Blepharoplasty, or eyelid surgery, is a facial plastic surgical procedure designed to enhance the aesthetic appearance of the eyes and upper one-third of the face. The position of the brow can contribute to upper eyelid aging and often a brow lift is necessary at the time of eyelid surgery. The eyes are often the first facial feature we are drawn towards, and unfortunately one of the earliest areas to show signs of aging, imparting a tired or unrested appearance. Skillfully rejuvenating and framing the eyes is a matter of millimeters and meticulous technique is an absolute. Crafting and sculpting the upper third of the face can restore the brighter and refreshed presence of your youth.

The Technique

Sometimes patients can have bags of periorbital fat protruding giving the appearance of puffiness around the eyes. This can be hereditary or just occur with time. Blepharoplasty may be performed on the upper eyelid to address skin redundancy or fat protrusion hiding a small incision in a natural eyelid crease. Lower eyelid surgery can be addressed from inside the eyelid or through a skin incision dependent on the degree of fat protrusion, skin redundancy and laxity. Blepharoplasty is performed as an outpatient surgery and can be performed under local anesthesia, sedation or a general anesthetic. Each patient will be examined individually to determine which approach is most appropriate. After awakening from anesthesia you will have ointment in the eyes and along any suture lines that exposed. Patients go home soon after awakening from the surgery.

The Recovery

The morning after the surgery, our board-certified facial plastic surgeon, Dr. Scott Shadfar, will see the patient in clinic and check all incisions and go over all wound care measures. The most important aspect of eyelid surgery is following the detailed moisturization protocol. You will continue to use lubricating drops and gel throughout the healing period. If sutures are used on the outside of the eyelids, they are removed on day 7 following the surgery, otherwise all the sutures on the inside will dissolve on their own. During the first week following your surgery you can expect some swelling, blurry vision, and bruising around the eyes. This is usually resolved by the end of the first week, and makeup may be worn after day 10 to cover any residual bruising. Swelling and blurry vision continues to improve over the first month. Patients usually have minimal downtime of 1-2 weeks before returning to work, and we ask those patients traveling from out of town to stay for routine checks during this time period. Contact lens wear can also be restarted after the two week mark.

Eyelid Surgery Frequently Asked Questions (FAQs)

Who is a good candidate for eyelid surgery?

Good candidates for eyelid surgery typically include individuals experiencing at least one of the following issues:

  • Extra (often hanging) skin in the upper and/or lower eyelids
  • Protruding fat pockets in the upper and/or lower lids
  • Visible wrinkles and creases on one or both eyelids
  • Noticeable bags and/or dark circles beneath the eyes

In addition to having cosmetic concerns, men and women whose vision is impaired by hanging upper eyelid skin are usually considered good eyelid surgery candidates, as removing excess skin can often help to improve one’s field of vision.

What if my aesthetic issues relate only to my upper or lower eyelids?

Contrary to what many believe, upper and lower blepharoplasty are actually two separate procedures. As a result, blepharoplasty can be performed exclusively on the upper eyelids or lower eyelids for patients whose concerns are limited to one lid or the other.

What are the benefits of upper blepharoplasty?

Based on each patient’s specific needs, key benefits of upper blepharoplasty can include reduction of lax, excess skin causing upper eyelid drooping; removal of fat accumulations and/or puffiness in and around the upper lids; smoothing of upper eyelid lines and wrinkles; and improvement of an obstructed field of vision.

What are the benefits of lower blepharoplasty?

Depending on an individual’s unique aesthetic goals, chief benefits of lower blepharoplasty can include removal of loose, redundant skin; reduction of excess fat pockets in the lower lids; tightening of crepey lower eyelid skin; and improvement of bags and dark circles below the eyes.

Where are eyelid surgery incisions located?

For upper blepharoplasty, a small incision will be hidden in a natural eyelid crease. For lower blepharoplasty, an incision is either made inside the eyelid or along the eyelash line on the outside of the lid. No matter where the incisions are located, they tend to heal well and are virtually indistinguishable to others once they reach their final appearance.

Why are blepharoplasty and brow lift surgery often combined?

For individuals bothered by significant eyelid sagging, a brow lift can usually help further raise the upper eyelids for an even greater improvement in one’s field of vision. Additionally, the brow lift procedure can smooth folds and creases between the eyebrows and along the forehead, helping to create a more comprehensive enhancement in the upper third of the face.

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