The eyes are one of the first areas of the face that demonstrates aging. It is therefore not a surprise that one of the most common facial surgeries is blepharoplasty, or cosmetic eyelid surgery. This procedure improves the droopy, tired appearance of the upper eyelid by removing the excess skin and fat. Eyelid drooping is caused by the weakening of the eyelid muscles and loss of skin elasticity due to natural aging processes. The puffiness of the lower eyelids is caused by the shifting of the fat from under the eyelid forward. The lower eyelid surgery removes and repositions the fat and removes some of the eyelid skin to improve the appearance.
It is important to have realistic expectations about eyelid surgery. This procedure is useful in the treatment of:
- Sagging eyelid skin, including skin of the upper eyelid that has created folds that are obscuring vision
- Lower eyelids that have drooped, possibly even to the point of exposing too much cornea below the iris of the eye
- Puffy appearance due to fat deposits on the eyelids
Other conditions may be better suited to other treatments. If the sagging appearance extends to the eyebrows, I often offer a brow lift to elevate the brow. Eyelid surgery cannot treat wrinkles around the eyes; for wrinkles, an injectable like Botox or Dysport may be a more effective treatment.
Candidates For An Eyelid Surgery
Candidates for this procedure, as with any surgery, should be in otherwise good health. If you have any eye problems, such as glaucoma or dry eye, it is especially important that these be disclosed before undergoing any eyelid surgery.
Prior to your surgery, you will have a consultation with your blepharoplasty surgeon, at which point you will discuss the treatment itself, preparation, local or general anesthesia, and any testing you will need. You may be given preparation instructions such as not eating for a period of time before the surgery. As always, it is important to follow all instructions.
During Eyelid Surgery
During surgery, an incision is made, and the excess skin or fat is removed. The opening is then closed up with very small stitches. I make the incision just in the crease for the upper eyelid and just below the lashes for the lower eyelids. They are placed in the areas because the goal is to disguise the scar within the folds of the eye. When possible, the incision may be made inside the lower eyelid so nothing will be visible on the outside after the surgery.
As with any surgery, some recovery is involved. You should arrange for a ride home from your appointment, and you should refrain from driving until you are told it is safe and your vision, which may be blurred, has returned to normal. This normally takes about twenty-four hours. Cold compresses are used to minimize swelling and bruising. I prescribe pain medication, although most patients do not use it, as the recovery is not painful. It is important to follow all of your physician’s instructions for home care. At day five, the small stitches are removed. Most patients return to work on day seven. Make up can be worn on day seven as well. Recovery times will vary among individuals, but as the swelling subsides and incisions heal, your new younger appearance will be revealed.