What Is Blepharoplasty?
Blepharoplasty, also known as eyelid surgery, is a plastic surgery procedure for correcting sagging or drooping eyelids. The eyelid droops because the skin is much thinner than the skin in other parts of the face. The Eyelids are often one of the first facial areas to exhibit signs of aging.
Risk Factors Of Droopy Eyelids
Eyelid surgery may become necessary when various factors, which include aging, smoking, sun damage, and obesity, cause the muscles and tissue that support the eyelids to weaken.
What Issues Can Blepharoplasty Correct?
A blepharoplasty is ideal for correction of the following:
- Loose, sagging and/or folded upper eyelids that may interfere with vision
- Puffy fat deposits in the eyelids
- Undereye bags
- Sagging lower eyelids that may show the whites of the eyes below the irises
- Excess skin in the lower eyelids
- Fine wrinkles in the lower eyelids
A blepharoplasty cannot raise the eyebrows, or treat deep wrinkles, dark circles under the eyes, or crow’s feet.
Candidates For Eyelid Surgery
The best candidates for blepharoplasty are patients that are in good overall health, does not smoke, does not have serious eye conditions, and has healthy facial tissue and muscle.
A person with eye disease, diabetes, thyroid disorder, cardiovascular disease or high blood pressure may not be a good candidate for a blepharoplasty.
Reasons for Eyelid Surgery
Eyelids that droop or sag can affect peripheral vision making daily activities such as driving difficult. Blepharoplasty will tighten the eyelid’s muscles and tissue and removes excess fat and skin.
Types of Blepharoplasty
Functional blepharoplasty will eliminate the drooping of skin into the visual field, improving peripheral vision. Cosmetic blepharoplasty is performed for strictly cosmetic reasons.
If the eyelids begin sagging into the field of vision, a functional blepharoplasty may be required. The procedure may be covered by medical insurance if it is deemed medically necessary. A determination of how much vision is affected is done by checking the peripheral visual field with an instrument called the Humphrey Visual Field (HVF) Analyzer.
Blepharoplasty can be performed on either the upper or lower eyelid, or on both, for cosmetic purposes. For a lower eyelid that needs fat rather than skin removed, a transconjunctival blepharoplasty is performed. During transconjunctival blepharoplasty, an incision is made inside the lower eyelid, so there are no visible scars, and the fat is removed. This procedure has no effect on vision, but results in a person’s looking younger and more refreshed.
It is important for a patient to have realistic expectations before undergoing cosmetic blepharoplasty. Although the procedure can enhance the appearance and improve self-confidence, it does not radically alter the face.
Blepharoplasty is typically performed as an outpatient procedure requiring local anesthesia and sedation. General anesthesia may be used for anxious patients. Patients can choose to have this procedure on their upper or lower eyelids or both. The procedure can take anywhere from 45 minutes to 2 hours, depending on whether both the upper and lower eyelids are operated on.
If the upper eyelid is being operated on, an incision is typically made along its natural crease. Once the incision is made, fat deposits are repositioned or removed, muscles and tissue are tightened, and excess skin is removed. For the lower eyelid, an incision is usually made just below the lash line so that excess skin can be removed.
After the procedure, the incisions are closed with sutures, tissue glue or surgical tape, and usually loosely covered with gauze so the area can heal.
Results Of Eyelid Surgery
The swelling and bruising around the surgical site will subside on its own, and the eyelids will improve in appearance for up to a year. The scars will be well-concealed and usually fade with time until they are virtually undetectable. Although the eyelids are still subject to aging, blepharoplasty produces long-lasting results.
After the blepharoplasty procedure, patients may be advised to apply lubricating drops/ointment and cold compresses to aid in healing and minimize the side effects. Most patients return to work within a few days to a week after surgery. Patients should avoid exercise and strenuous activities for at least 2 weeks. The stitches are usually removed after 3 or 4 days. The swelling and other side effects typically subside within 2 weeks. Patients may not wear contact lenses and eye makeup for 2 weeks after surgery. Patients are typically advised to wear dark sunglasses outside or in bright light for 2 weeks to protect their eyes from sun and wind.
Side Effects Of Blepharoplasty Surgery
Uncommon side effects include infection, reaction to anesthesia, and double or blurred vision. Eyes may be irritated and dry due to a temporary change in tear distribution. Side effects such as uneven healing and permanent scarring are rare but, if they occur, may require surgical correction.
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