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Abdi Ipekci Caddesi No:39Hayal Apt. Kat:2Sisli/İstanbul

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The purpose of blepharoplasty (eyelid) surgery is to improve the appearance of the aging upper and/or lower eyelids. Oftentimes, signs of aging such as excess skin and bulging fat pockets can contribute to a more tired or a more harsh appearance of the face. Blepharoplasty procedures can greatly improve these indications of aging and result in a more rested, youthful and softer appearance. Upper and lower eyelid surgery can be performed alone or together, depending on the patient’s needs, and are often performed at the same time as other procedures, such as a facelift.

Upper eyelid blepharoplasty

Upper eyelid surgery is performed primarily to remove the excess skin or drooping skin that may have formed around the upper eyelids due to the aging process. Heredity, sun damage and smoking can also hasten these changes. Younger individuals may also elect to have this procedure done to eliminate puffiness of the eyes from congenital excess fatty tissue deposits.

Upper blepharoplasty surgery can dramatically improve common problem areas such as excess skin on the upper eyelid itself (referred to as "hooding"). It can also greatly improve puffiness in the inner corner and middle of the upper eyelid caused by herniation (pushing forward) of fat in that area.

What happens during an upper eyelid blepharoplasty procedure?

In a typical upper eyelid surgery, Op. Dr. Ali Murat AKKUS carefully marks the skin to determine the precise amount of excess skin to be removed during the procedure. It is crucial to avoid excessive skin removal, in order to maintain both a natural appearance as well as normal function of the upper eyelid in lubricating and protecting the globe (eyeball) The incisions are closed with fine sutures, some of which are to be removed as early as 2 days postoperatively, thereby minimizing the visibility of any scars.

Lower eyelid blepharoplasty

While the main problem with the aging upper eyelid is generally excess skin, the main problem with the lower eyelid is generally excess fat or "bags." As we age, the fat surrounding the eyelids diminishes, while the fat that causes the bags does not. Furthermore, the membranes which frequently hold that fat back in youth become more relaxed with age and so that fat bulges out more. The reason the fat in bags does not diminish with age is that it belongs to a different compartment than the superficial fat in the face; it is actually orbital fat, meaning fat which surrounds the eyeball. That is why people often refer to bulging lower eyelid fat as herniated fat. These facts of nature lead to the lower eyelid area becoming increasingly harsh in appearance as many people age, with many seeking both nonsurgical as well as surgical options for improvement.

Reducing the excess fat of the lower eyelid is generally quite straightforward, and as explained below, can be done either from within the eye (transconjunctival) or from outside the eye (open approach).

Reducing the excess skin in the lower eyelid is an entirely different matter. It is frequently not possible in the aging eyelid to surgically remove significant amounts of excess skin, because the aging eyelid frequently lacks the support to tolerate such a removal.

What this means is that if the excess skin is simply surgically cut away, the lower lid itself will become pulled down. This creates an unsightly appearance called "scleral show," which means seeing the white of the sclera under the pigmented cornea in the lower lid. It can further lead to a phenomena called ectropion, which is an actual outward turning of the lower lid border. These issues can lead to tearing as well as significant dry eye problems, in addition to the unsightly appearance.

For these reasons, Dr. Ali Murat Akkus assesses each case individually and will advise whether any lower eyelid skin at all can or should be removed. In some cases, a procedure to improve the support of the lower eyelid is performed during lower eyelid blepharoplasty, and this is called a canthoplasty. This is a tightening of the actual support structure of the lower lid. It is not a simple procedure, and will be reviewed in detail if recommended.

What happens during a lower blepharoplasty procedure?

For eyelid puffiness primarily caused by excess fat, Op. Dr. Ali Murat AKKUS can often remove the fat using a transconjunctival approach. With this approach, the incision is made inside the lower eyelid, and excess fat is either removed or repositioned to achieve an improved contour of the lower lid.

Since the incision is inside the eyelid, no sutures are required in this case, and there is absolutely no visible scar. In cases where patients have excess skin of the lower eyelid, Op. Dr. Ali Murat AKKUS will choose to make the incision in an inconspicuous site along the lash line and smile creases of the lower lid. Excess fat and skin are then trimmed away, and the incision is closed with fine sutures.

Before & After

Blepharoplasty

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Recovery following blepharoplasty

For the first night after blepharoplasty, it is important to rest with the head of the bed elevated about 30 degrees. Cold compresses are applied intermittently for the first week. It is also very important to avoid any straining or bending over for that first week.

Sutures, if they are used, are removed on or around the second and fifth days after surgery. Patients can return to non-straining activities within 1 or 2 days, but many will take 5-7 days off because of the bruising that commonly occurs following the surgery. Dr. Ali Murat Akkus typically allows makeup to be applied one week after blepharoplasty.

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RETURNING TO PATIENT CARE AS USUAL, ONLY BETTER!

We are excited to announce that as of June 8th, 2020, our office will be open for ALL appointment types including Surgery, Cosmetic Injectables, Earlobe Repairs, Mole Removals, CoolSculpting, CoolTone, Morpheus8, miraDry, Skincare services, and more!

During this time, we are still encouraging virtual consultations & follows up as an initial step prior to an in-person appointment. We are requesting that established patients virtually consult/review their treatment plans with Dr. Rapaport or a medical aesthetician in advance of their scheduled treatments/procedures. We will be providing you with specific procedure-related instructions prior upon scheduling. If you left a deposit for a treatment and have not yet been contacted by our staff, please call, or e-mail our office so that we may get you scheduled.

Dr. Rapaport & his team have been working diligently to get our office prepared for our re-opening. Our main priority is the health and safety of our patients and staff. Thank you for following our guidelines and being so patient. See below for our re-opening guidelines:

  1. Please take the time to thoroughly read and complete our updated Appointment Policies, COVID-19 Patient Protocols, ASAPS COVID-19 Consent, and COVID-19 Patient Screening Questions. These forms will be sent via email and must be completed prior to your appointment. This will help to screen patients and ensure social distancing in the office.
  2. When we contact you, please let us know if you are or have been sick in the last 3 weeks, have been in close or prolonged contact with anyone who has been sick during that time, or have travelled outside the United States, or have returned from the following states within the last 14 days that have been added to the high covid risk government list including Alabama, Arizona, Arkansas, Florida, North Carolina, South Carolina, Texas, and Utah. Specific symptoms of COVID-19 may include fever, cough, loss of sense of smell and taste, chest pressure, or shortness of breath
  3. Alert us if you have any other health problems that make you more susceptible to developing COVID-19 or are at increased risk. Although our office has implemented additional measures to keep you safe during this time, we encourage you to consult your primary care physician for further instructions on how to remain safe. Typically, patients over age 65 who also have respiratory ailments, heart disease, hypertension, diabetes, or are immunocompromised are at greater risk.
  4. Medication refill and product requests: Routine requests for medication refills must be requested electronically through your pharmacy. Should you need to purchase skin or haircare products and would like them mailed to you, please e-mail office@DrRapaport.com or phone us at 212-249-9955.
  5. We ask that you come alone to office visits, if possible. To limit exposure and practice social distancing, we are doing our best to minimize the number of people in the office at one time. If you require someone to accompany you to your visit, he/she will need to be with you at all times throughout the duration of your appointment or they will be asked to wait outside.
  6. Please make sure to bring a mask with you to your office visit. If you do not have a mask, we will provide one for you. 
  7. Please abstain from handshake greetings and keep a “social distance” of 6 feet or more from other individuals when in the office whenever possible. 
  8. As soon as you enter the office you will be asked to use hand sanitizer provided to you upon arrival and departure from the practice. Coat both the front and back of your hands and wrists and let them air dry. Wash your hands often with soap and water for at least 20 seconds and avoid touching your face.  
  9. Please reply to all email and texts that we send you. We are working with limited personnel and resources, so responding to these messages will enable us to keep in touch with you safely. 
  10. We will provide ongoing care remotely using telemedicine. Our telemedicine system will allow us to speak with you, evaluate your face/body/breasts, prescribe treatment, and/or give you advice. We will be contacting you about your existing appointment to determine whether a virtual or in-person appointment is best. 
  11. You can obtain good and reliable information about local conditions regarding the pandemic at https://coronavirus.health.ny.gov/home. 

For any questions and/or concerns, please call our office at 212-249-9955 or email us at office@DrRapaport.com. We know each of you are eager to get back to your treatment regimens, so we will be extending our hours to accommodate everyone as best we can while maintaining health & safety protocols!

We thank you for your continued support & confidence in Dr. Rapaport and our staff the past few months. We look forward to welcoming you back to our office!

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