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Blepharoplasty (Eyelid Surgery)

Blepharoplasty or eyelid surgery removes or repositions the fat, along with excess skin and muscle, from the upper and lower eyelids.

It can also correct drooping upper lids and puffy bags below your eyes. Eyelid surgery will not, however, remove crow’s feet or other wrinkles, eliminate dark circles under your eyes or lift sagging eyebrows.

Who’s a Candidate?

The best candidates for eyelid surgery are men and women who are physically healthy. Some medical conditions make blepharoplasty more risky. They include: thyroid problems, dry eye (lack of sufficient tears), high blood pressure or other circulatory disorders, cardiovascular disease and diabetes. A detached retina or glaucoma is also a reason for caution.

Check with your ophthalmologist before having surgery.

What are the Risks of Blepharoplasty?

Minor complications include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring.  The lower lid may droop for several weeks following surgery.

Preparing for Surgery

You should provide the surgeon with any history regarding your vision and tear production. You should also provide any relevant information from your ophthalmologist or the record of your most recent eye exam. If you wear glasses or contacts, be sure to bring them along.

Be sure to arrange for someone to drive you home after your surgery.

A Typical Blepharoplasty Procedure

Eyelid surgery is usually performed under local anesthesia along with oral or intravenous sedatives or general anesthesia. The procedure 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.

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. Sometimes patients may have this lower incision placed on the lining inside of the eye. The incisions may extend into the crow’s feet or laugh lines at the outer corners of the eye. Working through the incisions, the surgeon separates the skin from the underlying fatty tissue and muscle, removes the excess fat and trims any sagging skin or muscle. The incisions are then stitched closed.

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. It is usually performed on young patients with thicker, more elastic skin.

After Your Surgery

The surgeon will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anesthesia wears off. Any discomfort can be controlled with pain medication.

You should keep your head elevated for several days and use cold compresses to reduce the swelling and bruising. The doctor will show you how to clean your eyes, which may be gummy for a week or so. You may also experience excessive tearing, sensitivity to light and temporary changes in eyesight for the first few weeks.

You should be able to read or watch television after two or three days. You won’t be able to wear contact lenses, however, for about two weeks. When going out, be sure to wear sunglasses and a special sun block for eyelids.