Thank you for your question.
You submitted a question without a photo but you’ve expressed in your question that essentially,
you’re interested in having an eyelift done but you are concerned about the downtime and
returning back to work and you’re looking for an alternative to an eyelift that may
get you back to work sooner. Well, I can certainly share with you a lot about my perspective
on this type of question.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. And I can tell you that you’ve asked a question that I focus on
answering from the first day I went into practice. You see, as a specialist in eyelid surgery,
my training allowed me a perspective that was a little bit different than what most
general plastic surgeons experience in terms of just the style in which surgery is done.
So I’ll explain further.
I first trained in eye surgery, ophthalmology, surgery of the eye. And one of the things
we do routinely was of course was intraocular surgery, surgery to remove the lens, the cataract
then to replace the lens. This is a very delicate surgery and it’s done under a microscope
and it’s done with patients awake and having to remain relatively still. So when I did
my training in oculofacial plastic surgery and then additional training in facial plastic
surgery, I found myself naturally inclined to ask the question: why can’t we do cosmetic
surgery whether it’s eyelids or facelifts and other procedures under local anesthesia?
And so what I did was essentially look at the reasons and with one simple goal in mind:
to make the procedure safer, to make the procedure allow for quicker recovery and allow people
to go back to work sooner rather than later. From the time I went into practice, my patients
have always been people who work. And regardless of their socioeconomic level, they needed
to get back to work sooner rather than later.
So what I can tell you is that in our practice, in how I advise my patients, is we do the
procedure whether it’s upper eyelid surgery or lower eyelid surgery, we do the surgeries
under local anesthesia with LITE™ sedation. Now the LITE™ sedation is very nice because
it allows you to relax but it’s the alternative to having general anesthesia. General anesthesia
is, for many of my colleagues in general plastic surgery or other plastic surgery specialties,
prefer to do things under general anesthesia which means that there’s a tube in your
throat and you’re paralyzed and you’re put under a respirator. That may be what they’re
comfortable doing and certainly, the surgeon should be comfortable. What I found that recovery
from general anesthesia and just the fear of undergoing general anesthesia was a big
area and obstacle for many people who pursue cosmetic eyelid surgery. So when I started
to show people that we can do this under straight local anesthesia or doing this under local
anesthesia with sedation, they became more willing to consider these procedures.
Now surgical technique, choice of procedures, approach then immediate aftercare is something
that’s also very important. And generally speaking, I would say that the majority of
our patients go back to work in one week and sometimes even less. Now a lot depends on
the type of surgery that’s being done and the degree or amount of surgery that has to
be done but as a basic rule, if it’s upper eyelid surgery where we’re addressing excess
skin, a little bit of fat then basically, the amount of swelling can be relatively minimal
and if it’s lower eyelid surgery where we typically do transconjunctival from the inside
of the eyelid, treatment of the fat, fat pockets and then we do PRP and fractional CO2 laser,
we still get people back to work in about a week. And it’s not uncommon for our patients
to come back in a week and have almost no bruising.
So we’ve definitely mastered to a certain significant level the art of helping people
achieve their desired cosmetic result and be able to get back to work sooner rather
than later. I know that a lot of people end up not choosing cosmetic surgery procedures
and choose other alternatives that try to camouflage what they’re unhappy about their
eyes and unfortunately, a lot of times, the camouflaging procedures whether they be injectables
like fillers or neurotoxins which try to compensate for these different anatomic issues, they
can end up more bruised than they would with surgery. They can end up looking more swollen
than they would with surgery. So that’s kind of interesting. In fact, we have many
patients who come to us to have fillers actually removed using an enzyme called hyaluronidase
to actually get rid of additional puffiness caused by “non-surgical” procedures.
Now I do a lot of these non-surgical procedures so it’s not like I’m against them but
if you need cosmetic eyelid surgery then I would just inform you that it is possible
to have these procedures with local anesthesia and LITE™ sedation. With good quality surgical
technique, you should be able to go back to normal life and work in about a week.
Now, it’s not the end of your healing process. The healing process is ongoing but in a broad
strategy, I should say, I always try to tell my patients that there is functional appearance
where you can get back to work, get back to the normal aspects of your life and then there’s
the cosmetic side where you are going to ultimately look your best. So we’ve done things like
help a woman whose son was getting married. In 10 days, we did her eyelid surgery and
her facelift surgery and 10 days later, she was attending her son’s wedding and she
looked very good. Now that’s a lot of pressure and I prefer not to do that but it just gives
you a sense of what is possible.
So meet with experienced, qualified cosmetic surgeons who perform a lot of eyelid surgeries
and learn about their approach and see if you can find someone you’re comfortable
with who can offer you this type of scenario.
So I hope that was helpful, I wish you the best of luck and thank you for your question.