Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient’s field of vision. Blepharoplasty can be combined with BOTOX® treatments to raise the eyebrows or reduce the appearance of wrinkles, crow’s feet or dark circles under the eyes.
The procedure is usually performed in an office with local anesthesia and lasts 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.
Stitches are removed after three or four days and most people return to work in ten. Contact lenses may not be worn for two weeks. The effects of blepharoplasty can last for a long time and are sometimes even permanent.
What can a blepharoplasty do?
A blepharoplasty is ideal for correction of the following:
- Loose, sagging and/or folded upper eyelids that may interfere with vision
- Puffy fat deposits in the eyelids
- Undereye bags
- Sagging lower eyelids that may show the whites of the eyes below the irises
- Excess skin in the lower eyelids
- Fine wrinkles in the lower eyelids
- A blepharoplasty cannot raise the eyebrows, or treat deep wrinkles, dark circles under the eyes, or crow’s feet.
Who is a good candidate for a blepharoplasty?
The best candidate for a blepharoplasty is in good overall health, does not smoke, does not have serious eye conditions, and has healthy facial tissue and muscle.
A person with eye disease, diabetes, thyroid disorder, cardiovascular disease or high blood pressure may not be a good candidate for a blepharoplasty.
It is important for a patient to have realistic expectations before undergoing a blepharoplasty. Although it can enhance appearance and improve self-confidence, it does not radically alter the look of the face.
How is a blepharoplasty performed?
Blepharoplasty is typically performed as an outpatient procedure requiring local anesthesia and sedation. General anesthesia may be used for anxious patients. Patients may choose to have this procedure on their upper or lower eyelids, or both. A blepharoplasty can take anywhere from 45 minutes to 2 hours, depending on whether or not both the upper and lower eyelids are treated.
If the upper eyelid is being treated, an incision is typically made along the natural crease of the eyelid. Once the incision is made, fat deposits are repositioned or removed, tissue and muscles are tightened, and excess skin is removed. For the lower eyelid, an incision is usually made just below the lash line so that excess skin can be removed.
After the procedure, the incisions are closed with sutures, tissue glue or surgical tape, and usually loosely covered with gauze.
What is recovery from a blepharoplasty like?
After blepharoplasty, patients may be advised to apply lubricating drops/ointment and cold compresses to aid in healing and minimize side effects. Most patients return to work within a few days to a week, but should avoid exercise and strenuous activities for at least 2 weeks. Stitches are usually removed 3 or 4 days after the procedure. Most of the swelling and other side effects typically subside within 2 weeks. Contact lenses and eye makeup may not be worn for 2 weeks after surgery. Patients are typically advised to wear dark sunglasses outside or in bright light for 2 weeks to protect their eyes from sun and wind.
What are the results of a blepharoplasty?
Although there may be swelling and bruising around the surgical site, they will subside on their own, and the eyelids will improve in appearance for up to a year. The scars from a blepharoplasty are well-concealed, and usually fade with time until they are virtually undetectable. Although the eyelids are still subject to aging, blepharoplasty produces long-lasting results.