What is blepharoplasty?
Eyelid surgery (also called eye lift surgery), reduces the lower eyelid pocket and removes excess skin from the upper eyelids. In short, it is about modifying the periocular tissues.
This surgery is usually done for aesthetic reasons. It is also an effective way to improve eyesight in older people, whose drooping upper eyelids block the correct path of their vision. And, consequently, it is practiced both for aesthetic and medical reasons.
However, there have also emerged treatments that have come to be called blefaroplasty without surgery that seek to reduce the excess of periocular tissues through non-surgical treatments, but the results can take longer and do not always solve the problem.
A blepharoplasty, on occasions, is accompanied by other measures to remove crow’s feet or other facial wrinkles. For this, it is often done together with other procedures, such as laser, filler injections, brow lifts or a facelift.
The graph below graphically schematizes what the blepharoplasty consists.
How is eyelid surgery performed? | Where is it done?
There are different techniques and different objectives, depending on the patient’s situation. Subciliary blepharoplasty is surgery on the lower eyelid in order to reduce the lower eye bags. In this case, the standard procedure is the one that reflects the previous graphic, and a very extended practice is the transconjunctival blepharoplasty that makes the incision inside the eyelid. The upper blepharoplasty makes the incision in the crease of the eyelid.
Where and who should perform blepharoplasty
A blepharoplasty usually takes about two hours if both upper and lower eyelids are made together. Depending on the scope of the operation your doctor will use local anesthesia (an analgesic injected around the eye), accompanied by sedation or total anesthesia.
It must be done in a hospital or an accredited surgical center. And logically, it must be done by a doctor, although their specialty may be varied. It is performed by ophthalmologists, plastic surgeons and oculoplastic surgeons, who are the ones who specifically dedicate themselves to it.
If the procedure is performed on your four eyelids, the surgeon will probably work on the upper ones first. The surgeon usually cuts following the natural lines of the eyelids. Through these cuts, the surgeon will separate the skin from the underlying tissue and remove excess fat, skin, and muscle. Next, the surgeon will close the cuts with tiny stitches. The stitches on the top covers will remain for three to six days. The lower covers may or may not require stitches, depending on the technique used.
Surgery on the lower eyelids can be done using several techniques. In one method, your surgeon makes a cut inside your lower eyelid to remove the fat. That cut will not be visible. The surgeon can soften the fine lines of the skin using a C02 or erbium laser.
Another method is to make a cut along the margin of the eyelashes. Through that cut, your surgeon can remove excess skin, loose muscle, and fat. The cutting line fades after a short time.
After any of these blepharoplasty procedures, your surgeon usually recommends rejuvenation with some treatment, usually with the laser.
What are the reasons for a blepharoplasty surgery?
Basically, it is the process of aging of the eyelid. As the skin ages, it gradually loses its elasticity. The lack of elasticity plus the constant pull of gravity causes the excessive skin to accumulate in the upper and lower eyelids.
Excess skin on the lower eyelid causes wrinkles and lumps. On the upper eyelids, an extra fold of skin may hang over the eyelashes and limit the vision.
The fat that cushions the eyeball can also cause protuberances in the upper and lower eyelids. The thin membrane that holds the fat in place weakens with age, letting the fat get into the eyelids.
Who undergoes eyelid surgery or blepharoplasty?
Those who undergo blepharoplasty are people who are in good health and who have realistic expectations. The age to perform a blepharoplasty can be varied, although it could be said that most people are over 30 years.
Blepharoplasty or eyelid surgery can improve your appearance and help build your confidence. Before deciding to have surgery, think about your goals and talk to a specialist.
How should I prepare for the eyelid surgery or Blepharoplasty?
You will have to agree with someone of your trust to take you home after the intervention. Usually, it will be some hours in the hospital or the clinic, and it will not require to spend the night entered, except for exceptions.
Wait and plan to stay home and limit your activities for several days after the surgery while your eyelids heal. Some people have dry eyes after surgery but rarely last more than two weeks. If you have dry eyes for more than two weeks, contact your doctor.
At home, after the blepharoplasty you should follow the specialist’s instructions, and you will usually have to have the following items ready:
• Ice pack (or you can use freezer bags filled with ice, frozen corn or peas)
• Small gauze pads
• Eye drops or artificial tears
• Clean towels
• Over-the-counter pain relievers (which your doctor can recommend). Advil, Motrin, Naproxen, Aleve, and Aspirin should not use because of the increased risk of bleeding.
How is recovery after eyelid surgery? – Postoperative
After eyelid surgery, it is common to have swelling and occasionally to bruise, but your eyelids should be healthy within a week or two. You must be very careful not to rub your eyes and stop the process of healing.
What are the possible complications of eyelid surgery?
Complications and unwanted results of an eye lift are rare, but sometimes they occur. They can include:
• Dry eyes
• Abnormal coloration of the eyelids
• Eyelid skin that folds in or out abnormally
• Not being able to close the eyes completely
• A lower line of tabs