Blepharoplasty, or eyelid surgery, is categorized into distinct cosmetic procedures or surgery procedures depending on the upper or lower eyelids. Both upper eyelid surgery and lower eyelid surgery can be performed together or separately.
Upper blepharoplasty is performed to remove excess upper eyelid skin, which can cause eyelid drooping and a tired appearance. Occasionally, sagging skin can cause so much visual impairment that it can become a medical necessity to have the procedure performed. In other cases, eyelid surgery is performed to add aesthetically-pleasing features, such as the upper eyelid crease in Asian blepharoplasty.
Lower blepharoplasty is performed to address a diverse set of conditions affecting the lower eyelid complex. Sagging skin, excess skin, excess fat, wrinkles, tear troughs, droopy eyelids, bulging, and hollowing can be often be addressed with surgery.
Technique
Upper blepharoplasty involves removing excess skin from the upper eyelid. The amount of skin to be removed is determined prior to surgery. Occasionally, fat is removed from behind the upper eyelid, especially when bulging can be seen. Care is taken to not remove too much, however, because removing too much fat can create a “hollowed-out” appearance.
Lower blepharoplasty is slightly more involved than upper blepharoplasty. In addition to removing extra skin, fat is lifted up from the cheeks and repositioned to smooth out the hollows and deep lines below the lower eyelid. Because healing in the lower eyelids can be more complicated than in the upper eyelids, additional precautions are taken to ensure the eyelids heal correctly. Additional sutures are placed under the skin, near the corners of the eyes, to support the tissue as it heals. As a result, the skin and eyes may appear to be bunched up after surgery. With time, the sutures dissolve and the bunching goes away as the scar tissue softens.
What to Expect After Surgery
Swelling and bruising may occur, sometimes severe enough to cause vision impairment. This will resolve with time, and supplements such as Arnica can be taken to help resolve bruising. Although the same procedure is performed on both sides, healing times between sides may vary, giving the appearance of asymmetry. With time, however, the symmetry returns as the healing process nears completion.
Similar to other surgical procedures, patients may want to avoid social situations for several weeks after surgery, until the swelling and bruising subsides. While most patients feel comfortable resuming normal social activities after 3-6 weeks, they may wait up to 3 months before attending certain events, such as weddings.
Eye irritation can occur after surgery. It is important to notify your plastic surgeon before surgery of any previous eye conditions or eye surgery, since dry eyes or eye irritation could potentially worsen with surgery.
Scarring is not typically a concern after eyelid surgery because the thin is very thin and heals well. Occasionally, skin can become trapped at the sites of the suture, creating whiteheads. This is one of the most common side effects from surgery, and typically resolves on its own or can be removed in clinic.