Blepharoplasty (Eyelid Surgery)

Blepharoplasty is eyelid surgery to reshape your eyelids and the area around them. A surgeon will remove or reposition extra skin, fat and muscle tissue from around your eyes. Some people call it an eyelid lift.

It’s usually a cosmetic surgery you choose to have to change your appearance. But your eye doctor might suggest blepharoplasty if your eyelids droop in front of your eyes and affect your vision. It might be medically necessary to have a blepharoplasty on your upper eyelid to improve your peripheral vision.

Your skin naturally loses some of its bounciness (elasticity) and full appearance as you age. Over time, this can lead to extra skin collecting around your upper and lower eyelids. If you don’t like how this looks, a blepharoplasty can help change the shape and size of your eyelids. Your surgeon can do:

• Upper blepharoplasty on your upper eyelids
• Lower blepharoplasty on your lower eyelids
• Both upper and lower at the same time

Benefits/risks

The primary benefit of eyelid surgery is changing how your eyes look. This can help you look more like you want and boost your self-image.

Be realistic about your expectations for blepharoplasty. It can alter your appearance. But you shouldn’t expect the surgery to drastically change your look. It’s important to know your face well before you decide to have surgery. Think carefully about your expectations and discuss them with your surgeon.

Like all surgeries, there’s a small risk of complications, including:

• Bleeding
• Infections
• Dry eyes
• Skin discoloration or your eyelid skin folding in or out more than you’d like
• Scarring
• Vision issues

What happens during eyelid surgery?

Before blepharoplasty, you’ll need an eye exam and a checkup to make sure you’re healthy enough for surgery. Tell your surgery care team which medications and supplements you take. You might need to stop taking some of them before your surgery appointment.

You’ll need to arrange for someone to drive you to and from surgery. You won’t be able to drive yourself. If possible, also plan for someone to stay with you for the first night or two after surgery.

Blepharoplasty usually follows these steps:

1. Your surgery care team will give you anesthesia so you don’t feel pain during the procedure. You might need a local anesthetic for the area around your eyes, numbing drops in your eyes and a sedative injected into a vein.
2. Your surgeon will make small cuts in the natural crease of your eyelids. For your upper eyelids, this incision will be hidden when your eyes are open. For your lower lids, the cut will be just below your eyelash line. Lower blepharoplasty may use cuts inside your eyelid (transconjunctival incisions).
3. Your surgeon will remove extra skin, fat or muscle tissue. They may also rearrange some tissue based on your appearance goals.
4. They may close the incisions with stitches.

Eyelid surgery can take anywhere from 30 minutes to two hours. It might take closer to two hours if you’re having both your upper and lower lids reshaped. It can also take longer if your surgeon is redistributing tissue rather than just removing it.

Blepharoplasty is an outpatient procedure. That means you can go home the same day. Your care team will move you to a recovery area to monitor you for a while after the procedure. They’ll tell you when it’s OK to go home.

You’ll have stitches in your eyelids for about a week after surgery. Your surgeon may use dissolvable sutures that safely absorb into your body. Otherwise, they’ll remove the stitches at a follow-up appointment.

Blepharoplasty recovery time

It usually takes a few months to recover completely after eyelid surgery. You’ll have bruising and some swelling that will get better gradually as your eyelids heal. Most people feel good enough to return to their usual routine after a week or two.

Your eyes may feel dry for a few weeks after surgery. Your surgery care team can suggest unmedicated ointment or drops to help manage this. They’ll also give you specific instructions that may include:

• How to care for your eyes and surgery sites
• How to manage pain and swelling with cold compresses and medications
• Which activities you should avoid, and for how long
• Medications to reduce your infection risk and help your eyes heal
• When you’ll need follow-up checkups

When should I call my healthcare provider?

Call your surgery care team if you have any of the following symptoms:

• Bleeding
• Discharge or pus coming from your eyes
• Severe swelling
• Severe pain
• Vision changes