What is blepharoplasty?
An outpatient surgical procedure designed to address changes of the upper or lower eyelids due to aging. Some of the most common issues addressed with this procedure include:
- Heavy, tired upper eyelids as a result of too much skin or protruding fat
- Excess skin in the lower eyelid leading to wrinkles, bags, and dark circles
- Malposition and protrusion of fat that can create contour irregularities, a bulge in the lower eyelid, and hollowing just below the eyelid (so-called tear trough deformity)
Who is a candidate?
Patients who are concerned about aging eyelids, with excess skin or protrusion of fat may be candidates for blepharoplasty. It is very important to have a thorough consultation prior to eyelid surgery as there can be many underlying issues that, if unrecognized preoperatively, may result in limited benefit or possible complications. Some examples of such issues include laxity of the lower lid tarsus, upper eyelid blepharoptosis (dysfunction of the upper eyelid elevators), and the presence of eyebrow ptosis. Additionally, there are a variety of different aging changes that can occur, and it is important to select the eyelid treatment that will be best for you.
What does a blepharoplasty procedure involve?
Eyelid surgery can be done with several variations, particularly when pertaining to the lower lid. When addressing the upper eyelid surgery, the surgeon will frequently remove excess skin, and will sometimes conservatively address some excess fat within the upper lid that is causing a tired, heavy look. This is far less common than in lower eyelid surgery. This procedure can easily be done under local anesthesia. The end result is to give the eye a lighter, refreshed appearance, with scars hiding very nicely in the eyelid crease.
Lower eyelid surgery is more variable depending on the patient’s anatomy and concerns. Lower lid blepharoplasty may involve removal of redundant and excessive skin. It may also include manipulation of fat to restore a smooth lower eyelid and improve hollowed, dark circles under the eye. Incisions may be on the inside of the eyelid (transconjunctival) or hidden just underneath the lash line (subciliary). In some cases tightening of a loose lower eyelid may be indicated. This is done to improve the lower lid contour and to protect against unfavorable scarring.
What is recovery like?
Recovery will vary based on the type of procedure performed. Upper eyelid surgery will involve some minor swelling and bruising that largely resolves within the first week. There may be some mild residual swelling that can take longer to resolve, but generally does not preclude returning to work or social events. Lower eyelid surgery is generally associated with slightly increased swelling and bruising particularly if the fat is manipulated. Patients are instructed to ice their eyes to help with this. Sutures are removed 5-6 days after surgery. The procedure is quite well-tolerated and very few patients have issues with controlling pain/discomfort postoperatively.