Eye Lift: Blepharoplasty (Eyelid Surgery)

The eyes are often one of the first areas of the face to show signs of aging. Excess skin, drooping, and under-eye fat pockets can cause a person to look sad, tired, angry, and older than they are. Eyelid surgery, or blepharoplasty, can remove excess skin from the upper eyelids and reduce bagginess from the lower eyelids, a procedure known as an eye lift.

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At Cincinnati Eye Institute, we are proud to feature a team of expert oculoplastic surgeons who are specially trained to perform cosmetic eye procedures on the fragile, delicate tissues of the ocular area. We can help you achieve comprehensive rejuvenation of the eye area with eyelid surgery (blepharoplasty) alone or in combination with another procedure such as a brow lift.

Benefits of Eyelid Surgery

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.

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
  • Under-eye 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 eyelids1

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Cosmetic Eyelid Surgery

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.

Upper Eyelid Blepharoplasty

Upper eyelid surgery can address:

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.

Lower Eyelid Blepharoplasty

Lower eyelid surgery can address:

The incision for lower eyelid blepharoplasty is made just below the lash line so that excess skin can be removed.

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.

Eyelid Surgery with Brow Lift

For more complete rejuvenation of the eye area, many patients might consider combining blepharoplasty with a brow lift (browplasty), sometimes referred to as a forehead lift.

In many cases, a droopy upper eyelid can only be partially rectified by a blepharoplasty procedure. During a brow lift, the position of the brow and upper lid are raised and additional excess skin is removed from the upper lid. Not only does raising the position of the brows and lids help to create a more youthful and refreshed appearance, but it can also make a person appear more alert, positive, and more expressive overall.2

Functional Eyelid Surgery

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.3

Eyelid Surgery Recovery

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. 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.

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.

happy middle age man

Although the eyelids are still subject to aging, blepharoplasty produces long-lasting results.

Side Effects of Eyelid Surgery

Side effects of eyelid surgery are rare, especially when the procedure is performed by an experienced oculoplastic surgeon (an eye surgeon who specializes in cosmetic procedures).

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.

Who is a Candidate 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.

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.

FAQS

Does this treat under eye circles?

Lower eyelid blepharoplasty can remove fatty deposits that cause under-eye puffiness and bags. While this procedure can also tighten the skin under the eyes, it does not treat dark circles that appear below the eyes.

Will my insurance cover?

If you are considering blepharoplasty, it is possible that the procedure will be covered by your insurance. When blepharoplasty is performed for functional reasons (if droopy skin impedes vision), insurance may cover all or part of the cost.

Why should I choose an oculoplastic surgeon for this procedure?

Unlike a plastic surgeon, who is trained to perform cosmetic procedures on all parts of the body, an oculoplastic surgeon is an eye surgeon who undergoes additional specialized training to perform aesthetic procedures on the delicate tissues of the ocular (eye) region. Not only does an oculoplastic surgeon possess the fine touch needed to manipulate the fragile skin in this area, but he or she is also highly skilled in avoiding complications that may affect the outcome of the procedure or even impact the patient’s eye health.

Interested in Eyelid Surgery or Rejuvenation?

If you are troubled by the appearance of saggy, droopy, or tired-looking eyelids, you might be an ideal candidate for blepharoplasty or eyelid surgery combined with a brow lift. During your consultation with a CEI oculoplastic surgeon, you will be fully educated about all options available to you. You and your doctor will then work together to arrive at the eye rejuvenation treatment plan that will help you achieve your goals. For more information on eyelid surgery and rejuvenation in the Northern Kentucky and Cincinnati areas, please contact CEI to schedule your personal consultation.

1 Mayo Clinic. Blepharoplasty. Available at: https://www.mayoclinic.org/tests-procedures/blepharoplasty/about/pac-20385174. Accessed November 17, 2020.
2 McCord, Clinton D. M.D.; Doxanas, Marcos T. M.D. Browplasty and Browpexy, Plastic and Reconstructive Surgery: August 1990 – Volume 86 – Issue 2 – p 248-254. Available: https://journals.lww.com/plasreconsurg/Abstract/1990/08000/Browplasty_and_Browpexy__An_Adjunct_to.7.aspx. Accessed November 17, 2020.
3 American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). White Paper on Functional Blepharoplasty. Available: https://www.asoprs.org/assets/docs/1%20-%20FINAL%20ASOPRS%20White%20Paper%20January%202015.pdf. Accessed November 17, 2020.

The doctors at Cincinnati Eye Institute have either authored or reviewed the content on this site.

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