Eyelid Surgery

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What is Blepharoplasty?

Eyelid 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.

The Best Candidates for Eyelid Surgery

You may be a good candidate for eyelid surgery if you have any of the following conditions:

Upper Eyelids

  • Excess skin that hides the natural fold of the upper eyelids
  • Loose skin that hangs down from the upper eyelids
  • Puffiness in the upper eyelids that creates a tired look

Lower Eyelids

  • Excess skin and fine wrinkles of the lower eyelids
  • Puffy “bags”
  • Dark circles in some cases

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 age. 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

When eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complication, including infection or a reaction to the anesthesia. You can reduce your risk by closely following your surgeon’s instructions both before and after surgery. The 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.

Following 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. 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.

The Surgery

Blepharoplasty 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.

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