The eyes are often the first facial feature we are drawn towards. Unfortunately, they are also one of the earliest areas to show signs of aging, often imparting a tired or unrested appearance. Blepharoplasty, or eyelid surgery, is a surgical procedure offered by our facial plastic surgeon that is designed to enhance the aesthetic appearance of the eyes and upper third of the face. The position of the brow can contribute to upper eyelid aging and, often, a brow lift can be beneficial at the time of eyelid surgery. Skillfully rejuvenating and framing the eyes typically come down to a matter of millimeters; therefore, meticulous technique is absolutely critical. When performed correctly, crafting and sculpting the upper third of the face can restore the brighter and refreshed appearance of your youth.

The Technique

Blepharoplasty is performed as an outpatient surgery and can utilize local anesthesia, sedation, or a general anesthetic. Each patient will be examined individually to determine which approach is the most appropriate. 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.

Sometimes patients can have bags of periorbital fat protruding outward, giving the appearance of puffiness around the eyes. This can be hereditary or simply occur with time. Blepharoplasty may be performed on the upper eyelid to address skin redundancy or fat protrusion. In upper eyelid surgery, a small incision is hidden in a natural eyelid crease. Lower eyelid surgery can be performed from an incision on the inside of the eyelid, or through a skin incision on the lower lash line depending on the degree of fat protrusion, skin redundancy, and laxity. After awakening from anesthesia, you will have ointment in the eyes. Patients can go home soon after awakening from surgery.

The Recovery

The morning after the surgery, our board-certified facial plastic surgeon, Scott Shadfar, MD, will see the patient in-clinic to check all of the incisions and go over 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 seven following the surgery— otherwise, all the sutures on the internal eyelid 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. Makeup may be worn after day 10 to cover any residual bruising. Swelling and blurry vision continue to improve over the first month. Patients usually have minimal downtime of one to two weeks before returning to work, and we ask those patients traveling from out-of-town to stay in the region for routine checks during this time period. Contact lenses can also be worn after the two week mark.

Asian Eyelid Surgery

Asian eyelid surgery is a procedure performed when patients of Asian descent would like to create the look of a crease in the upper eyelid. The surgery is designed for men and women who wish to improve the appearance of a low-hanging or nonexistent upper eyelid fold, a characteristic that is sometimes seen in Asian ethnicities. While not all Asian individuals experience a “single fold” eyelid, nor seek out this variation of blepharoplasty surgery, the procedure can help those who desire a “double fold” achieve a natural-looking eyelid crease over the upper lash line. For patients interested in this technique, the formation of the upper fold can be performed in conjunction with, or in lieu of, the removal of excess skin and fat that usually takes place with blepharoplasty.

Non-surgical Eyelid Rejuvenation

Some patients desire rejuvenation in the upper face, but cannot—or simply do not wish to—undergo a surgical procedure. For men and women looking for less invasive treatment options, there are other non-surgical solutions that can be used to provide a more youthful facial appearance. Advanced injectable formulations, such as BOTOX® Cosmetic, can achieve a refreshed aesthetic by smoothing crow’s feet around the corners of the eyes, brow creases, and other expression lines in the upper third of the face. Additionally, injectables and dermal fillers can be utilized to fill in hollow tear troughs under the lower eyelid for those who would benefit from redefined facial contours. While these treatments do not mirror the same quality of results nor longevity of the outcome as blepharoplasty, both can be effective methods of facial rejuvenation that do not require the need for extensive downtime. Dr. Shadfar can walk you through all of your treatment options after discussing your cosmetic goals during a consultation.

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 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.

To learn more about eyelid surgery, or to schedule a consultation, please contact our practice today.

Contact Us