Blepharoplasty, or eyelid rejuvenation surgery, is a popular cosmetic procedure among patients who want to combat the aesthetic effects of aging.
Blepharoplasty is the plastic surgery procedure of removing fat, excess skin, and extra muscle tissue from around the eyes, giving you smooth, firm skin around the eyes and ridding you of droopy eyelids.
As we age, the fat, muscle, and skin around the eyes begins to sag and droop, creating a tired, aged appearance. The blepharoplasty procedure involves the removal and repositioning of fat, muscle, and skin from around the eye to create a firmer, tighter, and more youthful look around the eye. In some cases, when there is enough excess skin around the eye that it obstructs the patient’s vision, the removal of excess skin can even improve the patient’s eyesight.
There are two main types of blepharoplasty: lower and upper eye lids. A given patient might receive just upper lid, just lower lid, or both, depending on individual needs and goals.
LOWER LID BLEPHAROPLASTY
Lower lid blepharoplasty is a procedure for reshaping and tightening the under-eye area by removing excess fat and skin, and by reshaping the area, lifting drooping fat deposits.
In lower eyelid blepharoplasty, depending on the patient’s individual needs, the surgeon may perform either transconjunctival blepharoplasty or transcutaneous blepharoplasty.
Transconjunctival blepharoplasty is usually indicated when the patient has large bags under the eyes caused by fat deposits, but little or no wrinkling. In this procedure, the surgeon makes a small incision on the inside of the lower eyelid, leaving no external incision, and repositions the fat deposits higher in the eye socket, eliminating the sagging effect.
Transcutaneous blepharoplasty is a more effective option for patients who have loose skin or muscle around the lower eyelids that requires tightening. In this procedure, the surgeon will make small incisions just below the eyelashes, so any scarring will be hidden, and will then tighten the excess skin and muscle that is creating the appearance of bags, creating a more vibrant and youthful appearance.
UPPER EYELID BLEPHAROPLASTY
Upper eyelid blepharoplasty is a procedure for tightening and reshaping the upper eyelid area, removing excess skin, muscle, and fat caused by loss of elasticity as a result of aging. The tightening of the skin in this area can create a more alert, vital appearance, and in cases in which the sagging is extreme enough to obstruct vision, it can even improve the patient’s eyesight.
In upper lid blepharoplasty, the cosmetic surgeon will make small incisions following the natural creases in the patient’s eyelid, or in the laughter lines along the outside corner of the eye, following the natural contours of the face so as to minimize potential scarring from the incision.
Blepharoplasty can be performed alone or in conjunction with other facial procedures such as facelifts or brow lifts. Your plastic surgeon will perform the procedure with either local anesthetics or under general anesthesia. If you are under local anesthesia for the pain, you will also have sedatives to help you relax. If you are under general anesthesia, then you will sleep through the entire procedure.
The eyelid surgery procedure, which lasts from one to three hours, is commonly performed while the patient is under sedation. However, eyelid surgery may also be performed under local anesthesia. Blepharoplasty is typically done on an outpatient basis. Generally, eyelid surgery patients report little significant pain from the surgery and, while recovery time will vary from individual to individual, most people should be able to return to a normal schedule within a week to ten days.
Following the procedure, the plastic surgeon will lubricate and bandage your eyes. Most of the time people can read and watch TV in just one or two days. Many patients feel comfortable to return to their normal activities and work after about a week.
POSTOPERATIVE EFFECTS ASSOCIATED WITH BLEPHAROPLASTY
Immediately following eyelid surgery, patients often feel tightness around their eyes, which is generally treated with a prescribed oral medication. During the first two days following the Blepharoplasty procedure, the patient will experience differing degrees of swelling and bruising, depending on the type of eyelid surgery performed and the patient’s individual reactions. Also, the patient often experiences temporary ocular discomforts such as itching, burning and general dryness of the eye, a blurring of vision, overactive tearing, and sensitivity to sunlight. Eye drops are recommended by some plastic surgeons to help relieve these symptoms. Dark sunglasses can also be worn for the first few weeks following surgery to help reduce the impact of light and wind on the eye.
Severe complications rarely arise from eyelid surgery. However, infection and bleeding can occur. Some patients experience difficulty pulling down the lower eyelid and sometimes in completely closing the eye. These symptoms are rarely permanent. In some extremely rare cases, bleeding has occurred following eyelid surgery and was not detected and treated immediately, resulting in blindness.
RECOVERING FROM BLEPHAROPLASTY
It is important to realize that recovery time can differ significantly from patient to patient. Hence, the following information consists of a set of estimations.
For the first few days after eyelid surgery it is advisable that the patient sleep in a recliner with his or her head elevated on pillows in order to keep swelling down. Regular application of a cold compress will also help with swelling during this period. The eyelid surgery patient will need to apply an antibiotic to the effected area twice a day for at least four days. Bandages are generally not used, but it is advisable that the patient has gauze handy. Patients may shower and wash their hair as they normally would. However they should try to avoid getting any soap on the incisions. After about three days eyelid surgery patients generally no longer require prescription pain medication.
Stitches are typically removed within a week following the procedure. The patient’s vision can remain a little blurry for a few days after the removal of the stitches. Swelling usually goes down within seven days, though some patients experience some minor swelling for several weeks. Bruising usually vanishes within seven to ten days. People are generally allowed to wear make-up within the first week following the surgery to help hide any discoloration, if they so choose. Scarring usually becomes imperceptible within a few weeks.
In order to minimize the temporary dryness and itching of the eye that often follows blepharoplasty, it is advisable to avoid activities that normally dry the eyes, such as reading, watching television and using a computer, for three to seven days following the surgery. Generally, eyelid surgery patients can go back to work after seven to ten days. Contact lenses can be used again after two or more weeks. Because increased blood flow to the eyes should be avoided for the first three to four weeks, any strenuous activity or exercise should be avoided during this period. Crying and excessive blinking should also be avoided, as these activities lead to an increase in swelling. Because alcohol increases fluid retention it can delay the patient’s recovery time. Hence alcohol is to be avoided for at least three weeks following the procedure. After the removal of the stitches and healing of the incisions, the use of sun block around the eyelid is advisable for six months. Depending on the type of surgery and the recovery time of the patient, the final result will be visible in two to six weeks.
Candidates for blepharoplasty include anyone who has pronounced bags under his or her eyes or droopy eyelids. Usually, people who elect to have the surgery are over the age of 35, but younger people can also have the procedure performed to correct bags under the eyes caused by heredity.
Before having a blepharoplasty procedure performed, your plastic surgeon should be in touch with your ophthalmologist to determine if there are unusual risks for you associated with getting the procedure. Some medical conditions provide additional risks with blepharoplasty procedures. If you have dry eyes, Graves’ disease, hypothyroidism, high blood pressure, or other circulatory conditions, check with your ophthalmologist or doctor before having the procedure.
As with any surgery, it’s important that the patient speak with a reputable cosmetic surgeon to discuss available blepharoplasty options and weigh the costs and benefits of those options in light of the patient’s individual goals, needs, and expectations.