What is a blepharoplasty?

Over time, during normal aging or even with weight loss, the face will change resulting in excess skin laxity, joweling, wrinkling and even elongation of the facial skeleton itself compelling patients to seek correction. In addition, the skin of the eyelids may also sag resulting even in obstruction of vision. Eyelid surgery aims to restore the eyelid by removing excess skin, fat, and muscle. Dr. Kayser is a Michigan Plastic Surgeon who is Board Certified in Plastic surgery. As a perfectionist, Dr. Kayser will take all measures necessary to ensure that your results are the best that he can offer. Please view the extensive gallery of before and after photographs of face lift patients.

Learn about the Lower Eyelid procedure in 3D
Learn about the Upper Eyelid procedure in 3D
Learn about the Outer Eyelid procedure in 3D

What incisions are used?

The upper lid incision uses an incision that is placed within the natural crease of the lid - about one-half inch above the lash line. The lower eyelid incision is placed just under the lash line through which excess fat, skin, and muscle are removed. In addition, a lax lower lid can be tightened through this incision. Another option involves placing the incision along the inner potion of the lid (trans-conjunctival) from which fat can be removed and restoration of the lid skin can be achieved with other methods such as chemical peels or laser resurfacing. The scars are well hidden and usually fade beautifully.

How long does a blepharoplasty last?

Although aging will always continue, one can expect long term changes with their eyelid surgery.

In addition, as the face ages, it actually looses volume and current trends in facial rejuvenation include the actual transfer of your own fat to help restore the natural contours of youth. This can also be applied to the periorbital region (the area around the eye) whereby the fat that is normally removed can actually be used to replace the volume lost in the upper cheek. Read Dr. Kayser's article on fat grafting (Lipostructure) or call Dr. Kayser for a complete consultation to answer all your questions.

Can other procedures be combined with a blepharoplasty?

The face can actually be divided into thirds with the upper third including the forehead the middle portion including the eyes and lower third including the cheeks and jowels. These areas can easily be combined with eyelid surgery and actually help to maintain a uniform appearance.

Are there any specifics points to be aware of?

Because the eyelids and the region of the midface is so intimately involved with other regions of the face, consideration of deficiencies in other areas may be beneficial. This is especially important with regard to the eyebrow position. In many situations, drooping of the eyebrow may be present in which case, correction may even negate the need for a formal blepharoplasty - indeed, should upper eyelid skin be removed without consideration of the brow, any future forehead rejuvenation may be difficult if not impossible. Dr. Kayser will be sure to discuss these options with you.

What type of anesthesia is used?

A face lift is usually performed with general anesthesia although local anesthesia with IV sedation is an option. The procedure usually takes 4-5 hours and patients are best served by staying overnight so that observation for possible bleeding can be made. The office of Dr. Kayser is strategically located at 20905 East 12 Mile Road, suite 300, which is directly across from the fully accredited St. John Hospital Outpatient Surgery Center just off the I-696 and I-94 loop in the Roseville and St. Clair Shores area - a suburban community northeast of the city of Detroit, Michigan.

What can I expect after surgery?

Most patients feel that surgery was less traumatic than they expected and many patients stop taking their narcotic pain medication only a few days after surgery. Sutures are removed at days two and five. Most of the bruising is resolved at 7-10 days, which is easily covered with make-up.

Follow up is very important and patients are encouraged to return to the office at six weeks, six months and a year. This allows Dr. Kayser to not only address any concerns that a patient may have but also make sure that both short and long term progress has been up to his high standards.

Will insurance coverage apply to a blepharoplasty?

Insurance will not pay for Surgery of the lower eyelid is purely cosmetic and will not be covered by insurance. However, if you have a visual obstruction due to hanging skin from your upper eyelids, this may be covered by insurance. A visual field test is often necessary to determine medical necessity.

Tell me about credentials - Is there a difference?

YES - ABSOLUTELY!!! A blepharoplasty is a procedure which, unfortunately, can be performed by any physician - whether adequately trained or not. Most states have very little regulation on this matter. Because of this, non-plastic - or so called "cosmetic" - surgeons can perform a face lift as well. In addition, some physicians who are legitimately board certified in other specialties, such as dermatology and gynecology, for example are performing "cosmetic" surgery even though they often have never had any formal residency training in the specialty of plastic surgery itself. Weekend courses abound and the patient is often confused as to which doctor to see.

Dr. Kayser is Board certified by the American Board of Plastic Surgery, which is the only plastic surgical specialty recognized by the American Board of Medical Specialties (ABMS) to perform plastic surgery of the face and entire body. Beware of self designated boards that are not recognizes by the ABMS. These would include The American Board of Aesthetic Plastic Surgeons, The American Board of Cosmetic Plastic Surgery, and The American Board of Cosmetic Surgery - just to name a few. The ABPS requires ongoing education and maintenance of certification to help ensure that each board certified plastic surgeon is current and able to provide the best care possible.

Dr. Kayser is also a member of the American Society of Plastic Surgeons (ASPS). This organization allows only board certified plastic surgeons in its membership. The ASPS says it best by stating that they "are dedicated to advancing quality care in plastic surgery by encouraging high standards in training, ethics, physician practice, research, and continuing education." Look for the circle - the symbol of excellence that represents which surgeons have fulfilled these criteria.

Dr. Kayser has been in practice over ten years and is the founder of Image by Design Plastic Surgery. Patient satisfaction is of the utmost importance. In addition, we have an extensive list of patients who are available to share their experience with you. Please call the office at 586-776-3223 and speak with either Denise or Janet to answer all your questions.

Does Hospital affiliation matter?

Again, yes. Although operating in an office setting is not in and of itself inappropriate, it is always possible that an extended hospital observation or additional care might be needed. Indeed, certain procedures or multiple surgeries are usually best treated within the context of a full hospital facility. In addition, hospitals usually require certain standards (credentialing) such as board certification before a physician can have staff privileges. Unfortunately, there are no legal restrictions in most states that prevent physicians operating out of their offices or non hospital associated free-standing surgery suites; so be sure to ask if your doctor does have admitting privileges at a fully accredited hospital facility. If they don't, their ability to either transfer patients or provide continuity of care is potentially compromised. Dr. Kayser is a fully credentialed and active staff plastic surgeon at St. John Hospital and Medical Center, St. John Macomb Hospital and Bon Secour and Cottage Hospitals. Make sure your Michigan plastic surgeon has full hospital privileges as well.

Any other helpful hints?

Needless to say, your decision in choosing a plastic surgeon can be a difficult and time consuming task making it even more important that you personally visit with the plastic surgeon that will perform your procedures. Evaluate their results (photos), office, staff, and testimonials and your feelings regarding your overall experience with their practice. You can often ask to speak to other patients who are willing to share their experiences with you.

Since certain aspects of the consultation and even visits after surgery can be vulnerable this can also become a relevant concern. Dr. Kayser is extremely sensitive to the needs of his female patients and every effort is made to ensure complete confidentiality, anonymity and comfort. Denise and Janet will also be able to relate to you on both a professional and personal level and answer any questions you may have. Prospective patients are even invited to visit separately with Denise before a formal consultation is even scheduled. Call the office at 586-776-3223 - you'll be glad you did.

How can I schedule a consultation with Dr. Kayser?

Considering a blepharoplasty is usually a well thought out process and, at Image by Design Plastic Surgery, we strive to ensure that all your questions are fully answered. Indeed, it is Dr. Kayser himself who conducts the entire consultation - a complete and thorough evaluation dedicated to each patient by the plastic surgeon that will be performing the procedure. This may take more time but it is essential so that each patient can make a fully informed decision. Call Denise or Janet to schedule your consultation with Dr. Kayser at 586-776-3223.