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Eyelid Surgery (Blepharoplasty)

Blepharoplasty is the repair or reconstruction the eyelid, sometimes known as an eye lift.  As part of the natural aging process, the muscles in the eyelid weaken and excess fat may collect. As a result, the skin on the eyelid may begin to droop or sag. Blepharoplasty is a procedure to help eliminate the appearance of drooping of the upper eyelids and/or bags under the lower eyelids.

What are the reasons for blepharoplasty?

Blepharoplasty is often done for both cosmetic and medical reasons. In many cases, the appearance of drooping eyelids can make a person look old or tired. They can also create bags under the eyes and excess skin on the lower eyelids. Blepharoplasty can provide a person with a younger, fresher look around their eyes. Beyond these cosmetic concerns, the sagging skin of the eyelids may obstruct the field of vision of some patients, particularly interfering with peripheral vision. Blepharoplasty can help to improve any vision problems that arise as a result of drooping or sagging eyelids.

How to prepare for blepharoplasty?

In preparation for blepharoplasty, the patient will meet with an ophthalmologist to discuss his or her medical history and expectations of the procedure.  The patient’s eyelids will be physically examined and measured. Patients can expect to have a comprehensive eye exam to test not only their vision, but also their tear production. In addition, patients can anticipate having their eyelids photographed to help the surgeon prepare for the procedure and to ensure that insurance claims of medical reasons for the surgery are validated

Prior to the blepharoplasty procedure, the patient will be advised to:

  • Avoid taking any medication that can increase the risk of bleeding,(e.g. aspirin, blood thinner, ibuprofen, naproxen and certain herbal supplements)
  • Arrange for transportation home from the surgery since, though procedure is performed outpatient,  the patient will not be able to drive immediately afterwards.

What to expect from the procedure?

Blepharoplasty is typically performed in an outpatient setting, making hospital stays unnecessary. Prior to the procedure, the surgeon will administer a numbing medication to the eyelids, as well as an intravenous sedative to help the patient relax. The entire procedure is completed in about 2 hours.

If both eyelids are being operated on, the upper eyelids are surgically corrected first.  The surgeon will make a cut along the fold of the eyelid and remove any excess skin, muscle or fat. Afterwards, the incision is closed with very small stitches. The stitches will remain in place for 3 to 6 days.

The lower eyelid is operated on second and may be corrected in two different ways. In the first method, an incision is made just below the lashes, inside the eye’s natural crease. Similar to the upper eyelid procedure, excess skin, fat and muscle are removed and the incision is closed up.

Another method sometimes used is to make a cut inside the lower eyelid to remove excess fat.  An erbium laser or carbon dioxide laser is then used to soften fine lines in the skin.

What are the risks of blepharoplasty?

Complications from blepharoplasty are rare, but sometimes can occur. If any complication occurs, seek medical attention promptly.

The risks generally associated with blepharoplasty include:

  • Infection
  • Dry or irritated eyes
  • Noticeable scarring
  • Difficulty closing eyes
  • Injury to eye muscles
  • Skin discoloration surrounding the eyelids
  • Temporarily blurred vision

In very rare cases, patients have an adverse reaction to anesthesia, bleed excessively, develop blood clots, cardiac complications or breathing difficulties, or experience a loss of vision. In certain unusual circumstances, follow-up surgery may be required.

What can be expected during recovery from blepharoplasty?

Patients should expect to spend time in recovery prior to being sent home. After surgery, some or all of the following may be expected:

  • Swelling
  • Bruising
  • Blurred or double vision
  • Sensitivity to light
  • Watery eyes
  • Redness and irritation at the site of the incision
  • Puffy eyelids
  • Pain.

As the patient recovers at home after the procedure, the doctor will recommend the following to ensure a smooth recovery:

  • Avoid smoking, strenuous activities, rubbing your eyes, heavy lifting, swimming and straining for a few days after the procedure
  • Refrain from using contact lenses for about 2 weeks after surgery
  • Use proper hygienic measures to clean the eyelids
  • Use prescribed eye drops or ointments to avoid infection
  • Apply cool compresses to help reduce swelling and pain
  • Sleep in an elevated position, head higher than chest, for a few days
  • Wear sunglasses to protect eyelids from sun and wind
  • Avoid the use of any medications that may increase bleeding.

Acetaminophen may be taken to help control pain.

Most people who undergo blepharoplasty find that the results of their surgery last a lifetime. Patients should expect that any scars from the incisions may take up to 6 months to fade. During this time, skin should be protected as much as possible to ensure proper healing.

Insurance typically only covers surgery in which a person’s vision has become impaired. If blepharoplasty is done only for cosmetic reasons, the cost of the procedure most likely will not be covered.

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