What Is Blepharoplasty?
Blepharoplasty is a kind of surgery performed on the eyelids. It’s done to remove excess skin from the upper eyelids and reduce bagginess from the lower eyelids. It’s also called an eye lift.
Why Is Blepharoplasty Done?
This surgery is usually done for cosmetic reasons. It's also an effective way to improve sight in older people whose sagging upper eyelids get in the way of their vision.
An eye lift won’t get rid of dark circles under the eyes, crow's feet, or other facial wrinkles. It’s often done along with other procedures such as laser resurfacing, filler injections, or forehead lifts.
The eyelid aging process
As skin ages, it gradually loses its elasticity. A lack of elasticity plus the constant pull from gravity causes excess skin to collect on the upper and lower eyelids.
Excess skin on the lower eyelid causes wrinkles and bulges. On the upper eyelids, an extra fold of skin can hang over the eyelashes and get in the way of seeing.
The fat that cushions the eyeball from the skull can also cause bulges in the upper and lower eyelids. The thin membrane that holds the fat in place weakens with age, letting the fat come forward into the lids like a hernia.
Who Is a Good Candidate For Blepharoplasty?
The best candidates for an eye lift are people who are in good health and who have a realistic idea of what they want. Most are 35 years or older, but if baggy eyelids or droopy eyelids run in your family, you may decide to have the surgery done sooner.
Eyelid surgery can improve your appearance and help build your confidence. However, it may not result in your ideal look or alter your facial structure. Before you decide to have surgery, think about your goals and discuss them with your surgeon.
You’ll need to arrange for another person to drive you home after your surgery. You should also have someone stay with you the night of the procedure.
Expect and plan to stay home from work and limit your activities for several days after surgery while your eyelids heal. Some people have dry eyes after surgery, but that rarely lasts more than 2 weeks. If you have dry eyes lasting more than 2 weeks, contact your doctor.
At home, you should have the following items ready:
Ice pack (or you can use freezer bags filled with ice, frozen corn, or peas)
Small gauze pads
Eye drops or artificial tears (ask your doctor to recommend the proper type to meet your particular needs)
Clean washcloths and towels
Over-the-counter painkillers (which your doctor can recommend)
Advil, Motrin, Naproxen, Aleve, and aspirin shouldn’t be used due to the increased risk of bleeding.
An eyelift usually takes about 2 hours if both upper and lower eyelids are done together. Your doctor will most likely use local anesthesia (a painkiller injected around the eye) with oral sedation.
If you are having the procedure done at a hospital or surgical center, you’ll most likely receive IV sedation.
If you're having all four eyelids done, the surgeon will probably work on the upper lids first. The surgeon will usually cut along the natural lines of your eyelids. Through these cuts, your surgeon will separate the skin from the underlying tissue and remove the excess fat and skin (and muscle if indicated). Next, the surgeon will close those cuts with very small stitches. The stitches in the upper lids will stay for 3-6 days. The lower lids may or may not require stitches, depending on the technique used.
Surgery on the lower eyelids may be done using one of several techniques. In one method, your surgeon makes a cut inside your lower eyelid to remove fat. That cut won't be visible. Your surgeon can then soften fine lines in the skin using a C02 or erbium laser.
Another method involves making a cut along the eyelash margin. Through that cut, your surgeon can remove excess skin, loose muscle, and fat. The cut line fades after a short time.
After either of these procedures, your surgeon may recommend laser resurfacing.
After the surgery
Your doctor will probably put ointment in your eyes to keep them moist and cover them with cold compresses while you’re in the recovery room. Right after surgery, you may have blurry vision from the ointment and be sensitive to light. Your eyes may feel dry or watery.
It will help to put ice packs on your eyes and sleep with your head raised the first night after surgery. Your doctor will give you detailed instructions for taking care of yourself.
Upper eyelid surgery is good for at least 5-7 years. Lower eyelid surgery rarely needs to be repeated. Of course, your eyes will still age after the procedure.
If your lids sag again, a forehead lift rather than another eye lift may be the preferred procedure.
After eyelid surgery, you’ll have stitches in both lids that will remain for as long as a week. It is common to have swelling and, occasionally, bruising, but your eyelids should look normal within a week or two.
Complications and unwanted results from an eye lift are rare, but sometimes they do happen. They can include:
Abnormal coloring of the eyelids
Eyelid skin that folds in or out abnormally
Not being able to fully close your eyes
A pulled-down lower lid lash line
A possible loss of vision
If you have any of these complications, contact your doctor as soon as possible
Eyelid surgery can cost several thousands of dollars. You’ll pay the surgeon’s fee, plus costs for the operating room, anesthesia, and any tests or prescriptions you need.
Health insurance companies usually don't cover cosmetic procedures. If you're getting eyelid surgery for a medical reason (for instance, because your eyelids are drooping so much that it affects your vision), and if a vision test confirms that, your insurance company may cover it. Check on that before you get the surgery so you know exactly what you’ll pay.