Eyelid Surgery (Blepharoplasty)
Eyelid Surgery Quick Facts
- Best Candidates: People who are seeking to eliminate sagging skin and puffiness from the upper and lower eyelids
- Procedure Length: 1 to 3 hours
- Inpatient/Outpatient: Usually Outpatient
- Anesthesia: Local with sedation or general
- Results: Long-lasting
- Procedures in 2020: 325,112 (source: American Society of Plastic Surgeons)
The effects of aging or an inherited condition can cause the upper eyelids to droop and bags, or puffiness, to appear beneath the eyes. Eyelid surgery (also called blepharoplasty) eliminates excess skin from the upper eyelids and reduces bagginess below the eyes to restore a brighter, more youthful look. The majority of eyelid surgery patients successfully achieve an improved appearance and an increase in self-confidence.
The procedure information contained in this article will give you a good introduction to eyelid surgery. Schedule a consultation with a Top Plastic Surgeon to receive a medical examination and discuss your eyelid surgery options.
Eyelid Surgery Overview
Aging can take its toll on the face by causing the skin to stretch, muscles to weaken and pockets of fat to accumulate. These changes become evident around the eyes when the upper eyelids begin to droop and puffiness, or bags, appear under the eyes. Heredity, damage from the sun and other factors can also play a role in developing this condition. Drooping, sagging skin around the eyes can make people look old or tired, and can even interfere with vision.
Eyelid surgery (blepharoplasty) is a surgical procedure that corrects drooping upper eyelids and smoothes the skin beneath the eyes by removing fatty deposits, usually along with excess skin and muscle. Hundreds of thousands of people each year undergo eyelid surgery to lessen the appearance of aging and achieve a more alert and youthful look. Eyelid surgery can be performed alone or in combination with other facial procedures, including a facelift, forehead lift or laser skin resurfacing, to rejuvenate the appearance of the entire face.
How Eyelid Surgery is Performed
The incisions for eyelid surgery are made along the natural skin creases of the upper and/or lower eyelids. The plastic surgeon then separates the skin from the underlying fat and muscle and removes the excess fat, skin and muscle before closing the incisions with fine sutures. People who have pockets of fat under the lower eyelids without the presence of loose skin may be candidates for transconjunctival blepharoplasty, which removes excess fat and muscle to reduce puffiness below the eyes without removing or tightening the skin.
Eyelid surgery usually takes 1 to 3 hours to complete, depending on the specifics of the surgery. The procedure may take place in your plastic surgeon's surgical facility, an outpatient surgery center or a hospital. Blepharoplasty is usually performed as an outpatient procedure, allowing the patient to return to the comfort of home on the same day as the surgery.
Eyelid surgery is usually performed using local anesthesia with sedation, which numbs the area of surgery and is combined with a sedative to render drowsiness. If your surgeon prefers to use general anesthesia, you will sleep throughout the procedure.
The best candidates for eyelid surgery (blepharoplasty) are people who are in good health and want to rejuvenate the appearance of their face by removing sagging skin from the upper eyelids and/or removing bagginess from beneath the eyes.
In general, the best candidates for eyelid surgery:
- Are in good general health.
- Are well-informed about treatment options and have realistic expectations.
- Are men and women age 35 or older who feel that eliminating excess fat, skin and muscle around the eyes caused by aging would improve their appearance.
- Are people of any age who want to revise an inherited condition such as bags under the eyes caused by fatty deposits.
Most eyelid surgeries are performed on people at least 35 years old to counter unwanted changes caused by age. Younger men and women with firm, elastic skin may be good candidates for transconjunctival blepharoplasty, which removes excess fat from beneath the eyes without removing any skin.
If you believe that you may be a good candidate for eyelid surgery, a qualified plastic surgeon can evaluate your condition, explain anything about the procedure you don't understand, answer all of your questions and help you decide if the procedure is right for you.
Eyelid Surgery Risks
Complications are rare and usually minor when eyelid surgery is performed by a qualified plastic surgeon. However, all surgeries carry risks. To minimize your risk, carefully follow all of your surgeon's instructions both before and after the procedure. Contact your surgeon's office immediately if you experience any symptoms you believe may indicate a complication.
The most common risks associated with eyelid surgery (blepharoplasty) include:
- Difficulty closing the eyes (usually temporary)
- Ectropion, or a pulling down of the lower eyelids
- Formation of whiteheads, or milia, when the stitches are taken out — can be easily removed by your surgeon with a fine needle
- Pain, swelling or bruising beyond normal levels
- Excessive bleeding
- Adverse reaction to anesthesia
- Impaired eyelid functions (rare)
- Dissatisfaction with results
The incisions and resulting scars from eyelid surgery are usually well-hidden in natural skin creases, resulting in scars that are almost invisible. Transconjunctival blepharoplasty, a procedure that removes fat from beneath the eyes, does not leave a visible scar. Scars may remain pink for 6 months or so before fading to thin, inconspicuous white lines.
Eyelid Surgery Costs
According to the American Society of Plastic Surgeons, the national average surgeon/physician fee for eyelid surgery in 2013 was $2,818. This figure does not include other costs, such as a facilities charge or anesthesia. Your plastic surgeon will provide you with complete information on costs and financing options at your consultation. The total fee for nose surgery can vary considerably depending on the region of the country, the extent of the procedure and the patient's specific needs.
Health insurance will usually not cover the cost of cosmetic eyelid surgery. However, blepharoplasty may be covered if your surgeon or ophthalmologist determines that drooping upper eyelids are obstructing your vision. Check with your insurance company to find out if eyelid surgery is covered and to determine the eligibility requirements.
Eyelid Surgery Consultation
If you decide that you might benefit from eyelid surgery, the first step is to locate a qualified plastic surgeon and schedule a consultation. At the consultation, the doctor will perform a physical examination to check the extent of fatty deposits and the condition of the skin. He or she may also evaluate your vision and tear production.
You will be asked to discuss your complete medical history, including existing health conditions, medications (prescription and non-prescription) and vitamins. Be sure to tell the surgeon if you have any allergies, if you smoke or if you have any thyroid problems (such as hypothyroidism, inadequate tear production or eye dryness), high blood pressure or other circulatory disorders, cardiovascular disease, diabetes, eye problems (such as a detached retina or glaucoma) or any other medical conditions.
The surgeon should carefully listen to your goals for eyelid surgery, fully answer all of your questions and explain the different options that are available. He or she should give you the full details of the recommended procedure, including the benefits, risks, costs and recovery time. Be sure to ask for before and after photos of the surgeon's recent blepharoplasty patients.
As the consultation concludes, you may wish to schedule your procedure, take some time to think or seek a second opinion. If you decide to proceed with the procedure, your plastic surgeon will provide you with specific instructions on how to prepare for eyelid surgery. These instructions will include guidelines for eating, drinking, and medications and vitamins to take or avoid before and after surgery.
Eyelid Surgery Recovery
After eyelid surgery, most patients experience some minor discomfort along with temporary swelling, bruising and numbness. Any pain should subside quickly and be easily controlled with medication. Swelling and bruising usually peaks a few days after the procedure and disappears after a week or so.
Eyedrops may be used to help relieve any dryness, burning or itching that occurs. You may also experience excessive tearing, sensitivity to light or blurred vision, which is common because of the ointment used to protect and lubricate the eyes after surgery. You will probably not be able to wear contact lenses for about 2 weeks, and they may feel uncomfortable for a while longer. Sunglasses should be worn to protect the eyes from sun and wind.
For the first few days after your eyelid surgery, take it easy, get plenty of rest and follow all of your post-operative instructions. Your plastic surgeon will ask you to keep your head elevated for a few days and apply cold compresses to reduce swelling and bruising. Stitches are usually removed within a week.
Always follow your plastic surgeon's advice on when you can resume your normal activities. Most patients are up and around almost immediately after surgery and can return to work in a week to 10 days. Strenuous activity or any activity that can increase your blood pressure should be limited for about 3 weeks.