Blepharoplasty

The eyelids are made of thin, delicate skin. It's not surprising, therefore, that in addition to wrinkles, the first signs of aging often appear in and around the eyes before other parts of the face. Aging eyelids can have a significant effect on your appearance. Not only do they make you look older, they can also make you look unusually tired, sad, or angry because these emotions are expressed through the eyes.

Cosmetic surgery can counteract these aging changes and restore a refreshed, energetic, youthful look to your eyes and face. The results of eyelid surgery (blepharoplasty) can be life-enhancing, helping you feel more confident about your appearance and portraying emotions more accurately. Sometimes, correction of sagging eyelid skin can improve your ability to see by fully opening your eyes.

According to the American Society of Plastic Surgeons (ASPS), around 350,000 people in the United States alone undergo blepharoplasty eyelid lift each year, many more worldwide. The surgery is done to correct droopy or sagging eyelids and create a vibrant, younger appearance. Continue reading to learn more about blepharoplasty eyelid surgery and how it can correct problems like lower lid eye bags and droopy upper eyelid skin.

What is a blepharoplasty?

With age, the skin around the eyes becomes thinner and stretches. This leads to drooping upper eyelids and puffiness of the lower eyelids. Combined with volume loss and other aging changes, it can make you look sad, tired, and older than you are. Blepharoplasty is a cosmetic surgery performed on the lower and upper lids to correct and reverse some of these changes. The goal of the procedure is to remove excess skin and excess fat and give aging eyes a more refreshed, open, naturally youthful appearance. Surgery on the eyelids can be combined with other procedures such as laser skin resurfacing to reduce wrinkles around the eyes (crow's feet) or other surgeries such as brow lift and facelift. A board certified cosmetic surgeon or plastic surgeon can provide medical advice and tell you about the various options for eyelid lifts.

Why is eyelid surgery done?

According to the Mayo Clinic, blepharoplasty may be recommended for sagging or droopy eyelids that prevent the eyes from opening fully. In such patients, removal of excess tissue during eyelid surgery can help to improve vision. Cosmetic reasons for doing an upper and lower lid blepharoplasty include making the eyes look younger and more alert.

Some of the problems that blepharoplasty surgery can correct include droopy or baggy upper eyelids, excess skin in the upper lids that interferes with vision, excess skin in the lower eyelids, under eye bags, and puffiness of the eyes due to fatty deposits.

Is there a difference between upper eyelid and lower eyelid surgery?

A blepharoplasty is also sometimes called an eyelid lift, although this term is a misnomer because the upper and lower eyelids are not actually lifted during the procedure. Rather, the procedure consists of removing excess skin and adding or removing fat as needed from the lower and upper eyelids.

An upper blepharoplasty procedure involves making incisions and removing sagging skin and excess fat. The incisions are then closed with stitches to bring the skin creases together.

To perform lower eyelid surgery, the surgeon places the incisions either inside the eyelid (this is called a transconjunctival approach) or below the lash line. The former approach leaves no visible scars and is preferred in patients who need removal of excess fat or addition of fat to correct volume loss.

Who is a good candidate for blepharoplasty?

Men and women with aging eyes who are in good general health, are non-smokers, and have a positive outlook and realistic expectations from the procedure are good candidates for eyelid surgery. You may not qualify for this procedure if you have a serious eye condition. Keep in mind that a drooping upper lid can occur due to reasons other than age-related changes. For instance, changes in the eyebrow, forehead skin, or eyelid muscle can cause drooping (ptosis). This problem requires a different surgical approach. A board-certified plastic surgeon can examine your face and suggest the best remedy for your problems.

How do you prepare for eyelid surgery?

Consultation

You will be seen in the office for an eyelid surgery consultation. At this time, your doctor will discuss your aesthetic goals. They will also review your complete health history including medical conditions, previous surgeries, medications, and allergies to ensure you do not have any risk factors for blepharoplasty surgery. At the time of the consultation, your doctor will take photos for before/after eyelid surgery comparison. They will recommend a course of treatment to you, discuss the likely outcomes and potential risks, and talk about the type of anesthesia used for eyelid surgery. You will have a chance to ask questions at this time as well.

Preparation

Your surgeon may order some lab tests as part of your pre-surgical evaluation. They may ask you to take some medicines or stop some of your medicines temporarily. You will need to stop smoking before your blepharoplasty to avoid healing complications. You should arrange for someone to drive you home after your eyelid surgery and stay with you overnight the first day.

What to expect during a blepharoplasty?

Anesthesia

Eyelid surgery can be done under intravenous sedation or general anesthetic. Your doctor will choose the best option for you. You will receive medications to keep you comfortable during the surgical procedure.

Incisions

Blepharoplasty incisions are planned so that the scars are well hidden in the natural skin creases of the eyelid area. For upper eyelid correction, the incision is usually placed within the natural eyelid crease. The surgeon removes or repositions fat, tightens muscle, and removes extra tissue through this incision. For the lower eyelid, the incision can be transconjunctival (inside the lower lid) if no skin is to be removed or just below the lash line if there is a need to remove excess skin and fat. Once the procedure is complete, the surgeon closes the incisions with sutures (stitches) or skin glue. The sutures are removed in office after one week.

Results

Eyelid surgery results appear slowly once the post-surgical bruising and swelling subside. You can expect smoother, more defined eyelids, a brighter, more vibrant eye area, and an alert, rejuvenated, youthful appearance.

How long is the recovery after eyelid surgery?

The upper and lower lids can be swollen and bruised for 1 to 3 weeks after surgery. This will continue to improve gradually over the next 4 to 12 weeks. Most patients feel comfortable going out in public and returning to work about 10 to 14 days after blepharoplasty.

There may be some bruising, swelling, dryness, and irritation during recovery. These symptoms can usually be controlled with lubricating ointment and ice packs or cold compresses. You should follow your doctor's instructions carefully in terms of caring for your eyes during eyelid surgery recovery. Your doctor will tell you the specific signs to look for at the surgical site and contact them. Be sure to keep all your followup appointments.

How long does a blepharoplasty last?

An upper lid surgery can last for around 5-7 years. A lower eyelid procedure is longer lasting and may last for 20 years or more, so it is unlikely you will need a repeat procedure.

What are the risks and complications of eyelid surgery blepharoplasty?

While a blepharoplasty is a generally safe procedure, it is a surgical procedure, and like all surgeries, it carries some risks. Potential complications of eyelid surgery include bleeding, infection, anesthesia risks, dry eyes, difficulty with closing the eyes, numbness or sensation changes, persistent pain, light sensitivity, swelling, bruising, lid lag (temporary pulling down of the lower lid, ectropion (rolling outward of the lower lid), changes in vision (temporary or permanent), unfavorable scarring, and need for revision surgeries. You can reduce your risk of eyelid surgery complications by choosing an experienced surgeon through the MeTime app and having your surgery done at an accredited surgical center or hospital.

What does blepharoplasty eyelid surgery cost? How much is blepharoplasty in UK?

According to the American Society of Plastic Surgeons, the average cost of blepharoplasty is around $4,200. In the UK, blepharoplasty can cost anywhere between £2,000 and £6,000. Insurance coverage for eyelid surgery will depend on whether the procedure is being performed to correct impaired vision. If you are having blepharoplasty for purely cosmetic reasons, like all cosmetic procedures, health insurance will not cover it. While upper lid blepharoplasty may be deemed medically necessary in some patients, lower lid blepharoplasty is almost always performed for cosmetic purposes.

Choosing a cosmetic surgeon

Eyelid surgery is a highly individualized treatment that not only requires in-depth knowledge of facial anatomy but also a keen aesthetic eye and the ability to adjust surgical techniques to the patient's unique facial structure. These skills are essential to create results that are natural and blend with the rest of a person's facial features. That's why it's so important to do your homework and choose the right cosmetic surgeon for your blepharoplasty.

The MeTime app makes it easy to find board certified cosmetic surgeons with extensive training and experience in facial cosmetic surgery. You can chat with experts, look at before/after eyelid surgery photos, send your photos across, set up a video consultation, and book your office appointment when you're ready. Download the MeTime app today and learn more about blepharoplasty eyelid surgery.