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Blepharoplasty (Eyelid Lift)

Blepharoplasty is surgical modification of the eyelid. Thanks to aging and at times genetics, patients can develop excess wrinkles and puffiness or "bags", which contribute to a tired look as well as a potential decrease in range of vision. Blepharoplasty is performed for either functional or for cosmetic reasons, ultimately reducing puffiness of the eyelids as well as removing excess skin and wrinkles. An excess of skin and fat causes the wrinkles and puffiness, which can be corrected by either removing the fat or repositioning the fat.  In order to bring about the most pleasing look about the eyes, the muscles and tendons surrounding the eyelid may need to be reinforced during the procedure.

Blepharoplasty is sometimes needed for functional reasons. When an excess amount of upper eyelid skin is present, the skin may protrude over the eyelashes and cause a loss of peripheral vision. The outer, upper parts of the visual field are most commonly affected and may cause difficulty with activities such as driving or reading. Blepharoplasty may be combined with an eyebrow lift to correct drooping eyebrows. Results are best appreciated by comparing before and after photos of surgical patients.

Asian blepharoplasty or "double eyelid surgery" 

This is a special type of blepharoplasty procedure that creates a crease on the upper eyelid, known as the "supratarsal fold". This fold is common on the eyelids of many races but is often absent on the eyelids of Asians. Surgery can artificially create this crease and make a 'single-lidded' patient appear 'double-lidded'. It is the most popular form of cosmetic surgery amongst patients of an Asian descent.

Patients, often younger patients, whose only complaint is the presence of excess fat under the lower eyelid may be able to undergo their blepharoplasty procedures using incisions made on the inside surface of the lower eyelid, allowing the surgeon to remove excess fat of the lower eyelid without having to create an external, visible scar. Blepharoplasty procedures utilizing this type of incision is known as "transconjunctival blepharoplasty". It should be known, however, that transconjunctival blepharoplasty does not allow for the removal of excess skin.

External skin resurfacing can also be performed during a blepharoplasty with a chemical peel or a fractionated carbon dioxide laser.

Procedure Description

  • Blepharoplasty can be performed under local anesthesia and sedation
  • External incisions are made along natural lines in the skin: along the creases of the upper eyelids and along the underside of the lower eyelids' lash line
  • Excess skin and fat under the eyelid muscle are removed
  • If there is significant skin laxity of the lower eyelid, a tightening procedure known as "canthopexy" may be done at the same time
  • Laser surgery can also be used to soften fine lines around the eyes
  • Incisions are closed carefully to prevent scarring
  • The procedure typically takes between one to three hours to complete

Recovery

  • Initial swelling and bruising usually resolves in one to two weeks but patients should take note that it will take several months until final results become stable
  • Patients will receive antibiotics and painkillers to ease any pain caused by incisions
  • Patients are instructed to apply ice pads on the eyes to decrease swelling and bruising
  • Patients are recommended to keep their heads higher than their bodies to decrease the amount of swelling; patients are instructed to place several pillows under their heads while lying down in order to do so
  • Patients are instructed to lubricate their eyes at night and to use artificial tears frequently during the day to prevent dry eyes.
  • Sutures are usually removed seven days after the surgery.
  • During the first few weeks after surgery, patients may experience excessive tearing, light sensitivity, and double/blurred vision. The whites of the patient's eyes may appear red. These symptoms usually disappear by themselves within two or three weeks after the operation.
  • Wearing contact lenses is prohibited until the incisions are completely cured. The doctor will advise patients who need to wear their contacts when it is safe to wear their contact lenses.
  • Patients should avoid bending at the waist for about five days after their surgeries. Strenuous exercise, lifting, and any activity that raises blood pressure should be held off until at least 2-3 weeks after the surgery.
  • Eye makeup may be used once the sutures have been removed and the incision has fully healed. It is advised that patients use new products in order to prevent the development of bacterial growth that can stem from old, used makeup.

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