What is Blepharoplasty (Eyelid Surgery)?

Many plastic surgery procedures can fulfill either cosmetic or functional needs, and a good example here is blepharoplasty, or eyelid surgery. It involves removal of excess skin, muscle and fat from droopy eyelids.

Many people consider blepharoplasty to look more youthful, but it can also be practically useful as well. Severe sagging skin around the eyes can reduce peripheral vision, particularly in upper and outer vision fields—blepharoplasty can reduce or eliminate these vision issues while also improving cosmetic appearance at the same time. Here’s a look at the common uses, risks and results associated with blepharoplasty.

Why It’s Used

Eyelid surgery can be performed on the upper eyelids, lower eyelids or both. As long as you’re generally healthy, don’t smoke, don’t have other serious eye conditions and are realistic about your goals for surgery, you could be a candidate for blepharoplasty. It can be used to treat:

Loose or sagging skin that creates folds or disturbs natural eye contours in the upper eyelid. These disturbances can impact vision.
Fatty deposits in the eye that appear as puffiness in the eyelids.
Bags under the eyes.
Drooping lower eyelids that reveal white below the iris.
Excess skin and wrinkles of the lower eyelid.

In some cases, a blepharoplasty is performed along with another procedure, including brow lifts, face lifts or skin resurfacing.

Preparation

Before scheduling a blepharoplasty, you’ll meet with your plastic surgeon to discuss your medical history and your expectations for the surgery. The process looks a little like this:

Physical exam: This may include testing tear production and measuring part of your eyelids.
Visual exam: Examination of the eyes and a vision test, including peripheral vision. For cases where insurance claims are being used, this test is required.
Eyelid photography: Photographs of the eyes taken from various angles, which can help with preparing for surgery.

You’ll be told to stop taking all aspirin, ibuprofen, naproxen or any other medication associated with increased bleeding for a specified time before and after surgery. You’ll also be asked to quit smoking, and to arrange for someone to drive you to and from surgery and stay with you the first night after you return home.

During the Procedure

During a blepharoplasty, procedure steps include:

Anesthesia: Usually a choice between intravenous sedation or general anesthesia. Your doctor will recommend the correct course of action here.
Incision: Incision lines for blepharoplasty are designed to conceal resulting scars within natural structures. Incisions may be made on the upper or lower eyelid.
Closing: Incisions are closed with sutures or skin glue. Sutures will be removed within a week. In some cases, your surgeon may suggest use of a laser or chemical peel to reduce discoloration in the lower eyelids.
Results

After the Procedure

You’ll spend time in a recovery room after surgery, and you’ll be monitored for complications. A few effects you might temporarily experience after surgery include:

Blurred vision
Watering eyes
Light sensitivity
Double vision
Redness at cut sites
Puffy, numb eyelids
Swelling and bruising similar to black eyes
Pain

Your surgeon will offer specific instructions on how to care for your eyes, and these could include medications and specific areas to pay attention to during recovery.

Risks and Results

Possible risks of blepharoplasty can include:

Infection and bleeding
Dry, irritated eyes
Difficulty closing the eyes, or other eyelid issues
Noticeable scarring
Injury to eye muscles
Skin discoloration
Follow-up surgery becoming needed
Temporarily blurred vision, or in rare cases, loss of eyesight
General surgery risks: Reactions to anesthesia, blood clots, and cardiac or pulmonary complications

Results of eyelid surgery are long-lasting, and most patients can resume regular activities within about 10-14 days. Final healing may take a few months. Good results are expected, but there is no guarantee—in some cases, additional surgeries may be necessary. For best results, be sure to follow all postoperative instructions carefully, and be sure not to apply significant force, abrasion or motion to the incisions during healing.

If you think you might be a candidate for blepharoplasty for cosmetic or health purposes, speak to your doctor or plastic surgeon to find out if it’s right for you.