The Surgery

• Depending on the extent of the surgery, blepharoplasty usually takes one to three hours.
• At the start of the surgery, the surgeon marks the incision sites, following the natural lines and creases of the upper eyelids.
• The surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and on the inside of the eyelid for the lower eyelids. An alternative method utilizes an incision just below the lashes in the lower lids.
• Once the skin is partially incised, a Colorado Needle is often used to remove the skin-muscle flap.

Skin Incision may be made with a

• Traditional steel blade
• Radio-Frequency Ellman
• CO2 Laser
• Colorado Needle

The extremely sharp tip on the Colorado Needle provides improvement in

	1. cutting precision
	2. reduction in tissue trauma
	3. reduction in bleeding

The very small size of the cutting spot and the high concentration of heat generated at the needle tip cause tissue to be dissected cleanly, requiring very low total applied power.

References

• Use of the Colorado MicroDissection Needle by Ian R. Munro, M.A., M.B., B.Chir., F.R.C.S. (C) - The Craniofacial Center, Medical City Hospital, Dallas, TX

  Lower Lid Transconjunctival Blepharoplasty Using the Colorado Needle by Jeffrey C. Popp, M.D, Omaha, NB, Aesthetic Surgery Quarterly, Summer 1996

  Blepharoplasty with Laser, Cautery, or Colorado Needle by Allen M. Putterman, M.D., Professor of Ophthamology, Univ. of Illinois College of Medicine

  Papay FA, et al.      The microdissection cautery needle versus the cold scalpel in bicoronal incisions.  J Craniofac Surg. 1998 Jul;9(4):344-7. PMID: 9780929; UI: 98454214.

Incisions

• Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle. This allows the removal of excess fat, and sagging skin and muscle.

• Alternatively, as laser may be used to incise and remove tissue

• The incisions are then closed with very small sutures which may be removed 4-7 days following surgery.

• Alternatively, Dermabond skin glue may be used to close the wound.

Dermabond® Demonstration

• Click here to see application of Dermabond^® (skin glue)  to close the wound with no visible sutures
  
  

• The eyelid is often closed in several layers
• The photograph above, is 5 days after surgery.
• Note, there is a blue prolene suture, running beneath the eyelid skin, visible at both the inner and outer corner of the eyelids.