 Blepharoplasty reshapes the upper and lower eyelids, restoring an open alert appearance in the eyes. Over time the shape of the eyes changes. The upper eyelids droop and the lower eyelids form puffy "bags" making you look tired and old. Sometimes, a dramatic change in eye shape can obstruct vision.
Blepharoplasty can be performed on all four eyelids, or just the upper or lower lids. It is commonly done on patients in as early as their mid-thirties. After carefully discussing your goals and expectations with your surgeon, he can recommend the appropriate course of action for you.
Patients who have "bags" or puffiness in the lower eyelids may be good candidates for the tranconjunctival blepharoplasty. To remove the excess fatty tissue below the eye, incisions are made just inside the lower lid, on the pink part that you see when you pull down your lower eyelid. The incisions are closed with tiny sutures that dissolve within a few days or they may not be sutured at all. This approach leaves no visible scarring.
Patients with excess or loose skin that hides the natural folds of the upper eyelids, excess skin and fine wrinkles of the lower eyelids, and/or puffiness in the upper eyelids may be good candidates for the subcilliary blepharoplasty. To remove excess skin or muscle, incisions may be made in a natural smile crease below the lashline. Eyelids heal remarkably quickly and well and scars are usually quite inconspicuous if there is any scaring at all.
Some patients find that, along with baggy eyelid skin, an additional source of concern is textural or surface changes (fine little lines) in the skin around the eyes. Skin Resurfacing removes textural imperfections and crows feet and is often performed in conjunction with blepharoplasty for full rejuvenation of the eye area.
Before Surgery
- Avoid taking any medicines containing aspirin or ibuprofen during the two weeks before and after surgery.
- Be certain you do not have a cold or sunburn the day of surgery.
- Eat a balanced nutrient-rich diet before and after surgery. A healthy diet will help speed recovery.
- Do not eat or drink after midnight the night before surgery, unless instructed differently by our anesthesia provider.
- Do not wear make-up or contact lenses to surgery.
- Arrange to have someone take you home after surgery and stay with you that evening and, if possible, help you around the house for a few days while you recover.
- Notify your physician if you have any of the following conditions: thyroid problems such as hypothyroidism, circulatory disorders such as high blood pressure, cardiac disease, diabetes, or eye conditions such as glaucoma, a detached retina, or dry eye.
The Procedure
Blepharoplasty takes from 1 to 3 hours depending on the extent of the procedure.
The procedure is performed in our state accredited surgery center on an outpatient basis. Patients are given general anesthesia during this procedure.
Tranconjunctival Blepharoplasty
- After the patient is anesthetized, the surgeon makes incisions inside the eyelid, invisible from the outside.
- Through the incisions, the surgeon separates the skin from the underlying fatty tissue and muscle, removing excess fat. Please note that in a transconjuctival procedure, excess skin is not removed.
- The incision may be closed with very fine sutures, if necessary.
- After the surgery your eyes are lubricated with an ointment and bandaged.
Subcilliary Blepharoplasty
- After the patient is anesthetized, the surgeon makes incisions along the natural lines of the eyelids.
- Through these incisions, the surgeon separates the skin from the underlying fatty tissue and muscle, removing excess fat, muscle, or sagging skin
- The incisions are finally closed with very fine sutures.
- After the surgery your eyes are lubricated with an ointment and bandaged.
After Surgery
Plan on staying in bed with your head elevated for the first day. Do not sleep on your side. After the procedure is over, patients may experience some numbness and mild swelling and/or discomfort at the incision sites. This is normal and will pass with time. Incision site pain is usually minimal, and can be controlled with medication, if necessary. If you experience severe pain, contact our office immediately.
You'll be instructed on how to clean and care for your eyes. They may feel goopy from the ointment used to lubricate them. Bandages around the eyes will be removed in our office the day after your surgery. Swelling and bruising may last from 2 weeks to a month. To reduce swelling and bruising you'll want to keep your head elevated and apply a cold compress. The bandage is usually removed in our office the next day, but patients should continue to wear a stretchy headband or stocking cap for one week.
Recovery
Patients usually go back to school or work within 7-14 days but should continue to take it easy. Although patients are ready to return to work or school, they should plan to limit rigorous activity for a couple of weeks.
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