The skin around our eyes is particularly delicate and prone to the signs of aging. Bags under the eyes or sagging upper eyelids are common problems that can make us look older than we actually are. Eyelid surgery is a popular cosmetic procedure that restores a more alert and rested appearance. We can address upper eyelids that are puffy with fatty deposits or droopy because of sagging skin.
There are several options of the procedure available. Eyelid surgery can be done on the upper or lower eyelids or both. The choice depends on the age of the patient, the amount of fat in the upper and lower eyelids, and the general elasticity and tone of the lower eyelid.
Many of our patients are surprised to find the major difference they can achieve with this relatively simple procedure that requires little downtime. Patients often report that their friends say they look great and “well-rested” afterward — without knowing why.
The eyelid procedure is routinely performed on patients from their late adolescence through later years. Younger patients who request this operation often have inherited fat pockets which may appear as dark circles underneath the eyelids. The nature of each procedure varies widely depending on the age and needs of the individual patient.
Final results from the procedure could take 6-12 months, but patients will notice a more rejuvenated appearance in just a few weeks following their procedure. Eyelid surgery provides long-lasting results and leaves patients looking years younger.
The classic incision for upper blepharoplasty is hidden within the folds of the eyelids. Excess skin and fat are removed, and the incision is closed. For lower blepharoplasty, the incision is made just under the eyelash margin or inside the lower eyelid. In either case, the scars are well-hidden. An external pinch technique can be used to reduce excess skin, and bags can be removed to create an overall smoother, tighter lower eyelid area. A technique called lateral canthoplasty can be done to improve eyelid support laxity.
After a preparation period, blepharoplasty is almost always performed under intravenous sedation anesthesia, supplemented with local anesthesia. Of course, as in all of our surgeries, the patient is continuously monitored by a board certified anesthesiologist. The patient is drowsy, pain-free, and unaware of the procedure that is being performed. The operation may take anywhere from 30 minutes to one hour. This depends on whether a four lid blepharoplasty is performed, or if just the lower eyelids or upper eyelids are done. The patient is then transferred to the recovery room, and will be discharged from our clinic approximately one hour after surgery.
Although the recuperation process following eyelid surgery is different for everyone, most patients’ experiences follow a similar timeline. During the first few days after surgery, your eyelids will likely be quite swollen. You’ll also see some bruising. It’s a good idea to use this time to rest at home, taking care to avoid activities that could impact the healing process, such as too much exercise or unprotected sun exposure. Applying icepacks and keeping your head elevated as much as possible reduces discomfort. If you wear contact lenses, be prepared to switch to glasses for at least a couple of weeks while your eyelids heal.
Although blepharoplasty is a quick and safe procedure, bruising and swelling will still be present after surgery for 5-7 days. During this time, a cold compress and lubricating ointments should be applied to the eyelids.
Swelling usually lasts up to three weeks, and the final eyelid result is obtained several months later. Scars are placed in inconspicuous areas that are most difficult to see on the upper lid. On the lower eyelid, if a transconjunctival blepharoplasty is not performed, the scar is placed right below the eyelashes, which is most difficult to see. On younger patients when a transconjunctival approach is used, incision is inside the eyelid, without any visible scar.