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(BLEPHAROPLASTY)

Age, sun damage and fat deposits can cause the skin around our eyes to look saggy and puffy. The effect can make you look older and more tired than you feel, and may even interfere with your vision. Eyelid surgery (Blepharoplasty) can correct droopy upper lids and puffy bags under your eyes by removing fat deposits and excess skin and muscle from the upper and lower eyelids. However, it won't remove crow's feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. Eyelids surgery will give you a more alert and youthful appearance that will last for years.

The Surgery

The surgery may take place in a surgeon's office, an outpatient surgery facility, or a hospital. It's usually done on an outpatient basis. Eyelid surgery takes between 1-2 hours and is performed under local anesthesia with an I.V. sedative, but general anesthesia can be used. The surgeon starts by making incisions in the crease of the upper eyelid and behind or beneath the lashes of the lower eyelid. Excess fat and skin are removed and, if necessary, the muscles around the eye are repositioned. This procedure is frequently done at the same time as other procedures, such as a facelift or forehead lift, and can be combined with laser or chemical resurfacing to smooth skin wrinkles.

The Recovery

Swelling usually occurs the first 48 hours after surgery and can last up to 14 days. Some patients will experience discoloration around their eyes for several months. The eyelids may feel tight and sore. The head should be kept elevated for the first few days and cold compresses can be used to reduce swelling and bruising. Stitches will be removed two days to one week after the surgery and patients should be able to return to daily activities after ten days. More strenuous activities should be avoided for about three weeks.

The Best Candidates for Eyelid Surgery

The best candidates for eyelid surgery are men and women who are in good health, and have realistic expectations. Most eyelid surgery patients are 35 or older, but the surgery can be performed at a younger age for someone with unusually droopy or baggy eyelids.

The Risks

Significant complications from aesthetic eyelid surgery are infrequent. As with any surgical procedure, however, there is always a possibility of infection, or reaction to the anesthesia. Other potential complications include: bleeding behind the eye, temporary tearing, decreased sensation, blurred vision, dry eyes and scarring Another very rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.

Background

Aesthetic (cosmetic) eyelid surgery, also called blepharoplasty, removes the excess fat and wrinkled, drooping skin of the upper eyelids that can result in tired or sad looking face. It also eliminates bags under the eyes and tightens the lower eyelid skin. Aesthetic eyelid surgery is performed to correct problems that are the results of aging as well as inherited traits that cause patients to seek treatment as early as their 20s or 30s.

Technique

The particular technique the plastic surgeon recommends will depend on many factors, such as the amount of excess fat and skin in the eyelid areas, the position of the eyebrows, and the condition of the muscle around the eyelids. For upper eyelid surgery, generally an incision is hidden in the natural fold of the upper eyelid and extends slightly beyond the outer corner into the laugh lines or other existing creases. Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it will be well camouflaged when healed. For lower eyelid surgery, often an incision is hidden just beneath the lower lashes. Through this incision, excess skin, muscle and fat are removed, or fat may be redistributed to eliminate puffiness and bulges. Other adjustments to correct special problems such as muscle laxity may be performed. As in upper eyelid surgery, the incision is well camouflaged by natural creases. In some cases, the best approach for removing excess fat is through an incision placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin.

Benefits

• Brighter, more alert and rested appearance.
• Incisions will fade over a number of months until they become barely visible.
• Significant complications from aesthetic eyelid surgery are infrequent.
• Usually performed on an outpatient basis. There is little discomfort, and patient will be able to resume most normal activities within 10 days.
• High level of patient satisfaction.

Other Considerations

• Every surgical procedure carries some risk. Potential complications include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia.
• Bruising, mild swelling, blurriness and "tight" sensation around the eyes are common, short-lived symptoms following surgery.
• Following surgery, there can be a feeling of dryness or irritation in the eye that requires treatment.
• Possibility of temporary decrease in sensation of the eyelid skin or impaired eyelid function sometimes requires additional surgery.
• High blood pressure, thyroid problems, diabetes, allergies or conditions like "dry eye" may increase the risks associated with eyelid surgery.