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What is Eyelid Surgery?

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1. What is blepharoplasty?

Generically, blepharoplasty refers to any operation that changes the form or function of the eyelid.  Patients and surgeons most commonly look at blepharoplasty as a procedure performed on the upper or lower eyelid to remove redundant tissue such as bulging fat or overhanging skin to cosmetically reshape the eyelid.

2. Will eyelid surgery rid me of my eye wrinkles?

In the upper eyelid a significant roll of redundant overhanging skin is often excised.  Much greater caution is taken in the lower eyelid, where techniques such as laser skin resurfacing are used to reduce the prominence of the lower eyelid wrinkles.  Most wrinkles in the eyelid area have a prominent dynamic component related to underlying muscle function.  This element is often best treated with Botox.

3. What should I expect post-operatively?

Postoperative discomfort is generally mild.  Significant swelling and bruising is common in the first week postoperatively.  Swelling is greater when upper and lower eyelid surgery is performed simultaneously.   Most patient’s vision is fine for ordinary activities within 48 hours postoperatively.   If lower lid surgery is performed with fractional CO2 laser resurfacing of the lower eyelid skin to tighten and smooth the eyelid skin, the skin surface must heal over the first week, and will remain slightly pink for some weeks postoperatively.  Women wearing makeup can generally resume full use 10-12 days after surgery.

4. When will I be able to see the final results?

As soon as the swelling is reduced to a moderate degree surgical results can be seen.  Results are often not “final” for a month or more postoperatively.  Like most surgery, small amounts of swelling  and incisional healing may obscure the absolute “final” result slightly for 2-3 months postoperatively.

5. Traditional Blepharoplasty vs. Laser Blepharoplasty for Eye Bags?

Traditional incisional surgery produces powerful changes in the amounts and position of skin, muscle and fat in the eyelids.  Many of these procedures are performed in-office, and I use a CO2 laser for most of the cutting in these cases, as it is a beautifully precise tool that minimizes bleeding and bruising and works fairly painlessly.  CO2  and Erbium-YAG lasers are also used for laser skin resurfacing, and in certain situations can both tighten skin and even eliminate secondary lower eyelid bags or festoons that can overlay the cheek in certain patients

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Voluma XC

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Voluma XC is the only FDA approved product to be placed in the cheek area to provide volume and lift.

This product is used to restore contour to the cheek that is normally lost during the aging process as the cheek area tends to flatten out. Patients within the Voluma XC study reported looking up to 5 years younger. This is a nonsurgical approach to give a lift to the aging midface.

Side Effects most commonly reported are:

·         Redness
·         Pain/tenderness
·         Firmness
·         Swelling
·         Lumps/bumps
·         Bruising
·         Itching
·         Discoloration


Less common potential adverse reactions are:

·         Vascular occlusion resulting in tissue necrosis (tissue death) that may be local or distant and could result in vision loss or blindness.

Patients should avoid any anti-inflammatory medications that increase the risk of bleeding for 7-10 days prior to injection. Please ask your medical physician prior to stopping any prescribed medication.  Such medications/supplements can include aspirin, ibuprofen, or other blood thinners as well as fish oil, flax seed, cinnamon, gingko or ginseng.

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Welcome to Our New Website!

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We are pleased to launch our new website. We have designed this website not only for our practice but to also serve as a resource for the St. Louis, Missouri area and beyond regarding facial surgery.

Dr. John B. Holds  has organized information on the various surgical procedures services that Ophthalmic Plastic & Cosmetic Surgery Inc. provides from blepharoplasty, eyelid reconstruction, lid malposition and browlift to dermal fillers  and BOTOX© injections. If you are interested in learning more about facial surgery, our website has been designed to provide the information you need.

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