Blepharoplasty, also known as eyelid surgery, is one of the most commonly performed cosmetic procedures in the United States. Puffy or droopy eyes can make you seem older than you are and even impair vision. Dr. Robert Walton is a board certified plastic surgeon who specializes in facial cosmetic surgery procedures like blepharoplasty to restore a more youthful and well-rested appearance to your face.
What is Eyelid Surgery?
As we age, our eyelid skin stretches and the muscles supporting the eyelids begin to lose their tone. This allows fat around the eyes to bulge, resulting in the commonly referred to “bags” in the upper and lower eyelids, puffiness, and drooping of the eyelids. The drooping, bulging eyelids not only create an older, more tired appearance, in extreme cases they can affect your vision as well.
Blepharoplasty is a cosmetic procedure that restores a more alert and youthful appearance to the eyes by correcting the fat bulges and droopiness of the eyelids. Eyelid surgery addresses these common signs of aging by removing sagging, excess skin and repositioning or removing fatty deposits in the eyelids. Blepharoplasty may be performed on the upper eyelids, lower eyelids, or both.
While blepharoplasty can be performed as a single procedure, it can also be combined with a browlift for sagging eyebrows or a facelift for more complete rejuvenation.
Why Have Eyelid Surgery?
Blepharoplasty has a very high patient satisfaction rate and complications are uncommon. Men and women choose to undergo eyelid surgery for a variety of reasons. This procedure can correct drooping eyelid (ptosis) caused by a medical disorder or age. Ptosis can even affect your vision, although it can be treated successfully with eyelid surgery to remove the excess skin blocking your vision. The procedure can also address bags or swelling under the eyes that often comes with age. Many patients choose blepharoplasty to restore a more youthful appearance to their eyes, especially when sagging skin or excess fat occurs in the 30s, 40s, or 50s. Eyelid surgery is performed on people of all ages.
If you have excess skin of the upper eyelids that impairs your peripheral (upper, lower, and side) vision, blepharoplasty may be covered by insurance. Most insurance companies cover functional blepharoplasty if you have a clinical examination establishing that you have drooping eyelids that impair your vision and that and you have demonstrated improvement in a visual field test when your excess eyelid skin is taped out of your field of vision. Lower eyelid surgery is not covered by insurance.
Eyelid Surgery Procedure
Both upper and lower blepharoplasty procedures are performed on an outpatient basis under local or general anesthesia. With an upper eyelid blepharoplasty, small incisions are made in the natural folds of the eyelids to remove excess fat and skin.
During a lower eyelid lift, incisions will be made in the creases below the eyelashes to remove excess fat and skin. Puffiness that is caused mostly by excess fat may be corrected with an incision inside the lower eyelid in a procedure called a transconjunctival blepharoplasty. With this procedure, the incisions will be closed with self-dissolving sutures and the resulting scars will not be visible.
For the first two days after your surgery, your incisions will need to be lubricated with ointment and you may use cold compresses to reduce swelling and bruising. Dr. Walton may advise you to wear dark glasses for about seven days to reduce irritation to your eyes, as they may be sensitive to sunlight. Eye drops will also be recommended as dry eyes are somewhat common following surgery.
Blepharoplasty recovery usually takes one to two weeks. Any stitches will be removed by the 5th day. While some bruising and swelling is common, most bruising can be concealed with makeup. Most patients are comfortable returning to work after one week, although strenuous activity should be avoided for about three weeks.
Once the incisions heal, they will be nearly invisible. Dr. Walton will take care to hide the incisions in the natural creases of the eyelids.
While eyelid surgery is a very safe procedure, there are potential risks and complications as with any surgery. Risks include dryness of the eyes, bleeding from incisions, bruising, swelling, anesthesia reactions, trouble closing your eyes, infection, poor healing, unfavorable scarring, and the possible need for revision surgery. These risks can be mitigated by choosing a skilled plastic surgeon like Dr. Robert Walton and following all pre- and post-op advice.
Are You a Candidate?
Good candidates for an eyelid lift have sagging or dropping upper or lower eyelids that cause a tired appearance, people with excess fatty deposits that lead to puffiness under the eyes, and those with wrinkles around the eyes. Individuals with upper eyelids that sag enough to impair vision are also excellent candidates. Blepharoplasty cannot correct dark circles under the eyes nor can it correct a sagging brow. Instead, it may be combined with fillers or a browlift if these areas are also a concern. As with any surgery, ideal candidates are non-smokers free of significant medical problems who have a realistic expectation of the outcome of the procedure.
Eyelid Surgery FAQs
How long will the procedure last?
In most cases, eyelid surgery takes two to three hours. The length of the procedure depends on the degree of aging, the cause of the puffiness or sagging eyelids, and whether the procedure is performed on the upper, lower, or both eyelids.
What can I expect after the procedure?
After surgery, you may experience light bruising and swelling around the eyes as well as some discomfort that can be relieved with cool eye pads and over-the-counter pain medication. Bruising and swelling will subside on their own over the course of one to two weeks. You may use eye drops and dark sunglasses to combat dry eyes for two or three weeks after surgery.
Are there risks?
As with any surgical procedure, there are risks with blepharoplasty. While serious complications are rare, there is a risk of dry eyes, infection, or a reaction to the anesthesia.
How soon can I return to work?
Eyelid surgery recovery varies by person, although most people are comfortable returning to work after 5 to 7 days.