As people age, the skin loses some of its elasticity and tightness, leading to sagging, lines, and wrinkles. This can be a problem when the skin is in the brows and eyelids.
Sagging skin over the eyes can narrow the eyes and make the person look tired and weary when they feel fine.
Blepharoplasty, also known as an eyelid lift, is a surgical procedure that removes excess skin, fat, and muscle that can make you look tired and older. After the procedure, the upper eyelids are wider, making the eyes look larger and more alert.
If you have a lower eyelid lift, too, bags below the eyes, and excess skin, these can also be removed. A systematic review published in PubMed found that upper blepharoplasty consistently yields a range of functional benefits, in addition to its cosmetic benefits. Examples include an enlarged visual field, fewer tension headaches, and improved vision-related quality of life.
People thinking about blepharoplasty should consider all of the information below, then talk to their plastic surgeon about the procedure.
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Why do people have Blepharoplasty?
Patients often consider an eyelid lift because of sagging and drooping eyelids, preventing the eyes from completely opening. Removing extra tissue from the eyelids can enhance your vision and make you look younger.
This procedure could be a good option for you if you have these issues:
- Droopy or baggy upper eyelids
- Extra skin on the upper lids makes it hard to see
- Excess skin and bags on the lower lids
If you have blepharoplasty, remember that it is a major surgery that requires a week or two of downtime. It isn’t as invasive as a facelift or tummy tuck, but you’ll need to take it easy for a while.
Most people recover from the procedure quickly and can return to work after about a week. According to the American Society of Plastic Surgeons (ASPS), blepharoplasty is among the most commonly performed cosmetic surgical procedures. It has a well-established safety profile and a high patient satisfaction rate when performed by a board-certified plastic surgeon.
Blepharoplasty procedure
You will probably have the eyelid lift done outpatient, which means a family member or friend can drive you home the same day. The surgeon will put numbing cream on the eyelids and medication to relax you and eliminate pain.
Most surgeons do the upper lids first if you have blepharoplasty on the upper and lower lids. They cut along the eyelid fold and remove the extra tissue to widen the eyes slightly, then close the incision.
On your lower lids, they make their incision under the eyelashes or inside the lid, depending on the situation. First, the extra fat and other tissue are removed, and then the incision is closed.
After the eyelid lift, you will be taken to the recovery area for an hour or two. There, they will watch you for complications, and you can leave as soon as they are sure all is well.
Most patients have some or all of these temporary symptoms after blepharoplasty:
- Watering eyes
- Double vision
- Numb and puffy eyelids
- Bruising and swelling around the eyes
- Mild pain
- Tightness around the eyes that fades after a week or two
A prospective study of 348 blepharoplasty patients published in PMC/PubMed found significant improvements across multiple patient-reported outcome domains following the procedure.
One of the most common questions we get is whether blepharoplasty is a ‘big’ surgery. The honest answer is that it sits in the middle, more involved than an injectable treatment but far less so than a facelift. Most of our patients are back to their normal routine within a week to ten days, and the improvement in how rested and alert they look is genuinely meaningful.
– Dr. Lahar
Preparing for Blepharoplasty
Before you set up your surgery, you need to consult with your surgeon. They will take your medical history and do a physical examination to ensure you are healthy enough for surgery.
Your surgeon will ask in particular about your medical conditions that can affect the procedure, such as dry eyes, diabetes, allergies, glaucoma, and thyroid issues. They will also ask about all medications and supplements you take.
Next, your surgeon will examine your eyes and test how good your vision is to determine if your peripheral vision is affected by sagging skin. If so, your insurance may cover the procedure.
The Mayo Clinic notes that insurers typically require documented evidence of visual field impairment from dermatochalasis before authorizing coverage. This is why preoperative vision testing and photography are an important part of the workup.
Also, the surgeon and staff will take images of your eyes from several angles. These help to plan the surgery for success. Also, the photos are necessary if you make an insurance claim.
If you smoke, you need to stop several weeks before and after the eyelid lift; smoking and tobacco use affect the healing process.
Recovering from Blepharoplasty
Most patients fully recover from this procedure after two or three weeks. Some tips to speed up your recovery include:
- Use cold packs on the eyes for 10 minutes every 60 minutes the night after the procedure. On the first full day, use the ice packs four or five times to reduce swelling.
- Clean your eyelids carefully every day and use any ointment or eye drops your surgeon prescribed.
- Don’t do heavy lifting, straining, or swimming for a week
- Don’t rub your eyes. It can help to wear a mask over your eyes while you sleep, so you don’t rub them.
- Don’t wear contact lenses for about two weeks if you have contact lenses.
- Use dark sunglasses if you need to be in the sun or wind.
- Put your head higher on a few pillows when you rest or sleep.
- Don’t use Advil, Motrin, aspirin, Aleve, or other medications that can increase bleeding. You should avoid these medications for at least a week. Use Tylenol if you have pain.
The following side effects are rare, but go to the hospital right away if you have:
- Bleeding from your incisions
- Vision issues
- Erratic heartbeat
- Chest pain
- Shortness of breath
- Severe eye pain
Blepharoplasty is a safe and effective procedure to remove sagging tissue from above the eyes. A lower eyelid lift can make all the difference if you have bags and loose skin under the eyes.
Talk to your plastic surgeon about blepharoplasty to find out if it can improve your eyelid symptoms.
Request a Blepharoplasty consultation
Thinking about blepharoplasty in Beverly Hills? Dr. Nicholas Lahar is pleased to provide plastic surgery procedures to his Beverly Hills patients. He will discuss your aesthetic goals during your consultation and help you decide if you are a good candidate for blepharoplasty.
References
- American Society of Plastic Surgeons (ASPS). Eyelid Surgery.
- Mayo Clinic. Blepharoplasty: About.
- Hollander MHJ, et al. Functional Outcomes of Upper Eyelid Blepharoplasty: A Systematic Review. PubMed. 2019.
- Domela Nieuwenhuis I, et al. Comprehensive Evaluation of Quality of Life Following Upper Eyelid Blepharoplasty: A Prospective Analysis. PMC/PubMed. 2024.