Eyelid surgery, medically referred to asblepharoplasty, is designed to remove fat and/or excess skin from the eyelids. It can be performed on the upper or lower eyelids, or both. This procedure can help you look younger, more refreshed and more alert.
Blepharoplasty is one of the most frequently performed cosmetic surgery procedures today. In 2007, according to the American Society of Plastic Surgeons, over 241,000 eyelid surgery procedures were in performed in the United States alone.
Types of Eyelid procedures
There are various methods used to enhance eyelid appearance. The following information will give you a basic understanding of each. It is important to note that each of these procedures carries its own set of risks and benefits.
Upper Eyelid Surgery
Upper eyelid surgery can improve two common problem areas: 1.) excess skin on the upper eyelid itself, often called “hooding of the upper lid, and 2.) puffiness in the inner corner and middle of the upper eyelid caused by herniation (pushing forward) of fat. The hooding of the upper eyelid can obstruct your vision, so its removal could actually improve the quality of your peripheral vision. Puffiness in the upper eyelid can cause patients to look old and tired; and upper eyelid surgery can create a more alert and younger appearance. Upper eyelid surgery can enhance the shape, position, and depth of the eyelid crease.
Lower eyelid surgery
Lower eyelid surgery is performed to remove the puffiness found in the lower eyelid. Some people refer to this as “bags” under the eyes. The accumulation of excess fat and skin, resulting from age and other factors, causes that puffy appearance in the lower eyelid, which makes people look older and tired. Removal of bulging fat in the lower eyelid can result in a younger, rested and alert appearance.
We perform different types of eyelid procedures depending upon the age of the patient and whether the problem is wrinkles, loose skin, excess fat or poor elasticity. The least invasive type of lower eyelid surgery is o use a laser to resurface the lower (and upper) eyelids. The laser tightens the skin and eliminates fine lines and small wrinkles. This is best performed on younger patients but works well after traditional eyelid surgery when the surgery eliminated excess skin but did not correct the fine lines. Laser resurfacing of the lower lids is often combined with Transconjunctival Blepharoplasty in which a tiny incision is made inside the lower eyelid and fat is removed with tiny forceps. No skin is removed and no sutures are needed.
For patients with a little more skin excess we perform a “pinch” blepharoplasty in which a sliver of skin is removed from the lower eyelid. This is usually performed with laser resurfacing but may also be combined with transconjunctival blepharoplasty.
More significant laxity will require a more traditional blepharoplasty as described below.
Asian Eyelid Surgery
Asian eyes have a different appearance than Western eyes. With Asian eyelids, the anatomical difference is that the orbital septum (the layer that holds back the fat) extends lower down towards the eyelid margin. The cosmetic procedure is also known as double eyelid operation and Asian blepharoplasty. The procedure is similar, but not identical to, traditional eyelid surgery. The goal is to enhance the patient’s eyelid appearance without taking away the natural beauty of their ethnic features.
What are the benefits to this procedure?
There are many reasons why a person would want to undergo eyelid surgery. Even though reasons vary from person to person, the more common include:
- Improving peripheral vision
- Gaining a fresher, more alert appearance
- Restoring a youthful eyelid appearance
- Enhancing overall appearance
- Gaining a boost in self-confidence
If you’re experiencing droopy upper eyelids or bags under the eyes, and are otherwise healthy, an eyelid lift may be appropriate for you. If the brow has also descended, your surgeon may recommend a brow lift as well, to create the most attractive result.
How the procedure is performed
Eyelid procedures are performed under local anesthesia, IV sedation or general anesthesia in our Boca Raton accredited in-office surgery suite on an outpatient basis. The choice of anesthesia will depend upon the type of procedure chosen and your comfort. Some patients prefer general anesthesia, while others wish to be awake but numb to the actual procedure. This will be discussed in detail at your consultation.
In upper eyelid surgery, an incision is created that follows the natural lines of the eyelids. Working through the incisions, we remove a crescent of excess skin and muscle, and any fat. The incision is closed with fine sutures, which will leave nearly invisible scars.
During lower eyelid surgery, the incisions are also made following the natural lines of the eyelids, just below the lashes in the lower lids. The fatty deposits are then typically repositioned (to prevent a hollow look) or removed from the inside of the lid. In some cases, excess skin is removed with an incision placed under the lashes to avoid making a conspicuous scar. As with the upper lids, fine stitches are used to close the incision. Lubrication with ointment is applied at the completion of both upper and lower eyelid surgery.
For patients who have less laxity or have had previous lower eyelid surgery, we may choose to use a laser (as described above) to resurface the skin to eliminate fine lines and tighten the lid skin. We have a variety of lasers that we currently use, some with downtime of 1 week or so and others with little to no downtime.
During your consultation we will also discuss the bony anatomy of your eyes and orbits. For some patients with significant upper cheek hollowing we may recommend an orbital rim implant (see section) to recontour the orbit.
What to expect during recovery
The recovery period for eyelid surgery is approximately one to two weeks. In that time, patients must follow our post-operative instructions to promote better healing, reduce chances of complications, and to add more comfort during recovery. Eye drops may be recommended because the eyelids might be dry, and eyes may burn or itch. Also, patients who wear contact lenses must avoid wearing them during the recovery period. Because the eyes will temporarily be sensitive to sunlight, wind, and other irritants, wearing sunglasses and sunblock is highly recommended. Patients will also be instructed on how to clean their eyes while recovering.
Upper and lower eyelids are each performed differently and each displays a different result. Scars will still be visible six or more months after surgery in a slightly pink form, and then eventually fade to thin, nearly invisible lines. After undergoing eyelid surgery, your appearance is enhanced, because the upper eyelids are no longer drooping and the skin under the eyes is smooth and firm. The results can last for many years, and in many cases, are permanent.