Blepharoplasty (Eyelid surgery)

Eyelid surgery, technically called blepharoplasty, is a procedure to remove excess fat, skin and muscle from the upper and lower eyelids. The procedure can correct drooping upper eyelids and puffy bags below the eyes - features that make you look older and more tired than you feel, and sometimes even interfere with your vision. Eyelid surgery will not remove crow’s feet or other wrinkles, nor will it eliminate dark circles under your eyes or lift sagging eyebrows. The procedure is sometimes performed in conjunction with other facial plastic surgical procedures such as a facelift or brow lift.

The best candidates
Most commonly, eyelid surgery is performed on men and women who are 35 years or older. If droopy, baggy eyelids run in your family, you may decide to have the procedure at a younger age.

If you have thyroid problems such as hypothyroidism and Graves’ Disease, dry eyes or lack sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, or diabetes, eyelid surgery is more risky. Also, a detached retina or glaucoma is reason for caution. Please check with your ophthalmologist before you consider surgery.

How the surgery is performed
In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lid in order to keep the scars as hidden as possible along the natural folds. Then, the incision is made and excess fat, muscle, and loose skin are removed. The incision is closed with fine sutures and sometimes small strips of surgical tape are applied.

In lower eyelid surgery, the surgeon makes an incision along the lash line and smile creases of the lower lid and excess fat, muscle, and loose skin are then removed. The incision is closed with sutures. If you only require removal of fat on the lower lid, transconjunctival blepharoplasty may be performed. In this procedure the incision is made inside your lower eyelid, leaving no visible scar.

Eyelid surgery usually takes one to three hours, depending on the extent of the procedure. The procedure is usually performed in-office under local anesthesia along with an oral sedative. You will be awake during the procedure, but will feel relaxed and insensitive to pain.

What to expect after surgery
Immediately after surgery, the surgeon will apply an ointment to the incisions to prevent dryness of the eye area and promote healing. A certain degree of swelling and bruising is normal. Your eyelids may feel tight and sore as the anesthesia wears off. Cold compressed, as well as elevation of your head when lying down for the first several days, will help healing and relieve some discomfort and swelling. You may experience some throbbing or headache at first which is typically relieved with over-the-counter acetaminophen (Tylenol). Other prescription pain medications are normally not indicated.

Bruising varies from person to person, but typically reaches its peak during the first week and lasts from two weeks up to one month. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

Resuming work and other activities
The usual time for return to work is three to four days. You should be able to read or watch television after two to three days, but you must wait at least two weeks before you wear contact lenses. You may be sensitive to sunlight, wind and other irritants for several weeks, so you will want to wear sunglasses when you go out. Strenuous activity and consumption of alcohol may be resumed after three weeks. It is most significant to avoid activities that raise your blood pressure, such as bending, lifting, and rigorous sports.