address drooping brows and forehead lines
• lift the brows
• lift the cheeks
• smooth out wrinkles
• address lower eyelid festoons

Upper and Lower Eyelid Surgery Results

Not every patient’s journey to eyelid rejuvenation is the same. Together, we’ll help you discover the best treatment options to restore youth and beauty to your eyes. Some typical results of upper and lower eyelid procedures are featured in our gallery.

*Each patient is unique and individual results may vary.

What to Expect During your Consultation

If you are interested in blepharoplasty, we encourage you to schedule a private consultation with us to determine whether your candidacy for the procedure. Dr. Wulc will review your medical history and take a close look at their eye area to make a determination of the potential benefits.

We encourage you to bring in pictures of yourself younger so that we can determine the extent to which things have changed—how much drooping of the brows or cheeks may have contributed to the aging appearance around your eyes. We will share before and after images so that you can understand how results of the procedure might enhance your eye region and give you an idea of what you look like during your recuperation after the surgery. During the consultation, we encourage you to ask any questions you might have regarding the procedure, the risks, the recovery period, and our level of experience.

How to Prepare for Blepharoplasty

Prior to your blepharoplasty, we make a number of pre-surgery recommendations that will enhance your healing and speed your recovery. You need to stop taking medications like aspirin and ibuprofen (and many others on our list) for at least two weeks before the procedure. Patients who smoke should try to quit at least a month before the surgery as smoking may increase the complication risk and slow the healing process. We also provide you with a list of nutraceuticals to take that reduce bruising and that are necessary to optimize wound healing, and suggest a low salicylate diet to help reduce swelling and bruising.

Because we utilize sedation during the surgery, you should make arrangements for a ride home after the surgery, as you will not be able to drive after it’s been completed. We will give you a detailed summary of what to expect with this procedure if you trust place your trust in us to perform the surgery.

The Blepharoplasty Procedure

Dr. Wulc performs upper or lower blepharoplasty or both in combination. Upper eyelid surgery is designed to resolve upper eyelid skin that lingers over the eyes. In some cases, it may also improve the appearance of fine lines and wrinkles surrounding the eye area.

Incisions are placed within the natural crease of the eyelid to create inconspicuous scars. Excess fat can be removed and hanging glands can be resuspended, the lid can be lifted and the lid crease can be modified. Finally, redundant skin is removed. Our goal is to enhance the appearance of the eye region—to restore, refine and rejuvenate this area without causing any eye issues like difficulty closing the eyes or worsening of dry eye symptoms.

Lower eyelid blepharoplasty surgery addresses puffiness, bags, and dark circles under the eyes. We usually place the incisions on the inside of the lower lid to minimize scarring.

How to Recover from Blepharoplasty

Most patients are relieved to find out that recovering from upper, lower, or 4 eyelid blepharoplasty is easy. Mild swelling, bruising, and tenderness usually fade quickly.

You are encouraged to stay at home and rest for a few days after surgery. We advise you to avoid exercise and other strenuous activities for 8 to 12 days. In most cases, patients may return to light work 5 to 7 days following their surgery.

 

Frequently Asked Questions About Philadelphia Blepharoplasty Surgery

How long does blepharoplasty take?

Eyelid surgery usually takes 45 minutes to an hour to complete at our location in Philadelphia.

Do you do surgery with a laser?

Yes we do, especially in the appropriate patient. We almost never use a scalpel! We feel that a kinfe is not as precise. We either use a laser or a radiofrequency electrosurgery unit (Renuvion made by Apyx) that performs a bloodless cut. We also use lasers for resurfacing the delicate eyelid skin.

How long does eyelid surgery last?

Blepharoplasty typically lasts forever. In practice for almost more than 30 years, we haven’t seen a patient return to request another blepharoplasty after a satisfactory first one. Sometimes a patient feels that it’s time for another blepharoplasty—in that situation, it’s usually that the brows have come down and need to be lifted.

*Each patient is unique and individual results may vary.

Can makeup be worn after blepharoplasty?

Many women ask us whether they are allowed to wear eyeliner, mascara, and other eye makeup after their surgery. We recommend that you wait at least three weeks after the surgery before applying eye makeup so that the incision can heal efficiently.

Does eyelid surgery lead to vision changes?

Although some patients may face temporary changes to their vision, there should not be any permanent vision changes associated with this surgery. Patients can expect clear vision about three weeks after their eyelid surgery, and clearer vision if significant upper eyelid skin requires removal to help with vision in the superior field.

How much bruising can I expect after blepharoplasty?

Typically, bruising after eyelid surgery lasts 5 to 10 days but can last up to three weeks. Patients can conceal their bruising after their stitches have been removed—or have dissolved–by applying a light powder or foundation. This may be a good idea — both for men and women who need to get back to work as soon as possible.

How does LASIK affect eyelid surgery?

LASIK is a popular procedure that allows patients to achieve excellent vision so they no longer have to wear glasses or contacts. Patients who have undergone LASIK often wonder how eyelid surgery will affect their LASIK results.

While blepharoplasty will not affect LASIK results, it may lead to worsening of dry eye symptoms. We encourage patients to inform us if they’ve had LASIK so that we can suggest ointments or proper eye drops to help them recover—it’s part of the routine questions we ask preoperatively.

Sometimes the postoperative course in patients who have had Lasik is more complex, with more associated swelling and dryness than in other patients without dry eye. We will often solicit the help of your eye care professional or a consultant with experience in refractive surgery who graciously helps us with complex cases.

Can blepharoplasty be performed on men?

Of course! In fact, blepharoplasty is one of the most popular men’s procedures. Saggy eyelids can make men appear older and exhausted. Men can be just as reinvigorated after this procedure as women! Often there are professional –job related– reasons for trying to look better. For men, blepharoplasty does achieve admirable rejuvenative benefits.

If you are wondering whether you would benefit from a blepharoplasty, we can answer any questions you may have during your initial consultation.

What are the complications of blepharoplasty?  

Complications of blepharoplasty described in the literature include exacerbation of dry eye, inability to close the eyes, scarring, hemorrhage, pigment changes, lumps, irregularities of lid crease and contour, inability to close the eyes, paralysis, double vision, perforation of the globe and blindness, and eyelid tightness after blepharoplasty.

Ask us how often we see these complications—fortunately they are exceedingly rare. But they need to be considered before embarking on the surgery.

These are the hiccups postoperatively that we see commonly:

• For a period of time after surgery, the eyelids feel tight. This is due to the swelling and temporary weakness of the muscle caused by the surgery itself. This improves over time. The amount of time varies but in our practice, it is present even in our most sensitive patients for four and up to a maximum of six weeks.
• Swelling of the eyeball. Called chemosis, the conjunctiva swells and is also caused by temporary weakness of the muscles that close the eye and to the fact that our surgery is done transconjunctivally (with an incision in the conjunctiva). Massage alone and topical drops are helpful. Rarely the chemosis needs to be drained with a conjunctival incision after numbing drops are applied to the eye.
• Blurring of vision and or dryness due to the use of ointments and potentially to the underuse of ophthalmic lubricating drops. This is usually eminently treatable by either discontinuing the ointment or increasing the frequency of the drops.

A patient reports, “I have lumpy scars after my blepharoplasty elsewhere. What’s going on?”

It is possible that your surgeon moved fat around when the surgery was performed (adjacent fat transfer). This is an increasingly popular procedure. These lumps may or may not get better and can be treated both with massage and occasionally with injection. This does not happen in our practice because we don’t do this procedure.

Lumpy scars:  

A patient reports, “I have lumpy scars after my blepharoplasty elsewhere.  What’s going on?” It is possible that your surgeon moved fat around when the surgery was performed (adjacent fat transfer).  This is an increasingly popular procedure. These lumps may or may not get better and can be treated both with massage and occasionally with injection. This does not happen in our practice because we don’t do this procedure.  Along the incision lines, small bumps can form. These are called milia and are usually related to ingrowth of skin around the suture line. These can occur with absorbable sutures or nonabsorbable sutures. These are easily treated in the office by unroofing them.  The healing takes approximately one week.

My blepharoplasty failed to correct my issues. What is the problem?  

The failure of a blepharoplasty is a rarity.  Usually, the surgeon removes enough skin and fat that there is an improvement, but improvement may not be to the extent that you like.  Sometimes this occurs because other issues have not simultaneously been addressed such as drooping of the brow with a brow lift, or drooping of the cheeks with a mid face lift.  Often, a long lower eyelid cannot be treated by blepharoplasty alone and requires either liposculpture, fat transfer, nano fat transfer, or a midface or cheek lift. Occasionally a face lift also can worsen the area around the eyes if the cheek tissues are redraped unfavorably.  

A blepharoplasty failure can also be interpreted as a procedure that does not provide a desirable result or that leaves excess fat or skin.  In these cases, a minor procedure often improves the result. This is not a failure. It is a work in progress.

What is double eyelid surgery?  

Double eyelid surgery is one of the most common procedures performed in Asia. A “single eyelid” is seen in many Asians. The eye is missing a lid crease, namely that area up to where a woman might typically apply eye shadow. A single eyelid that extends from the orbital bone down to the lashes without a lid crease.

Double eyelid surgery creates a lid crease—a place where you would wear eye shadow if that were your goal. A Western eyelid has a long, deep, hollow upper eyelid crease. A double eyelid in Asians should be created at a much lower level. In general, when we perform Asian eyelid surgery, we decide with the patient where the double eyelid crease should be placed. It is then placed there precisely with the agreement of the patient and is completelyn tailored to the patient’s goals. We make suggestions, but most often try to be conservative.

Festoon laser treatment:  

The most desirable treatment for malar festoons is laser therapy.  We have been performing this surgery since 2007. We have CO2 and Erbium technologies but prefer the Erbium laser because of the more rapid recovery and less frequent complications. We use the dual-mode Sciton Erbium laser.  We have other modalities of treatment that are less aggressive than this as well and have recently presented papers on this nationally including the Global Aesthetic Surgery Meeting and the American Society of Ophthalmic Plastic and Reconstructive Surgery Meeting.

What are the causes of malar festoons?  I have swelling on my cheeks below the eye. What are the causes?  

Malar festoons are most commonly caused by thyroid issues.  We see them in patients that have hypothyroidism, hyperthyroidism, or who have had a bout of thyroiditis in the past.  Often an episode of thyroiditis would go unnoticed and only show up in bloodwork. When we see patients with festoons, we will almost always have patients obtain thyroid studies along with antibody studies to show whether you have had a bout of thyroiditis in the past.  You might be completely asymptomatic other than having these festoons. Other causes of festoons include rosacea, protein-deficient states, kidney failure, certain drugs, and sleep apnea. Wearing a sleep apnea device alone can cause obstruction of draining and fluid accumulation which is worse in the morning when you take off the mask.  

Why choose Dr. Allan Wulc?

If you live in Philadelphia and are interested in eyelid surgery, you owe it to yourself to visit Dr. Wulc of W Cosmetic Surgery. Dr. Allan Wulc, MD, FACS, is board certified by the ABMS board in Ophthalmology. Additionally, he is board certified in Facial Cosmetic Surgery by the American Board of Cosmetic Surgery, where he served as a trustee for six years. He is also board certified in plastic surgery by the American Board of Physician Specialists.

He is board-certified in:

• Ophthalmology by the American Board of Ophthalmology
• Cosmetic Surgery, Facial by the American Board of Cosmetic Surgery
• Plastic Surgery by the American Board of Physican Specialties
• a diplomate of the American Society of Ophthalmic Plastic and Reconstructive Surgeons.

Related Blepharoplasty Articles

• Dr. Allan Wulc Upper and Lower Blepharoplasty Review | W Cosmetic Surgery®
• Dr. Allan Wulc Blepharoplasty Review | W Cosmetic Surgery®
• Should You Ever Consider Blepharoplasty Without a Brow Lift?
• Cosmetic procedures before saying “I do”
• 5 Reasons Why More Men are Getting Cosmetic Surgery

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Schedule a Blepharoplasty Consultation in Philadelphia at W Cosmetic Surgery®

What are you waiting for? If you’d like to look younger and more vibrant by improving the look of your eyelids, schedule a blepharoplasty consultation with Philadelphia’s own Dr. Wulc today. You can give us a call at 610-828-8880 or fill out our handy online contact form. We serve customers in Plymouth, Philadelphia, Main Line, PA and surrounding areas. We look forward to helping you restore your self-confidence.