Eyelid Surgery (Blepharoplasty)

What is blepharoplasty?

Blepharoplasty, or eyelid surgery, can improve the appearance of the area around your eyes. It’s a procedure that reduces bagginess from your lower eyelids and removes excess skin from your upper eyelids. As skin ages, it gradually loses its elasticity. A lack of elasticity, combined with the relentless pull of gravity, causes excessive skin to collect in your upper and lower eyelids. Blepharoplasty can be performed on your upper eyelids, lower eyelids or both.

Blepharoplasty often means removing excess skin, muscle and underlying fatty tissue. But sometimes providers can reposition tissues rather than removing them. While it’s primarily a cosmetic procedure, blepharoplasty can also improve the field of vision in people whose sagging upper eyelids obstruct their visual field.

Blepharoplasty with fat removal doesn’t eliminate dark circles under your eyes or remove crow’s feet or other facial wrinkles. Other surgical and nonsurgical procedures that reposition fat, fill the hollows under the eyes or lift your cheeks can improve dark circles. Providers can perform blepharoplasty at the same time as other facial surgery procedures, such as laser resurfacing or brow lifts.

Who is a good candidate for blepharoplasty (eyelid surgery)?

The best candidates for blepharoplasty surgery are generally people at least 30 years old who are in good health and have no other eye conditions. Tell your healthcare provider if you have any of the following conditions:

• Eye disease, like glaucoma, dry eyes or a detached retina.
• Thyroid disorders, like Graves’ disease, hypothyroidism or hyperthyroidism.
• Cardiovascular disease, high blood pressure or other circulatory disorders.
• Diabetes.

Be realistic about the expectations you have for blepharoplasty. Eyelid surgery can enhance your appearance and help build your confidence. But you shouldn’t expect the surgery to drastically change your look. Many people have eyes that aren’t perfectly aligned or that appear to be different sizes. Asymmetrical features occur during the early stages of development. Blepharoplasty won’t alter your facial structure. 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.

How should I prepare for eyelid surgery?

To prepare for a blepharoplasty procedure, your ophthalmologist (an eye care specialist) or oculoplastic surgeon may ask you to:

• Get a medical evaluation or lab testing done.
• Quit smoking.
• Adjust your current medications or start taking certain medications.
• Stop taking anti-inflammatory drugs, aspirin, blood thinners, multivitamins and herbal supplements, as they can all increase your risk of bleeding.

You’ll need to arrange for a trusted family member or friend to drive you home from surgery. They’ll also need to stay with you the first night after the procedure.

What happens during a blepharoplasty procedure?

Depending on your goals and the recommendation of your surgeon, blepharoplasty can involve your upper eyelids, lower eyelids or both.

Upper blepharoplasty

During an upper blepharoplasty, your surgeon will make cuts (incisions) in the natural crease of your upper eyelid. These incisions will be hidden when your eyes are open. Your surgeon will remove excess skin and protruding fat, and then they’ll close the incisions.

Lower blepharoplasty

During a lower blepharoplasty, your surgeon will make an incision just below your lower eyelash line. They’ll remove excess skin in your lower eyelid through this incision. They may also use an incision hidden inside your lower eyelid (transconjunctival incision) to correct lower eyelid issues and redistribute or remove excess fat.

How long does a blepharoplasty procedure take?

A surgeon can typically complete an upper blepharoplasty in about 45 minutes to one hour. It takes about two hours if both upper and lower eyelids are done at the same time, depending on whether fat is repositioned or if there’s additional work performed.

What happens after a blepharoplasty procedure?

There will be a stitch in each of your upper lids that’ll remain for about a week. The lower lids don’t require stitches if the incisions are made on the inside of your lids. It’s common for swelling and bruising to occur in your upper and lower lids. Expect to stay home from work and limit your activities for several days after surgery to allow your eyelids to heal.

Are there possible complications with blepharoplasty (eyelid surgery)?

As with any surgical procedure, there’s some degree of risk. Complications and bad results from blepharoplasty are rare, but sometimes they do occur. Problems that can occur include:

• Bleeding.
• Infection.
• Dry eyes.
• Abnormal discoloration of your eyelids.
• Scarring.
• Abnormal folding in or out of your eyelid skin.
• An inability to fully close your eyes.
• A pulled-down, lower-lid lash line.
• Possible loss of vision.

However rare they might be, it’s important to be aware of potential complications before you decide to have the surgery. Most people are happy with their results following the blepharoplasty procedure.

What is the blepharoplasty recovery time?

Although the surgery is typically painless, you may have some swelling and bruising. Most people feel comfortable going out in public after 10 to 14 days. But it can take a few months to heal completely.

During your blepharoplasty recovery, you can use cold compresses and antibiotic ointment to ease any swelling. Your surgeon will give you specific instructions that may include:

• How to care for your eyes.
• Medications to aid healing and reduce the potential for infection.
• Specific concerns to look for at the surgical site.
• When to follow up with your surgeon.

How long does a blepharoplasty last?

Blepharoplasty won’t stop your eyes from aging. But the results usually last a long time. Upper eyelid surgery can last anywhere from five to seven years to an entire lifetime, while lower eyelid surgery rarely needs to be done more than once.

When should I call my healthcare provider?

Some people experience dry eyes after surgery, but the condition rarely lasts more than two weeks. If you have dry eyes for more than two weeks, contact your healthcare provider.

How painful is blepharoplasty surgery?

Blepharoplasty is one of the least painful cosmetic procedures. You may have some slight discomfort on the day of surgery, but you should feel better quickly.

What is the best age to have blepharoplasty?

Anyone over the age of 18 can get eyelid surgery. However, the best candidates are healthy adults ages 30 and up. According to the American Society of Plastic Surgeons, most people who get the surgery are over age 40.