Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: Eyelid Surgery

Male Blepharoplasty – Easy Does It!

June 27th, 2015 — 9:44pm

Facial Plastic Surgery in Men Requires a Conservative Approach

This attractive middle aged man wanted to look a little less tired.  He had a little excess skin and a lot of excess fat in his eyelids and those puffy eyelids made him look like he’d been up all night even when he hadn’t.  I removed a little excess skin and quite a bit of excess fat from his upper and lower eyelids.   I was careful not to remove too much fat or skin to avoid feminizing his face.  Most of facial plastic surgery procedures we do can be feminizing if not done very carefully and conservatively.  I can think of at least half a dozen male celebrities over the years whose faces look overly feminized after eyelid surgery, and I’m not thinking of the person formerly known as Bruce Jenner who obviously was looking for feminization.

So when I am operating on a man, I dial it back a couple of notches.

Thanks for reading and I wish the person formerly known as Bruce Jenner all the best!  Dr. Lisa Lynn Sowder

Eyelid Surgery, For Men Only, Male Plastic Surgery

Chemosis – a bummer of a problem after lower eyelid surgery.

November 14th, 2013 — 3:04pm

Seattle Plastic Surgeon discusses a self limited but very annoying postsurgical eyelid condition: chemosis.

Seattle eyelid surgery

Chemosis. It looks bad and feels bad too.

If you have had lower eyelid surgery and have never heard the term “chemosis”,  count yourself as one of the lucky majority.  If the term “chemosis” is familiar and you have suffered from it, you have my sympathy.

I have had a run on eyelid surgery the past few weeks and currently have a patient who has developed post-blepharoplasty chemosis which translates into infammation and swelling of the eyeball skin following eyelid surgery.  I have had a handful of these cases in my 22 years of practice and am happy to report that all of those cases have resolved within a couple of weeks.  But that couple of weeks can be really, really miserable for the afflicted patient.

Why a small minority of  eyelid surgery patients develop chemosis is not well explained.  It almost always occurs with lower lid surgery and I have never seen nor heard of a case develop when only the upper eyelid is operated on.  Incisions inside the eyelid (transconjunctival) seem to trigger this inflammation more often than incisions on the outside of the eyelid.

I have my transconjunctival lower eyelid patients use anti-inflammatory eyedrops the first few days after surgery to help prevent this problem from occuring.  If chemosis does occur, it often helps to patch the eyes at night and use generous doses of artificial tears during the day.  The thing that seems to help the most is “tincture of time”.  I have never seen a case that did not resolve completely but waiting for “tinture of time” can seem like an eternity.

Thanks for reading and join me in wishing my chemosis patient a speedy recovery!  Dr. Lisa Lynn Sowder

Eyelid Surgery, Postoperative Care

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