After precise measurements are taken and local anesthetic, using the smallest needle (Botox size), the patient is prepped and relaxes listening to the music of their choice. Dr. Iyengar then removed the upper eyelid skin on both sides, and fat in some cases. The muscle within the eyelid responsible for eyelid closure is preserved and both upper eyelids incisions are closed with a running 6-0 prolene suture. This is a very small suture that is removed in 7-8 days. As it is inert and removed at that time, the body does not need to break down the suture. The theory behind the use of this suture versus an absorbable, or dissolvable, suture is that since the body does not have to break down this suture, there is less inflammation at the wound site and subsequently a less visible scar. This is a topic that Dr. Iyengar and his colleagues have debated at national meetings on eyelid surgery. Surgical technique and the patient certainly also play a role in the healing after eyelid surgery. Sutures after eyelid surgery are kept in place a little longer in patients who are smokers or have poor wound healing.
Dr. Iyengar removing sutures at one week after upper eyelid surgery in the Encinitas office