Your eyes reveal how you feel more than any other facial feature. If you believe that your eyes make you look tired, sad or older than you feel, cosmetic eyelid surgery (blepharoplasty) may be the right choice for you. Eyelid surgery can remove the excess fat and drooping skin of the upper eyelids, minimize bags under the eyes and tighten the lower eyelid skin. The result is a more alert, relaxed and confident appearance.
You may be a good candidate for eyelid surgery if you have any of the following conditions:
- Excess skin that hides the natural fold
- Loose skin that hangs down from the upper eyelid
- Puffiness that creates a tired look
- Excess skin and wrinkles
- Puffy bags and some cases dark circles
Eyelid surgery needs to be approached with extra caution if you have – thyroid problems, lower eyelids that droop significantly and have scleral show, eye problems – such as “dry eye”, glaucoma or retinal problems, high blood pressure or other circulatory problems, cardiovascular disease or diabetes. It is important that you inform your plastic surgeon if you have any of these problems.
How is Blepharoplasty performed?
Blepharoplasty is performed in a hospital, under local or intra-venous sedation or general anaesthesia. Your doctor will recommend the best choice for you.
Upper eyelids – Typically, the incision lies within the natural crease and extends slightly into the laugh lines. Through this incision, excess skin, muscle and fatty tissue are removed. This incision when healed is barely visible. A form of brow lift can be performed through this incision at the same time. Please discuss this option with your cosmetic surgeon.
Lower eyelids – Usually the incision is concealed below the eyelashes (sub-ciliary) or in some selected cases the incision may be taken on the inner side of the eyelid (on the conjunctiva). Through the sub-ciliary incision, excess skin, muscles and fatty tissue are removed. In most cases the muscles and other eyelid structures may be tightened. Through the trans-conjunctival incision only the excess fat tissue can be removed.
The incisions are closed with very fine sutures and adhesive tapes may be applied to support the skin and minimize swelling.
After surgery you will experience bruising and swelling (the amount and duration varies from person to person). You will be advised to rest with your head elevated and to apply cold compresses to minimize swelling. Although everyone heals at different rate, your recovery may be as follows:
The swelling and bruising around the eyes will reach its peak in 2 days and then gradually subside. Initially, you may experience excess tears or dryness, itching or light sensitivity (temporary). Stitches will be removed by the 7th post-operative day . You may resume routine non-strenous activities within one week. You may resume exercises and wearing contact lenses after several weeks.
Blepharoplasty is a surgical procedure and has some potential problems associated with it. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.
Possible risks include:
- Anesthesia risks
- Swelling and bruising
- Bleeding from the incision lines
- Dryness to the eyes
- Sensitivity to sun or other bright light
- Difficulty closing your eyes
- Ectropion, an outward rolling of the eyelid
- Lid lag, a pulling down of the lower eyelid may occur and is often temporary
- Temporary or even permanent change in vision, and very rare chance of blindness
- Changes in skin sensation
- Possible need for revision surgery
- Unfavorable scarring
During consultation be prepared to discuss:
- Your surgical goals
- Medical conditions, drug allergies, and medical treatments
- Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
- Previous surgeries
Your aesthetic surgeon will also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine the eyelids with respect to skin laxity, fat bulges, overall lid laxity as well as examine the adjacent cheek and mid-face region
- Take clinical photographs
- Discuss your surgery options.
- Recommend a course of treatment
- Discuss likely outcomes of and any risks or potential complications
It’s very important to understand all aspects of your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your cosmetic surgeon.
Preparing for Blepharoplasty
In preparing for surgery, you may be instructed as follows:
- Get lab testing or a medical evaluation. You may be advised to closely monitor your blood pressure and even consult an eye specialist to rule out any existing pathology.
- Take certain medications or adjust your current medications
- Stop smoking
- Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding