Blepharoplasty ( also called “eye lift” ) is a surgical procedure to remove excess skin and/or fat & muscle from both the upper and lower eyelids. Underlying fatty tissue that produces bagginess can be selectively removed or repositioned. Blepharoplasty can improve drooping skin and bagginess. It can help improve vision in older patients who have hooding of their upper eyelids. Although it can add an upper eyelid crease to the Asian eyelid, it will not erase evidence of one’s racial or ethnic heritage. Blepharoplasty will not remove “crow’s feet” or other wrinkles, eliminate dark circles under the eyes, or lift sagging eyebrows.
Blepharoplasty surgery is customized for every patient, depending on his or her needs. Blepharoplasty can be performed on the upper lid only, lower lid only or on both upper and lower lids. It can also be done in conjunction with other surgical procedures of the eye, face, brow, or nose. In some patients who have laxity of the skin/tissue between the lower eyelid and the eyeball, consideration for tightening of the lower eyelid (canthoplasty/canthopexy) at the time of blepharoplasty may be recommended. Eyelid surgery cannot stop the process of aging.
The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.
Upper lid blepharoplasty surgery takes approximately 1 hour and this can be performed under local or general anesthesia as an outpatient. Recovery time is approximately 2 weeks. Lower lid blepharoplasty surgery takes approximately 1.5 hours and it can also be done under local or general anesthesia. Recovery time is approximately 2 weeks.
Questions on this page include:
- Am I A Good Candidate For Eyelid Surgery?
- Results of Your Eyelid Surgery
- Your Personal Consultation– How will my plastic surgeon evaluate me for aesthetic eyelid surgery?
- How Aesthetic Eyelid Surgery is Performed
- Understanding Risks
- Your Surgical Experience (Preoperative Preparation and Recovery) for Eyelid Surgery
- The Day of Eyelid Surgery
- Eyelid Surgery Recovery
- How Much Will Eyelid Surgery Cost?
- Maintaining a Relationship with your Plastic Surgeon
Any one or combination of the following conditions may indicate that you may be considered a good candidate for eyelid surgery:
- Excess skin obscuring the natural fold of the upper eyelids
- Loose skin hanging down from the upper eyelids, perhaps impairing vision
- A puffy appearance to the upper eyelids, making the eyes look tired
- Excess skin and fine, “crepe paper type” wrinkles of the lower eyelids
- Bags under the eyes
- Lower eyelid droopiness
Aesthetic eyelid surgery can usually correct these problems, though other treatments may also need to be considered. Some examples follow. If the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of crow’s feet may be accomplished with Botox®, chemical peeling or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with fillers such as Hyaluronic Acid or fat as well as bleaching solution or chemical peel. Dr. Sian can provide further information if you have an interest in any of these additional procedures.
Results of Your Eyelid Surgery
Aesthetic eyelid surgery has the effect of making you look more rested, refreshed and alert. Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months usually becoming barely visible.
The results of aesthetic eyelid surgery are usually long-lasting, but they may be affected by heredity and lifestyle factors. Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur. The skin continues to age, however, and skin laxity along with the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows which mimics a recurrence of drooping upper eyelids. If this happens, correction may require a forehead lift or a secondary eyelid procedure. Even though the aging process continues, patients are usually happy with their appearance for many years following eyelid surgery. Some patients find that they want to make additional improvements at a later time.
Your Personal Consultation–How will Dr. Sian evaluate me for aesthetic eyelid surgery?
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help Dr. Sian understand your expectations and determine whether they can realistically be achieved.
You should come to the consultation prepared to discuss your medical history including previous surgeries, past and present medical conditions and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems, diabetes, etc. should be reviewed as these medical conditions may increase some risks associated with eyelid surgery.
Dr. Sian will want to know if you have allergies, especially if they affect your eyes. He or she may ask whether you have ever tried and were unable to wear contact lenses.
How Aesthetic Eyelid Surgery is Performed
One of several surgical techniques may be suggested to improve the appearance of your eyelids. The particular technique that Dr. Sian recommends will depend on many factors such as the amount of excess fat and skin in the eyelid areas, the position of your eyebrows, and the condition of muscles around your eyelids.
Because of individual factors, not everyone will achieve the same results from eyelid surgery. Dr. Sian will select the surgical technique that he or she feels will obtain the best outcome for you.
For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it usually is inconspicuous.
For lower eyelid surgery, often an incision is hidden just below the lower lashes. Through this incision, excess skin, muscle and fat are removed, or fat may be redistributed to eliminate puffiness or bulges. Other adjustments to correct special problems such as muscle laxity may be performed. As in upper eyelid surgery, placement of the incision in natural crease lines allows for the scar to usually heal in an inconspicuous fashion.
In some cases, you and Dr. Sian may decide that the best approach for removing excess fat is through an incision placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. A laser may sometimes be used in conjunction with this method to tighten the lower eyelid skin.
Fortunately, significant complications from aesthetic eyelid surgery are infrequent. Every year, many thousands of people undergo eyelid surgery successfully, without experiencing any major problem.
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Sian. The risks in most surgeries are similar. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection, changes in sensation, scarring, allergic reactions, damage to underlying structures, need for revisions, unsatisfactory results possibly necessitating additional procedures and medical risks. Following the surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. There is a possibility of impaired eyelid function that sometimes may need to be corrected by additional surgery.
Your Surgical Experience (Preoperative Preparation and Recovery) for Eyelid Surgery
The goal of Dr. Sian and his entire staff is to make your surgical experience as easy and comfortable for you as possible. If you are a smoker, it is highly recommended to stop smoking well in advance of surgery. Smoking can impair your ability to heal. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for at least 1-2 weeks before surgery. Dr. Sian will provide you with additional preoperative instructions.
The Day of Eyelid Surgery
Your eyelid surgery may be performed in the hospital, clinic or at a surgery center.
Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia with or without intravenous sedation is used for patients undergoing eyelid surgery, although general anesthesia may be desirable in some instances.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your vision will be blurry as a result of ointment used to soothe and protect the eye during surgery as well as from the swelling that is a normal aftermath of eyelid procedures. There should be surprisingly little discomfort, however, from the surgery. You will be permitted to go home after a period of observation.
Eyelid Surgery Recovery
It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first few days after surgery, you should rest quietly and try to keep your head elevated. It is OK for you to apply cold compresses to your eyelids during the first 24 hour after surgery. Remember, you must not take aspirin or certain anti-inflammatory medications. Initially, you may feel a “tight” sensation around the eyes and some mild discomfort that can be controlled with oral medication. During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. Some patients find that mild swelling persist for several weeks, while others may see swelling resolve in as little as one week. Bruising typically disappears within seven to ten days. Within the first week or so, you will be permitted to use makeup, if desired, to conceal any discoloration. Stitches are usually removed within a week of surgery.
Your vision may continue to be somewhat blurry for a few days or longer. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. Dr. Sian may recommend eye drops to help relieve any burning or itching. You may want to wear dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation.
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within ten days or less. Although you might feel like going back to work just a few days after surgery, your vision may still be slightly blurry which could make reading or other paperwork more difficult.
How Much Will Eyelid Surgery Cost?
Cost is always a consideration in elective surgery. Prices for eyelid surgery vary widely and these will depend on the complexity of the procedures being done, where the surgery is performed (hospital versus office) and what type of anesthesia (local versus general anesthesia) is used. You will be given a quote for your surgery at the time of your initial consultation.
Maintaining a Relationship with Your Plastic Surgeon
You will return to Dr. Sian’s office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Please remember that the relationship with Dr. Sian does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact Dr. Sian or his staff.