Eyelid Surgery
Understanding Blepharoplasty
Every year, hundreds of thousands of men and women choose blepharoplasty to improve the way they look. Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Though blepharoplasty is often performed as a single procedure, your surgeon may also recommend a brow lift, facelift, or skin resurfacing to achieve the best results.
My droopy eyelids were driving me crazy. I always had very fleshy eyelids, and as I got older, they began to sag. Putting on makeup was difficult. My eyelids felt funny, too, like they were in my way. Without realizing it, I started keeping my brow muscles tensed upward all the time. I was shocked when I saw that I hadn't developed permanent creases in my forehead from doing that.
— agnesw., age 58
Figure 1: External incisions Figure 2: Internal (transconjunctival) incision
Understanding the Surgery
In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat is removed or repositioned, and then the loose muscle and skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.
In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lash line and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also commonly self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.
A more refreshed look is often the result when eye bags are improved with blepharoplasty.
What to Expect After the Surgery
Immediately after the surgery has been completed, your surgeon may apply tiny sterile bandages. This is not done for transconjunctival blepharoplasty. It is not crucial that the eyes be covered. However, an ointment to prevent dryness of the eye area may be used. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort. Your surgeon will prescribe medication for discomfort.
For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eye drops may be recommended. Your surgeon will also list activities and environments to avoid in the weeks immediately following surgery. Permanent stitches will be removed in three to five days after surgery. Self-absorbing stitches will dissolve on their own.
Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, facial plastic surgery can help change how you feel about yourself.
Insurance does not generally cover surgery that is done purely for cosmetic reasons. Surgery to correct or improve vision or surgery for eye deformity or injury may be reimbursable in whole or in part. It is the patient’s responsibility to check with the insurance carrier for information on the degree of coverage.
In a blepharoplasty, the eyelids heal remarkably quickly and scars are usually quite inconspicuous.