Tired of Looking Tired

Nothing quite conveys how you are feeling like your eyes. It is frustrating when people think you look tired or upset when that isn't how you feel. This is often a primary complaint for patients who have excess skin or bulging fat around their eyes. Facial surgical specialist, Dr. Kate Impastato, in Vancouver, WA empathizes with the profound emotional impact of looking into a mirror and finding a face that no longer reflects one's inner sense of self.

Lower Eyelid Surgery

Frequently Asked Questions

Be The Best Version Of Yourself

What is a lower eyelid blepharoplasty or lower eyelid surgery?

Lower eyelid blepharoplasty is the technical name for lower eyelid surgery. A lower eyelid blepharoplasty is a surgery that improves the appearance of the lower eyelid by removing excess skin and/or bulging fat. Lower eyelid "bags" are one of the most common complaints of aging patients, both men and women.

What is done during a lower eyelid blepharoplasty?

During a lower eyelid blepharoplasty, also known as an eyelid lift, the delicate skin and fatty tissue of the lower eyelid are manipulated by facial specialist and board certified plastic surgeon, Dr. Kate Impastato. This procedure is done in an operating room with sedation. During your consultation Dr. Impastato will do a physical exam of your eyelids and discuss the options with you to ensure they are in line with your personal goals. Based on each patients anatomy, Dr. Impastato will remove fat from the lower eyelid to improve the appearance of bags and remove eyelid skin as needed through an incision designed along the eyelid.

Am I a candidate for a lower eyelid surgery?

As a Board Certified Plastic Surgeon by the American Board of Plastic Surgery, it is Dr. Kate Impastato's number one priority to keep you safe. In order to keep you safe you will be asked to complete a health history questionnaire. During your one on one consultation you will also be asked about your health history to ensure for example that your blood pressure is normal or well controlled with medications. Dr. Impastato will want to know what other facial procedures you have had (including radiofrequency treatments, CO2 laser resurfacing, what injectables you have had). She will ask you about any medications you are on, if you have diabetes, if you have any cardiac history, if you use any form of nicotine, if you use any form of CBD/THC, and if you have any personal or family history of problems with anesthetics.

It is important to share any history of surgery on your eyes, LASIK surgery, any symptoms of dry or runny eyes. Based on each patient's goals, concerns, and health Dr. Impastato will make an individualized treatment recommendation to best accomplish your goals while keeping you safe.

During your consultation, Dr. Impastato will ask you to point out what is bothering you and help you to understand what blepharoplasty can reasonably obtain and what it will not.

At Evergreen Plastic Surgery, Dr. Impastato strives to offer the best eyelid surgery Vancouver, WA.

Are there medications I cannot take prior to lower eyelid surgery?

Prior to undergoing lower eyelid blepharoplasty patients cannot take any medications that thin their blood for two weeks prior to surgery. In general any over the counter pain medications (ex. Ibuprofen, Aleve, Aspirin, Naproxen) cannot be taken for the two weeks prior to surgery. If you need an over the counter pain medication during that time, Tylenol is okay to take prior to surgery. Other supplements including Vitamin E, ginkgo biloba, garlic, ginseng, ephedra, St. John's wort, Kava, flax seed oil, and fish oil.

What is recovery like following a lower eyelid blepharoplasty?

Immediately following a blepharoplasty you will be bruised and swollen. There are no bandages placed, only a thin layer of Vaseline over the suture line. Most patients do not have a lot of pain after surgery and usually only take Tylenol, but a stronger medication is available if you need it. You will be asked to use cold compresses on your eyes and to keep your head elevated for the first few days to help minimize swelling.

Two days after surgery you can get the incision wet in the shower and wash it gently with soap and water. On the 5th day after surgery you will return to the clinic to have your sutures removed. One week after surgery you can wear makeup. By 2-3 weeks, almost all patients are able to go out in public without others being able to tell they have had something done. If you don't mind being out in public with sutures, bruising, and swelling or if you work from home most patients can return to work 5-10 days after surgery.

What does the scar look like after lower eyelid blepharoplasty?

Immediately following an lower eyelid blepharoplasty you will be bruised and swollen. It is common for the scar to be pink during the first few weeks and slowly become less and less noticeable over the ensuing months. Scars are nearly invisible as they are hidden within natural creases and can be covered with makeup. If takes scars 12-18 months to fully mature.

What surgeries are commonly paired with lower eyelid surgery?

During your consultation with Dr. Kate Impastato, she will learn about what is bothering you most. She strives for a natural appearing elegant outcome with the least surgery possible. There are times when doing more will actually lead to a more natural appearance by allowing the components of the face to match. Patients choose to do surgery on multiple areas to reduce the number of recovery periods and days off of work for recovery. Adding the second procedure does not increase the recovery time in most cases. Dr. Impastato will help you navigate which procedures are safe to do at the same time and which are safer to stage. Here are the most common surgeries done by Dr. Impastato at the same time as lower eyelid blepharoplasty:

Upper Eyelid Blepharoplasty (Upper eyelid surgery)

Upper eyelid blepharoplasty is very commonly paired with lower eyelid blepharoplasty. During this careful procedure the excess fat and skin of the eyelid are carefully sculpted to restore a more youthful rejuvenated appearance. Dr. Impastato designs her incisions in natural creases to help make them as unnoticeable as possible, with time eyelid scars are typically imperceptible. The upper eyelid blepharoplasty addresses the skin and fat excess of the upper eyelid while the lower eyelid blepharoplasty addresses the skin and fat of the lower eyelid that gives patients the appearance of "bags" under their eyes. This is a great operation for patients who complain that people often think they are upset or tired because of the appearance of their eyelid skin.

Brow lift

Brow lift is commonly done at the same time as eyelid surgery. Dr. Impastato will recommend the particular type of browlift based on your anatomy and goals. The goal of the brow lift is to lift the eyebrow into its native position which is usually a subtle elevation, not an exaggerated change that leaves you looking surprised.

Lip Lift

As we age our upper lip lengthens allowing the pink portion of our lip to roll in. To restore the youthful pout of the lip board certified plastic surgeon, Dr. Kate Impastato uses a technique known as the 'bull horn lip lift' to shorten the upper lip. By doing this the upper lip rolls out. This technique allows for more of the lip to be exposed but it does not add volume to the lip. For patients who desire fullness, Dr. Impastato recommends lip filler. This can be done during surgery on in clinic.

Neck lift

Deep plane neck lift is a procedure that can be done on its own or with other procedures. During this intricate procedure Board Certified plastic surgeon, Dr. Kate Impastato, in Vancouver, WA makes a small incision under the chin to access the deep structures of the neck. This allows her to contour these deep structures of the neck and trim and tighten the platysma muscle to obtain a sleek and well defined neck.

Deep Plane Facelift

As the gold standard of facial rejuvenation, the deep plane facelift can be done at the same time as other facial procedures to address the appearance of jowls and to address different layers of the neck to obtain a sleek and well defined neck.

Why does Dr. Impastato need me to stop using nicotine for two months prior to surgery?

As a board certified Plastic Surgeon, Dr. Kate Impastato's main goal is to keep you safe while helping you to achieve your goals. Nicotine in any form (cigarettes, patch, gum, or vape) can increase the risks of having problems after surgery that can effect your outcome and even be life threatening.

Decreased Blood Flow leads to Increased Risk For Complication: Nicotine causes blood vessels to constrict or narrow, leading to a reduction in blood flow. Proper blood flow is crucial for the delivery of oxygen and nutrients to tissues, especially during the healing process after surgery. Restricted blood flow can compromise the body's ability to heal and recover. Insufficient blood supply to the surgical site can delay the healing process, leading to prolonged recovery times and potential complications including infections
Higher Risk of Tissue Necrosis: Nicotine's impact on blood vessels can potentially lead to tissue necrosis, where a lack of blood supply causes tissue cells to die. This is a serious complication that can result in the need for additional surgeries or interventions to address the damaged tissue.
Increased Risk of Blood Clots: Nicotine use is associated with an increased risk of blood clot formation. Blood clots can pose a serious threat, especially in the postoperative period, as they may lead to complications such as deep vein thrombosis (DVT) or pulmonary embolism.