Women and men from Toronto and the regions of Durham and North York come to Dr. Derek Ford for eyelid surgery (blepharoplasty) when they want smoother, uplifted, younger-looking eyelids. This is an operation performed to improve eyelids that have sagging skin, loose muscle and ligaments, as well as bulging fat and hollowing around the eyes.
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The goal of eyelid rejuvenation is to make the eyes look cleaner and more youthful without changing the shape of the eyelids that frame the eye. Most patients seeking this procedure are 35 years of age or older, although puffy eyes — which are often hereditary — may prompt some younger people to inquire about this procedure.
In some patients, the position of the eyebrow may contribute to the appearance of heavy upper eyelids. In these situations, it's important to consider a brow lift procedure to satisfactorily improve the upper face.
Your health and safety are Dr. Ford's top priorities. During your in-office consultation, he will gather the following information:
Your health and safety are Dr. Ford's top priorities.
A recent examination by an optometrist prior to your consultation is important to evaluate eye function. Dr. Ford takes his patients' wellness and safety very seriously, and he only performs surgery on qualified candidates.
While serious complications are extremely uncommon, Dr. Ford will discuss the potential risks of blepharoplasty during your consultation. This is simply to be transparent through all phases of the surgical process and make sure you have all the information you need to make a decision about the procedure.
Men and women seek eyelid surgery for the upper lids to correct age-related changes, including:
Dr. Ford makes discreet incisions for both upper and lower blepharoplasty. In upper eyelid surgery, the incision is camouflaged in the eyelid's natural crease. Lower eyelid surgery usually involves a thin incision just below the lash line, but in some cases, Dr. Ford makes the incision inside the lower eyelid.
It is important for Dr. Ford to perform an organized, sequential assessment of your upper eyelid and brow during the consultation process. He carefully evaluates your brow for droopiness (ptosis) and symmetry. In women, it is desirable for the brows to arch laterally. Most men, however, request a straighter, more horizontal position. If brow laxity is not corrected, or if the brow is not properly stabilized, it can contribute to further sagging after surgery.
A gland in the outer area of the upper eyelid may also drop with age, creating a sad or tired appearance. This gland may need to be re-suspended at the time of upper eyelid surgery in order to ensure a clean-looking upper eyelid contour.
Glabellar furrows and crow's feet are best addressed with the use of injectable neuromodulators such as BOTOX Cosmetic®.
When examining the upper eyelid, Dr. Ford looks for the presence of upper eyelid sagging. This looks like a droopy upper eyelid without a crease, and Dr. Ford can correct this with eyelid surgery. He also evaluates any asymmetries and the amount of fat framing the upper eyelid. With age, the upper eyelid becomes hollow-looking, and it is important not to remove upper eyelid fat during surgery. In some cases, Dr. Ford even adds fat to this area or uses an injectable hyaluronic acid filler, such as Restylane®.
Bulging or prominent eyes may appear as the result of a thyroid condition and require medical evaluation prior to surgery.
Our practice offers Crisalix, a way for patients to preview their results in 3-D. This adds a tangible, visual element to your planning process, giving you and Dr. Ford a common, beautiful goal.
Dr. Ford typically performs upper eyelid surgery with the patient under local anesthesia, but he may use general anesthesia if the surgery is combined with other procedures. Most eyelid surgery procedures take about 1 hour to perform.
During surgery, Dr. Ford makes an incision along the upper eyelid crease — the point where the upper eyelid skin transitions from being fixed to being loose on the lid. He removes a crescent-shaped piece of excess skin and muscle in a conservative fashion, especially since it's vital to leave enough tissue to allow for full eyelid closure. Since this area can become hollow with age, Dr. Ford takes great care not to remove upper eyelid fat during surgery. In some cases, he even adds fat to this area or uses an injectable hyaluronic acid filler, such as Restylane®. By allowing the upper eyelid fat to fall down to the crease, a symmetrical, gentle arch above the upper eyelid fold is created.
Dr. Ford closes the incision using non-absorbable sutures. He uses meticulous techniques to reduce tension on the incision for a superior, discreet scar.
Men and women seek eyelid surgery for the lower lids to correct age-related changes that include:
Before surgery, Dr. Ford evaluates both the lower eyelid and cheek. He also assesses the shape and canthal tilt of the lids. A negative canthal tilt occurs when the outer eyes appear lower than the inner eyes. This may indicate lower lid laxity as the result of aging or the presence of a prominent eye. People with prominent or bulging eyes are often at a higher risk of complications. For these patients, Dr. Ford tailors his technique to make the surgery as safe as possible.
Dr. Ford also examines the lower eyelid for laxity. He notes the presence of "scleral show" (visible white below the iris), excess skin and muscle, and protruding fat bags, and deep tear troughs.
For patients interested in eyelid rejuvenation without surgery, Dr. Ford often recommends a treatment with an injectable hyaluronic acid filler such as Restylane. These products can fill in the tear trough, which is the depressed groove between the puffy lower eyelid and cheek. Although this option doesn't replace the results that can be achieved with formal eyelid surgery, it does offer an in-office non-surgical alternative that reduces the appearance of lower eyelid aging.
Dr. Ford prefers to perform lower eyelid surgery using general anesthesia. Because the procedure typically takes 2 hours to perform, general anesthesia is a good way to ensure patient comfort and safety. Dr. Ford makes a long, thin incision just below the lower lash line. He manipulates the underlying muscle, raising it to create a cleaner and more alert appearance. Often, he also raises the cheek tissue, blending the lower eyelid with the cheek for a more natural-looking delineation. He removes any excess skin and closes the incision with sutures. He also uses sutures to splint the outer upper and lower lids together. All of these sutures are removed 7 days after surgery.
Asian patients often prefer double eyelid (single crease) instead of a single eyelid (absent crease). During a double eyelid procedure, the desired location of the upper eyelid crease is typically lower than that of the Caucasian upper eyelid. Dr. Ford removes a small amount of skin and fat. He creates a dynamic upper eyelid fold by using precisely placed sutures. He typically removes skin closure sutures after about 7 days.
For the first 72 hours after your surgery, Dr. Ford recommends keeping your head elevated and applying clean, cool compresses to your eyes. He suggests the application of ophthalmic antibiotic ointment to the incisions and into the eye to reduce the loss of the protective tear film. Patients who do not have a history of glaucoma may use a fluorometholone 0.1% ophthalmic suspension to minimize early inflammation. Dr. Ford removes all sutures 7 days after surgery, although he recommends keeping your activity level minimal for the first 2 weeks after surgery. You may begin wearing makeup 10 days after surgery. Nearly all bruising and swelling subside about 3 weeks after the procedure.
Although it can produce beautiful results on its own, blepharoplasty is often performed in conjunction with other procedures for a more profound result. Typical pairings include endoscopic brow lift, facelift and neck lift, and micro fat grafting.
The exact recovery time needed varies from patient to patient, but Dr. Ford usually recommends taking at least a week off after eyelid surgery. Of course, the nature of your job will also be a factor in determining the amount of time off needed. If your occupation involves strenuous activity, you may need to extend your time off by an additional week.
Lower blepharoplasty can be an appropriate treatment for patients concerned about dark circles, but it depends on the cause. Sometimes large bags or hollowness in the area of the tear trough creates shadows, an issue that can be improved by repositioning fat during blepharoplasty. However, surgery cannot address dark circles caused by excessive pigmentation, thin skin, or allergies.
The price of eyelid surgery depends on whether you are getting a lower or upper blepharoplasty, or both. If you are getting upper eyelid surgery to improve your field of vision, the Ministry of Health in Ontario will cover the cost, provided that an optometrist documents at least a 50% reduction in your visual field.
Here are the eyelid surgery prices at our practice (not including applicable taxes):
Blepharoplasty ‐ Lower: $5,690
Blepharoplasty ‐ Upper: $3,450
Blepharoplasty ‐ Upper & Lower: $8,370
Blepharoplasty ‐ with Endoscopic Brow Lift: $14,320Request a Consultation