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What is Blepharoplasty

Eyelid surgery, known medically as blepharoplasty, is one of the most common cosmetic surgery procedures, with about 100,000 men and women undergoing the procedure in the United States every year. Surgeons perform eyelid surgery to correct droopy, hooded upper eyelids and puffy lower lids that make the face look tired and older. In some people, the upper eyelids sag so much that they impair vision. (In this case, eyelid surgery may be covered by health insurance because it is not performed only to improve appearance.)
In blepharoplasty, the surgeon removes excess fat, skin, and muscle from the upper or lower lids, or both. Eyelid surgery does not remove dark circles from under the eyes, erase fine lines such as crow’s feet, or lift sagging eyebrows. Sometimes doctors combine eyelid surgery with a forehead lift or a facelift to achieve better results.
People who should have a thorough medical evaluation before having eyelid surgery include those who have glaucoma, a detached retina, a thyroid problem such as hyperthyroidism, high blood pressure, diabetes, or heart disease.

Blepharoplasty Risks

  • Anesthesia risks
  • Swelling and bruising
  • Bleeding from the incision lines
  • Dryness to the eyes
  • Sensitivity to sun or other bright light
  • Difficulty closing your eyes
  • Ectropion, an outward rolling of the lower eyelid
  • Infection
  • Lid lag, a pulling down of the lower eyelid, may occur and is often temporary
  • Temporary or even permanent change in vision, and very rare chance of blindness
  • Changes in skin sensation or numbness of the eyelashes
  • Pain, which may persist
  • Possible need for revision surgery
  • Unfavorable scarring
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Blepharoplasty

The Procedure

Eyelid surgery is usually done on an outpatient basis using either a local anesthetic with sedation or general anesthesia. The surgery can take from 1 to 3 hours, depending on whether both the upper and lower lids are modified.

During surgery on the upper eyelids, the surgeon marks the natural creases and folds of the eyelids so he or she can make the incisions along those lines, hiding the scars in the folds. He or she makes the incisions and removes or repositions the surplus fat, muscle, and skin. When working on the lower eyelids the surgeon makes an incision either along the eyelash line or inside the lower lid, which leaves no visible scar, and trims away the excess fat, muscle, and skin. He or she then uses fine absorbable stitches (which do not have to be removed) to sew the incisions closed. Scarring from the incision will be hidden in the natural folds of the lids.

After Blepharoplasty Surgery

If you have had eyelid surgery, you can expect to have bruising and swelling, especially at the corners of your eyes, for about 2 or 3 weeks. A feeling of tightness in the eyelids is normal, and some people feel as if their eyelids are so tight, they cannot close their eyes, but this feeling usually goes away in a few weeks. You will probably have some pain or discomfort. Your eyes may feel dry and may burn and itch for a few weeks, and you may have double vision or blurred vision during the recovery period. You may also have increased tearing and sensitivity to light and wind. In very rare cases, the lower eyelid can pull down and turn outward, requiring further surgery or longer recovery time to correct. The main risk after eyelid surgery is infection. Your doctor may prescribe an eye ointment to relieve drying, and pain medication to minimize your discomfort.

To immediately relieve some of the swelling, gently apply cold, wet cloths to your eyes. Keep your head elevated at all times—even while sleeping. Carefully clean your eyes every day as your doctor recommends to get rid of any sticky residue and to prevent infection. Don’t wear contact lenses for at least 2 weeks after surgery or until your doctor says it is OK to do so. You probably can begin to read or watch TV 2 or 3 days after your surgery and you will probably be able to return to work within a week. But avoid strenuous activity, such as jogging, until 1 or 2 weeks after the procedure.

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