Eyelid Surgery (Blepharoplasty)
Blepharoplasty is the technical name for eyelid surgery. Its goal is to improve the appearance of your eyelids by removing excess fat and drooping skin from your upper eyelids and reducing the bagginess and tightening the skin of your lower eyelids. Blepharoplasty is also sometimes recommended for people whose peripheral vision is impaired by overhanging folds of upper eyelid skin. But it can’t remove crow's feet or other wrinkles, or dark circles under your eyes, nor can it lift sagging eyebrows.
What Eyelid Surgery Can (and Cannot) Do
As with other forms of cosmetic plastic surgery, you need to have a clear and realistic understanding of your motivation and goals for the surgery, and you need to discuss them honestly with your surgeon. Improving your appearance can’t solve all of the difficulties that you might face in life, but it may increase your self-confidence as you deal with them.
Before Eyelid Surgery
During your first consultation, your doctor will ask you about your general health, your vision, tear production, and use of glasses or lenses, and any specific conditions that might interfere with surgery. You'll discuss the details of the procedure (such as whether all four eyelids, or just the upper or lower ones, will be operated on), the type of anesthesia that will be used, what to do before and after the surgery. Together, you'll develop a plan for surgery and healing.
You may not take aspirin or any non-steroidal, anti-inflammatory medicine (such as Advil or Motrin; Tylenol is acceptable) for about two weeks before the surgery.
What to Expect
Blepharoplasty is usually an outpatient procedure lasting between one to three hours. Normally you’ll be given local anesthesia. That means you’ll be sedated and the area around the surgery will be numbed. You’re awake during the surgery, but relaxed and feeling no pain.
The incisions for the upper eyelids are usually made through the central portion. A segment of skin is removed along with portions of fat and muscle underneath the skin. For the lower eyelids, the incisions are made about 1/16th of an inch below the rim of the lower eyelid and extend onto the side of the face. Again, the procedure involves removing skin, fat and muscle.
All surgery includes some risk and uncertainty. Serious complications or side effects of this surgery are quite rare, but they include:
Possibility of infection
Drying of the eyes
Reaction to the anesthesia
You may also have difficulty closing your eyes when you sleep. (In rare cases this condition may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids, which can be corrected with further surgery.)
Immediately Following Surgery
For the first 48 hours after surgery, the incisions will be lubricated with ointment and you’ll be asked to keep iced eye pads on your eyes to reduce swelling and bruising. After 48 hours, the eye pads can be used intermittently for any sensation of burning or itching. You may also be asked to use eyedrops for a while. On the third day after surgery, you may put lukewarm eye pads on your eyes if you need them for comfort. You may also need to wear dark glasses for a week or so to prevent irritation from the sun and wind.
After a Few Weeks
Your stitches will be removed two days to a week after surgery. Your eyelids will be discolored and swollen for about seven to ten days, and feel “tight” or “stiff” for a while. To keep your eyes lubricated during this time, you’ll try exercises such as close your eyes, then “looking” at the ceiling.
During the first few weeks after surgery, you may have excessive tearing, sensitivity to light, and double or blurred vision. The whites of your eyes may have red splotches, but they will disappear after two to three weeks.
You should be able to read or watch television after two or three days, but don’t wear contact lenses until your doctor approves it. You should be able to go back to work in a week to ten days, and can use make-up then to cover the redness of the scars. You’ll avoid bending at the waist for about five days and strenuous activity (especially activities that raise your blood pressure, such as lifting and rigorous sports) for about ten days to two or three weeks.
You'll have some scars from the surgery, but they're usually hidden and will fade in time and should be scarcely visible.
Healing is Slow - But Results Are Great
Healing does take time and often people feel depressed for a while after plastic surgery, especially in the early days when their faces are bruised and swollen. This is quite normal and will pass. And remember why you chose to have the surgery. If you've met your goals, then your surgery is a success.
Read more about Eyelid Surgery in our Online Medical Encyclopedia