What is Blepharoplasty surgery?
A blepharoplasty is a surgical rejuvenating procedure that may be performed on the upper and/or lower eyelids.
An upper blepharoplasty may include excision of drooping eyelid skin, repair of the muscle that opens the eyes, and removal of excess fat.
A lower blepharoplasty corrects undereye bags with repositioning and possible removal of redundant fat and skin. It also treats sagging lower lids that may reveal excess white space beneath your iris (the colored circular portion of your eyes surrounding your black pupil).
Upper Lid Blepharoplasty
As you age, the decreased production and organization of collagen and elastin may result in redundant or sagging eyelid skin. This is referred to as Eyelid Ptosis. When the descent of your skin becomes clinically apparent, it is referred to as Ptosis. Sometimes, the fibers that connect the muscles that open the eye become detached, or dehisced, as you age and causes your upper eyelid to droop. This is called blepharoptosis and can be repaired by your plastic surgeon with or without an upper blepharoplasty procedure. Fat may also herniate into the thin upper eyelid tissue as we age due to weakening connective fibers, and this may result in puffy and droopy eyelids.
Eyelid ptosis may also be caused by brow ptosis. This would require a brow lift for correction. The cause(s) of the eyelid ptosis is important for your plastic surgeon to identify for appropriate surgical planning. Your plastic surgeon will also perform testing to assess for the presence of dry eyes. If present, your surgeon will have to modify the surgical procedure and prepare you for appropriate postoperative planning.
The degree of upper eyelid drooping may be severe enough to obstruct a portion of your visual field. This becomes an issue that is medically necessary to treat. You may qualify for insurance coverage if this is the case.
Lower Lid Blepharoplasty
Similar to the upper lids, the lower lids are also subject to the effects of aging. As we age the skin in this area tends to become thinner, connective and soft tissues under the eye descends and bulges into unsightly bags. Fluid may also collect in these areas, worsening the appearance of the under eye bags.
Am I a good candidate for Blepharoplasty surgery?
- Droopy eyelids due to aging or muscle dehiscence that make you appear tired
- Droopy eyelids that obstruct your visual field
- You are unsatisfied with your eyelid shape
- Your eyelids appear puffy and/or you have prominent bags under your eyes
Your plastic surgeon will make an incision along your new eyelid crease. Excess skin and herniated fat may be removed or repositioned. The incision is closed and typically heals with a cosmetically acceptable scar hidden within your eyelid crease.
There are several different approaches to the lower blepharoplasty. Your surgeon may opt to create an incision immediately along your lower lash line, or perform an incision along the pink mucosa, also known as the conjunctiva of your lower lid. Fat is repositioned with or without conservative resection of fat.
Depending on the laxity or droopiness of the lower lid, your surgeon may perform an additional procedure on the outer corner or lateral canthus of the eye. The additional procedures include a canthopexy or canthoplasty. A canthopexy, where the Greek suffix “pexy” means to bind, or surgical fixation, is a procedure that anchors the outer corner of your eye to the underlying structure to prevent additional sagging. A canthoplasty, where “plasty” means to mold, or reshaping through surgery, is typically a bit more involved and entails more rigorous dissection and reattachment.
- Most patients experience minimal pain after surgery.
- Ice compress for 72 hrs immediately after surgery, followed by warm compress
- If non-dissolvable sutures are used, they will be removed 5-7 days after surgery.
- Bruising usually resolves at about 2 weeks.
- You may return to work (desk job) after 1 week. If you would like to conceal the degree of swelling, you may benefit from wearing thick framed glasses.
- You may drive 1-2 weeks after surgery.
- You may gradually resume physical activity 2-4 weeks after surgery.
Possible Risks with Blepharoplasty Surgery
- Temporary vision problems - double or blurred vision may occur after undergoing eyelid surgery. This typically lasts for just a few days following the surgery.
- Eye closure problems - some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent.
- Swelling or asymmetry changes - temporary swelling and a slight imbalance of one eye in relation to the other may occur during the healing or scarring process.
- Acne - after the stitches are removed, tiny whiteheads may appear. The surgeon can remove the whiteheads with a very fine needle.
- Ectropion - this extremely rare complication is the pulling down of the lower lids. Further surgery may be required in order to correct this symptom.