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General

Blepharoplasty
Corrections of the [upper and | or lower] eyelids, called blepharoplasty, are carried out for various reasons. People may have complaints of heavy and tired eyes, pressure behind the eyes, headache or visual impairment. This procedure can also be performed for cosmetic reasons: To look younger, less tired and less bleak. The operation is performed on both women and men.

TECHNIQUE
The eyelid surgery takes place under local anesthetic. The skin is disinfected with iodine. After that, the part of the skin that needs to be removed is accurately drawn out. After this, the anaesthesia is administered. These are typically 1 to 2 small injections. This is done with a very fine needle; you will hardly feel anything. When the anaesthetic has taken effect, the skin gets removed. Small blood vessels are coagulated [cauterized]. Then the pockets of fat will be searched and removed with fine scissors and forceps. This can cause a short sensation of pressure on the eyes. Removing these pockets of fat is essential for a good and lasting result. After this, the skin is carefully sutured with a non-dissolvable suture.

AFTER SURGERY
After the procedure slight pressure is still applied to the wound edges. This should continue on the way back and at home until the pads are almost dry. It is preferable that you do not drive yourself home, let someone else drive you. Cooling at home is best done with wet cold compresses. Possibly with cooling glasses. We recommend cooling for 10 minutes every 2 hours during the first 4 days. At night, you do not need to cool. It is normal that the eyelids are somewhat swollen the first few days after surgery. It is usually at its worst on the 2nd or 3rd day. This and the fact that you need to cool regularly can restrict your daily activities during these days. After 6 days the sutures get removed during the check-up.

COMPLICATIONSComplications can arise with any surgery. Fortunately, these are extremely rare. Should there be an infection or bleeding, please contact us immediately. You will receive our mobile phone after the operation. 

FINALLY
Prior to surgery, you will have an intake interview. Do not hesitate to ask all your questions. It’s also quite normal for you to be somewhat tense before surgery. It is important that you report the use of special medicines such as blood thinners and other medications.

Frequently Asked Questions

■  Orientation
WHY IS THERE AN INTERVIEW IN ADVANCE?
You will be fully informed about the nature of the surgery, possible complications, aftercare and costs. Your doctor can get a picture of your motive [aesthetic and | or complaints], health, medication, your medical history, familial predisposition and your expectations. Thus, the information and the procedure can be tailored to your wishes.

 Orientation
CAN CLIENTS FROM ABROAD ALSO VISIT THE BEAUFORT?
Jazeker. Regelmatig Yes. The Beaufort regularly treats clients from abroad, particularly from the Benelux, but also from beyond. 

■  Orientation
WHY ARE THE RATES SO FAVOURABLE?
The treatments take place in a health centre that already has all the necessary medical facilities. This has a favourable influence on the overhead costs. It is also the Beaufort’s vision that eyelid surgery should be financially feasible for everyone.

■  Orientation
IS THE TREATMENT COVERED BY MY INSURANCE?
Blepharoplasty has been considered a cosmetic procedure since 2006 and is therefore not covered by most health insurers. You can check this with your own insurance to be sure.

■  Orientation
WHAT DO PEOPLE MEAN WITH BLEPHAROPLASTY UNDER THE NHG GUIDELINES?
The objective of the NHG [Dutch GP Society] is to improve the quality of general practice care. Since recently, however, upper blepharoplasty has been brought to the GP’s attention as an easy to perform surgery. Here only a small part of the skin is removed. We dissociate ourselves entirely from this NHG view and regret that it holds such careless position.
The Beaufort’s opinion is that it is not about eyelid surgery in this case but about skin correction of the upper eyelids. Blepharoplasty requires more extensive technique, ability and experience.

■  Orientation
WHAT TYPES OF BLEPHAROPLASTY ARE THERE?
The most commonly performed types of eyelid surgery are: upper blepharoplasty, lower blepharoplasty without skin correction and lower blepharoplasty with skin correction.

■  Orientation
WHICH IS PERCEIVED MORE PAINFULLY, UPPER OR LOWER BLEPHAROPLASTY?
A lower blepharoplasty is generally perceived as a heavier surgery.

■  Orientation
CAN UPPER AND LOWER BLEPHAROPLASTY BE PERFORMED SIMULTANEOUSLY?

■  Orientation
WHAT ARE THE ADVANTAGES AND DISADVANTAGES OF GETTING UPPER AND LOWER BLEPHAROPLASTY SIMULTANEOUSLY?
The advantage is that you only have one recovery/ cooling period. That is attractive for people who work and want to miss as little as possible.

The disadvantage is that the surgery takes longer and is a little more radical.

■  Orientation
WWHAT IS THE DIFFERENCE BETWEEN LOWER BLEPHAROPLASTY WITH AND WITHOUT SKIN CORRECTION?
The essence of a lower blepharoplasty is that the adipose tissue [the bags] is removed.
However, if a skin surplus exists it is also cosmetically recommended to correct this. This is possible if the scar in the skin lines | folds is concealable so you cannot see it afterwards.

■  Orientation
WHAT ARE THE COMPLICATIONS AND RISKS?
Complications can arise with any surgery. Fortunately, these are extremely rare. Problems that may occur are allergic reactions, slow wound healing, infection or bleeding. The probability that an eye gets damaged through blepharoplasty is very small. In rare cases this can lead to loss of vision.

■  Orientation
IS IT POSSIBLE THAT TOO MUCH SKIN GETS REMOVED BY ACCIDENT?
It can be possible that too much excess skin gets removed, which is not desired of course. It is, however, a built-in safety in the treatment protocol. After the doctor carefully marks the area that needs to be removed, it can be assessed whether the markings are correct and if there is not too much skin likely to be removed.

■  Orientation
ON WHICH DAYS ARE THE PROCEDURES PERFORMED?
The interventions are always in mutual consultation. Surgery takes place on an almost daily basis, however, we must take account of holiday, busy days, etc.

■  Preperation
WHEN SHOULD I STOP WITH BLOOD THINNERS?
The use of blood thinners [like Ascal and acetylsalicacid] should be stopped one week before surgery. The use of blood thinners can be continued the day after surgery. Timely consult with your doctor about stopping with other blood thinners such as sintrom and marcoumar. Often this is done in consultation with the thrombosis service. 

■  Preperation
DO I HAVE TO TEMPORARILY STOP SMOKING?
Smoking is of course discouraged due to many health reasons. With regard to eyelid surgery, smoking has an unfavourable influence on the blood flow. Good circulation is necessary for proper healing. It is advised to stop smoking from 2 weeks to 2 weeks after surgery.

■  Preperation
CAN I DRINK ALCOHOL?
Alcohol werkt bloedverdunnend. Alcohol thins the blood. It is therefore advisable not to consume alcohol for a few days before and after the surgery. In addition, it unnecessarily causes additional swelling. 

■  Surgery
IS THE TREATMENT PAINFUL?
The treatment is NOT painful. However, you will experience a short period of pressure when removing the pockets of fat. If you still feel something then make it known. We can always provide additional anaesthesia.

■  Surgery
HOW LONG DOES THE SURGERY TAKE?
Upper as well as lower blepharoplasty rarely takes longer than 1 hour. Upper and lower blepharoplasty simultaneously takes one and a half to two hours. 

■  Surgery
HOW IS THE ANAESTHESIA ADMINISTERED?

A general anaesthetic is really not necessary and has more disadvantages than advantages for a blepharoplasty.

■  After surgery
DO I RECEIVE INSTRUCTIONS FOR THE AFTER CARE AT HOME?
Yes. During the intake interview and after treatment, we explain exactly what to do. You will also receive this note on paper.

■  After surgery

The eyelids are somewhat swollen the first few days, most notably on the 2nd or 3rd day. Sometimes the eyelids get a little blue. This gradually declines. The use of cold, wet compresses promotes recovery. You will perhaps look a bit less presentable for a week. But usually it not too bad. [Sun] Glasses can mask the swelling if necessary.

■  After surgery
WILL MY FACE TURN BLUE AFTER SURGERY?
It is unusual that the face of a patient turns blue after surgery. On average this is less than 1%. Usually it is the result of bumping, straining, coughing, lifting, alcohol consumption etc.

■  After surgery
HOW CAN I ACCELERATE RECOVERY?
Arnica tablets may help to prevent haematoma, and promote wound healing. This is of particular importance with the elderly or those with a thin skin that instantly bruises after receiving a punch. We do therefore not recommend it to anyone. But it cannot hurt. The most important thing is that you rest adequately and take plenty of time to cool the first three days after surgery. This reduces the risk of unnecessary swelling, bruising, infection and delayed wound healing. Manual lymph drainage by beauty specialist or dermatologist is usually not necessary. Are you planning to do this anyway than please consult with your doctor.

■  After surgery
CAN I ACCELERATE COOLING? WITH ICE FOR EXAMPLE?
We recommend wet cold compresses. Another option is cold tap water with an ice cube in it. Direct contact with ice causes rapid freezing phenomena in this area and should therefore be avoided.

■  After surgery
DO I HAVE TO ADEPT A SPECIAL SLEEP POSITION?
This is not necessary. You could possibly raise the head end slightly. A good night’s sleep is important. Hence, we do not give specific advice. If necessary, you can wear an elastic hair band with gauze underneath over the eyes. This counteracts the swelling. Sleep position advice has little use. You will roll over frequently anyway and will eventually take to your preferred position.

■  After surgery
WHEN I CAN GO BACK TO WORK?
You can perform light work again after two days, but you will be less presentable the first week. Heavy physical work is not recommended during the first two weeks. In general, most people go back to work after one week.

■  After surgery
WHEN CAN THE SUTURES BE REMOVED?
The stitches are removed after an average of 6 days.

After surgery
I LIVE IN AMSTERDAM. CAN MY OWN GENERAL PRACTITIONER REMOVE THE SUTURES AFTER 6 DAYS?
Yes, that is no problem. You will receive written instructions. That way your doctor will know how he can do so in the best manner.

■  After surgery
CAN I DO EVERYTHING WHEN THE SUTURES ARE REMOVED?
After the removal of the suture, the wound is not firm yet. Therefore, you should still be careful. We recommend not to exercise intensively for three weeks after the operation and wait six weeks before the use of a sauna.

■  After surgery
WHEN DOES THE SWELLING DISAPPEAR?If you cool properly 90% of the swelling will have disappeared when removing the sutures after 6 days. Gravity may cause the lower eyelids to swell temporarily. This will disappear. Formally it takes 2 – 3 months before the swelling has completely disappeared. Usually it goes faster.

■  After surgery
WHEN CAN I SHOWER AGAIN?
You should shower only briefly the first 2 weeks. Hot water is not good for wound healing. The area around your eyes in particular should be cleansed carefully.

■  After surgery
WHEN CAN I PRACTICE SPORTS AGAIN?
You can practice sports after 3 weeks, except for swimming. This will be possible after six weeks.

■  After surgery
WHEN CAN I USE MAKEUP AGAIN?
You can use makeup again 5 days after the removal of the sutures.

■  After surgery
WHEN CAN I WEAR LENSES AGAIN?
Both before and after the surgery you can wear lenses. However, it is better to wear a pair of glasses during the first week after surgery. It is also easier with regard to cooling. You should also keep in mind that the feeling in the eyelids is temporarily less after surgery, sometimes making inserting and removing contact lenses a bit more difficult.

■  After surgery
WON’T I GET SCARS AFTER SURGERY?
The scar will remain visible as a red line for several weeks to months. This is barely noticeable. The scar falls into the fold of the eyelid. Eventually, what remains will be no more than a small white stripe. The same applies for lower blepharoplasty.

■  After surgery
HOW LONG DOES IT TAKE FOR A SCAR TO HEAL?
Formally a scar 6 – 12 needs months to heal. However, this is often faster. This has to do with the suture technique and the skin lines.

■  After surgery
HOW LONG DOES THE RESULT OF A BLEPHAROPLASTY LAST?
On average the effect lasts 10 to 15 years. The duration of the result depends on the individual aging process that continues after surgery. The skin type and skin condition also play a role. Excessive exposure to sunlight and smoking have an adverse effect on long-term outcome. By removing the skin pockets a longer-lasting result can be retained.

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