What Is Blepharoplasty?

Got tired eyes or bags under the eyes? You might want to consider eyelid surgery, also referred to as an eye lift. This procedure, called blepharoplasty, eyelid surgery or eye lift is a surgical procedure that reduces bagginess from lower eyelids and removes excess skin from the upper eyelids.

Eyelid surgery (blepharoplasty) can refresh and rejuvenate your eyes, correct sagging or drooping eyelids and remove excess fat, skin and atrophied muscle around your eyes.

The procedure involves the removal of excess skin, muscle, and underlying fatty tissue. While it is primarily a cosmetic procedure, an eye lift is also an effective method for improving sight in older patients whose sagging upper eyelids obstruct their vision.

An eye lift will not eliminate dark circles under the eyes, remove crow’s feet, or other facial wrinkles. It is often performed in conjunction with other procedures such as laser resurfacing or forehead lifts.


The Eyelid Aging Process

As skin ages, it gradually loses its elasticity. A lack of elasticity, combined with the constant pull from gravity causes excessive skin to collect in the upper and lower eyelids. Excess skin on the lower eyelid causes wrinkles and bulges and on the upper eyelids an extra fold of skin forms which can hang over the eyelashes and obstruct vision.

Bulges in the upper and lower eyelids can also be caused by the fat that cushions the eyeball from the skull. The thin membrane that holds the fat in place weakens with age, allowing the fat to protrude into the lids.


Who Is a Good Candidate for Eyelid Surgery?

If you have loose, sagging eyelids, you may be a good candidate for eyelid surgery. The best candidates for an eye lift are individuals with good physical and mental health who have realistic expectations. Most are 35 years or older, but if baggy eyelids or droopy eyelids are hereditary, you may decide to have the surgery at a younger age. Eyelid surgery can enhance your appearance and help build your confidence.

A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery.


How Should You Prepare for Eyelid Surgery?

The initial consultation with your surgeon will require your complete medical history, so you will want to be prepared to provide the necessary information. You must be completely open and honest with your surgeon. If there is any medical problem, you will be referred to a specialist.

With all of this information, your surgeon can plan the best procedure for your needs and tell you how to adequately prepare for the procedure by giving you guidelines.

Expect and plan to stay home from work and limit your activities for several days after surgery to give your eyelids a chance to heal. Some patients experience dry eyes after surgery, but the condition rarely lasts more than two weeks.


How Is Eyelid Surgery Performed?

Eyelid surgery is usually performed under local anesthesia–which numbs the area around your eyes–along with oral or intravenous sedatives. Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you’re having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.

In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.

If you have a pocket of fat beneath your lower eyelids but don’t need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar.


Will the Results of Eyelid Surgery Be Permanent?

The procedure is usually very long lasting. Upper eyelid surgery can last anywhere from five to seven years to an entire lifetime, while lower eyelid surgery rarely needs to be done more than once.


What Is Recovery Like After Eyelid Surgery?

In the first week after the operation, patients are instructed to avoid activities that can contribute to the drying of the eyes. This includes reading, watching TV, wearing contacts, and using a computer. The doctor should remove the stitches between two and seven days after the procedure; patients may feel restored to do normal activities around the tenth day of recovery.

For the first couple of weeks, wearing dark sunglasses is advised to shield the eyes from irritations caused by the wind and sun. Patients are likely to tire their eyes quicker for the first few weeks during recovery, in which case naps are encouraged.

In the first three to four weeks, any activity that can raise blood flow to the eyes should be warded off. Such examples include bending, lifting, sporting activities, as well as crying. Any type of exercise regimen can be resumed when the doctor approves it.

Comfort usually settles back in after a few weeks. Full recovery can take from four to six months.

While rates of healing vary widely and can sometimes be a source of worry, the final result is what matters most.


What Are Possible Complications From Eyelid Surgery?

When the procedure is performed by a highly qualified cosmetic surgeon complications are rare and usually minor. However, as with any surgery, there are potential complications and risks. Your physician will spend time discussing these with you during your scheduled consultation. Be sure to bring a list of questions or concerns with you. All patients are instructed to discuss the general surgical risks with their surgeon.