If you're considering eyelid surgery...
surgery (technically called blepharoplasty) is a procedure to remove
fat--usually along with excess skin and muscle from the upper and lower
eyelids. Eyelid surgery can correct drooping upper lids and puffy bags
below your eyes - features that make you look older and more tired than
you feel, and may even interfere with your vision. However, it won't
remove crow's feet or other wrinkles, eliminate dark circles under your
eyes, or lift sagging eyebrows. While it can add an upper eyelid crease
to Asian eyes, it will not erase evidence of your ethnic or racial
heritage. Blepharoplasty can be done alone, or in conjunction with
other facial surgery procedures such as a facelift or browlift.
you're considering eyelid surgery, this information will give you a
basic understanding of the procedure-when it can help, how it's
performed, and what results you can expect. It can't answer all of your
questions, since a lot depends on the individual patient and the
surgeon. Please ask your surgeon about anything you don't understand.
THE BEST CANDIDATES FOR EYELID SURGERY
can enhance your appearance and your self-confidence, but it won't
necessarily change your looks to match your ideal, or cause other
people to treat you differently. Before you decide to have surgery,
think carefully about your expectations and discuss them with your
The best candidates for eyelid surgery are men and women
who are physically healthy, psychologically stable, and realistic in
their expectations. Most are 35 or older, but if droopy, baggy eyelids
run in your family, you may decide to have eyelid surgery at a younger
A few medical conditions make blepharoplasty more risky.
They include thyroid problems such as hypothyroidism and Graves'
disease, dry eye or lack of sufficient tears, high blood pressure or
other circulatory disorders, cardiovascular disease, and diabetes. A
detached retina or glaucoma is also reason for caution; check with your
ophthalmologist before you have surgery.
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
eyelid surgery is performed by a qualified plastic surgeon,
complications are infrequent and usually minor. Nevertheless, there is
always a possibility of complications, including infection or a
reaction to the anesthesia. You can reduce your risks by closely
following your surgeon's instructions both before and after surgery.
minor complications that occasionally follow blepharoplasty include
double or blurred vision for a few days; temporary swelling at the
corner of the eyelids; and a slight asymmetry in healing or scarring.
Tiny whiteheads may appear after your stitches are taken out; your
surgeon can remove them easily with a very fine needle.
surgery, some patients may have difficulty closing their eyes when they
sleep; in rare cases this condition may be permanent. Another very rare
complication is ectropion, a pulling down of the lower lids. In this
case, further surgery may be required.
PLANNING YOUR SURGERY
initial consultation with your surgeon is very important. The surgeon
will need your complete medical history, so check your own records
ahead of time and be ready to provide this information. Be sure to
inform your surgeon if you have any allergies; if you're taking any
vitamins, medications (prescription or over-the-counter), or other
drugs; and if you smoke.
In this consultation, your surgeon or a
nurse will test your vision and assess your tear production. You should
also provide any relevant information from your ophthalmologist or the
record of your most recent eye exam. If you wear glasses or contact
lenses, be sure to bring them along.
You and your surgeon should
carefully discuss your goals and expectations for this surgery. You'll
need to discuss whether to do all four eyelids or just the upper or
lower ones, whether skin as well as fat will be removed, and whether
any additional procedures are appropriate.
Your surgeon will
explain the techniques and anesthesia he or she will use, the type of
facility where the surgery will be performed, and the risks and costs
involved. (Note: Most insurance policies don't cover eyelid surgery,
unless you can prove that drooping upper lids interfere with your
vision. Check with your insurer.)
Don't hesitate to ask your
doctor any questions you may have, especially those regarding your
expectations and concerns about the results.
PREPARING FOR YOUR SURGERY
surgeon will give you specific instructions on how to prepare for
surgery, including guidelines on eating and drinking, smoking, and
taking or avoiding certain vitamins and medications. Carefully
following these instructions will help your surgery go more smoothly.
you're making preparations, be sure to arrange for someone to drive you
home after your surgery, and to help you out for a few days if needed.
WHERE YOUR SURGERY WILL BE PERFORMED
surgery may be performed in a surgeon's office-based facility, an
outpatient surgery center, or a hospital. It's usually done on an
outpatient basis; rarely does it require an inpatient stay.
TYPES OF ANESTHESIA
surgery is usually performed under local anesthesia--which numbs the
area around your eyes--along with oral or intravenous sedatives. You'll
be awake during the surgery, but relaxed and insensitive to pain.
(However, you may feel some tugging or occasional discomfort.) Some
surgeons prefer to use general anesthesia; in that case, you'll sleep
through the operation.
usually takes one to three hours, depending on the extent of the
surgery. If you're having all four eyelids done, the surgeon will
probably work on the upper lids first, then the lower ones.
typical procedure, the surgeon makes incisions following the natural
lines of your eyelids; in the creases of your upper lids, and just
below the lashes in the lower lids. The incisions may extend into the
crow's feet or laugh lines at the outer corners of your eyes. Working
through these incisions, the surgeon separates the skin from underlying
fatty tissue and muscle, removes excess fat, and often trims sagging
skin and muscle. The incisions are then closed with very fine sutures.
you have a pocket of fat beneath your lower eyelids but don't need to
have any skin removed, your surgeon may perform a transconjunctival
blepharoplasty. In this procedure the incision is made inside your
lower eyelid, leaving no visible scar. It is usually performed on
younger patients with thicker, more elastic skin.
AFTER YOUR SURGERY
surgery, the surgeon will probably lubricate your eyes with ointment
and may apply a bandage. Your eyelids may feel tight and sore as the
anesthesia wears off, but you can control any discomfort with the pain
medication prescribed by your surgeon. If you feel any severe pain,
call your surgeon immediately.
Your surgeon will instruct you to
keep your head elevated for several days, and to use cold compresses to
reduce swelling and bruising. (Bruising varies from person to
person: it reaches its peak during the first week, and generally lasts
anywhere from two weeks to a month.) You'll be shown how to clean your
eyes, which may be gummy for a week or so. Many doctors recommend
eyedrops, since your eyelids may feel dry at first and your eyes may
burn or itch. For the first few weeks you may also experience excessive
tearing, sensitivity to light, and temporary changes in your eyesight,
such as blurring or double vision.
Your surgeon will follow your
progress very closely for the first week or two. The stitches will be
removed two days to a week after surgery. Once they're out, the
swelling and discoloration around your eyes will gradually subside, and
you'll start to look and feel much better.
GETTING BACK TO NORMAL
should be able to read or watch television after two or three days.
However, you won't be able to wear contact lenses for about two weeks,
and even then they may feel uncomfortable for a while.
people feel ready to go out in public (and back to work) in a week to
10 days. By then, depending on your rate of healing and your doctor's
instructions, you'll probably be able to wear makeup to hide the
bruising that remains. You may be sensitive to sunlight, wind, and
other irritants for several weeks, so you should wear sunglasses and a
special sunblock made for eyelids when you go out.
will probably tell you to keep your activities to a minimum for three
to five days, and to avoid more strenuous activities for about three
weeks. It's especially important to avoid activities that raise your
blood pressure, including bending, lifting, and rigorous sports. You
may also be told to avoid alcohol, since it causes fluid retention.
YOUR NEW LOOK
is a gradual process, and your scars may remain slightly pink for six
months or more after surgery. Eventually, though, they'll fade to a
thin, nearly invisible white line.
On the other hand, the
positive results of your eyelid surgery-the more alert and youthful
look-will last for years. For many people, these results are permanent.