Eyelid Surgery (Blepharoplasty)

Blepharoplasty, or eyelid surgery, is the third most popular cosmetic procedure (after liposuction and breast augmentation). It is usually performed to reduce the signs of aging, but increasing numbers of younger people, especially Asians, are now opting to create a crease in the upper eyelid, or “double eyelid” with the procedure.

During typical eyelid surgery, fat is removed from the upper and lower eyelids. Excess skin and muscle may also be removed as well. This procedure can correct drooping eyelids and puffy bags below the eyes, giving them a less tired, more youthful appearance.

How Eyelid Surgery is Performed

Incisions are made following the natural lines of the eyelids – in the creases of the upper eyelids, and just below the lashes in the lower lids. Through these incisions the surgeon separates the skin from fatty tissue and muscle, removes the excess fat, and in some cases, trims the skin and muscle as well. Very fine sutures are used to close the incisions.

Transconjunctival Blepharoplasty

If eyelid surgery is being performed to remove only fat from the lower eyelid, the surgeon may make an incision inside the lower eyelid instead of below the lashes. Dissolvable sutures are then used to close the incision. After the procedure, there is no visible scar. Patients undergoing this procedure are usually younger, with thicker and more elastic skin.

Double Eyelid Surgery

In Asian or other patients whose upper eyelids are taut from brow to lashes, a crease may be created. The surgeon excises a crescent shaped piece of skin out of the eyelid, removes some of the underlying fat, and then stitches the two sides together. The height and curvature of the crease may be maniuplated through different surgical methods.

Double eyelid surgery creates a “double eyelid” fold, uncovering more of the eyes and making them appear slightly larger and rounder. After surgery the eyelashes become more exposed, and the reduction in upper eyelid fat makes it easier to apply eyeliner.

Risks of Blepharoplasty

Certain medical conditions make blepharoplasty more risky and must be considered by the surgeon before a decision is made. These include:

• Thyroid problems
• Dry eye
• Detached retina
• Glaucoma
• High blood pressure
• Cardiovascular disease
• Diabetes

In all patients, as with any surgical procedure, eyelid surgery carries some risks. Complications are usually minor and infrequent, but may include:

• Infection
• Reaction to anesthesia
• Double or blurred vision for several days after surgery
• Asymmetrical healing or scarring

What to Expect During Eyelid Surgery

• The procedure usually lasts 1 – 3 hours
• Local anesthesia is used to numb the area around the eyes
• Oral or intravenous sedatives are usually given, and the patient remains awake during surgery. Occasionally general anesthesia is used instead, and the patient sleeps through the procedure.

Recovery After Eyelid Surgery

• The eyes may feel sore and tight. Lubricating ointment and a bandage may be applied.
• Bruising may last from 2 weeks to a month. Cold compresses may be recommended to reduce swelling and bruising.
• Pain and discomfort is usually mild; patients may take non-aspirin analgesics.
• Activity should be kept to a minimum for 3 – 5 days, and strenuous activity, especially anything causing blood pressure to increase, should be avoided for 3 weeks.
• Eyedrops may alleviate dryness, burning, and itching.
• During recovery, patients may also experience excessive tearing, sensitivity to light, and temporary changes in sight such as blurring or double vision.
• Patients should not wear makeup for at least 10 days (to prevent allergic reaction).
• Stitches may be removed 2 – 7 days after surgery.
• Patients can usually read and watch television after 2 –3 days.
• Patients may resume wearing contact lenses as early as 2 weeks, although they may be uncomfortable for longer than that.
• Most patients go out/ resume work in about 10 days.

Appearance after Eyelid Surgery

Scars may remain slightly pink for six months. In time, however, they fade to a very thin, virtually invisible white line. The more youthful, alert appearance achieved by the procedure lasts for years, if not permanently.

More information on Asian Blepharoplasty