Cosmetic Eyelid Surgery

Cosmetic eyelid surgery, or blepharoplasty, can remove unwanted fat and wrinkled skin of the upper eyelids, as well as the bagginess and redundant skin of the lower eyelids. This can result in a change from a constantly tired or sad look to a more cheerful, brighter, and youthful appearance.

The best candidates for surgery are healthy men or women with realistic expectations. The majority of patients are over 40 years old, but others have inherited traits that lead to treatment at a younger age. Medical conditions such as hypothyroidism, Grave's disease, high blood pressure, cardiovascular disease, and diabetes place the patient at higher risk and may prevent surgery. Other eye conditions such as dry eyes, glaucoma, or detached retina may require ophthalmology evaluation prior to consideration for surgery.

Most insurance plans do not cover eyelid surgery, unless a significant visual impairment is present as a result of the problem.

Complications can occur following eyelid surgery. Dry eyes, temporary double or blurred vision, asymmetrical scarring or swelling, difficulty closing the eyelids while sleeping, infection, and anesthesia reactions may occur. Ectropion, or pulling down of the lower lid, may also occur. This is usually temporary, but occasionally becomes a permanent problem requiring additional surgery. Carefully following your surgeon's directions before and after surgery reduces the risks of these complications.

Eyelid surgery can be done in a surgeon's office-based facility, an outpatient surgery center, or a hospital, depending on the patient's medical condition and the surgeon's recommendations. The surgery is usually done as an outpatient. Local anesthesia and sedation are usually used, but some surgeons prefer general anesthesia.

The operation takes from one to three hours. Surgery can be done on all four eyelids on the same day. Incisions are made along the natural creases of the upper lids, and usually just below the eyelashes along the lower lids. Excess fat, muscle, and skin are then removed. The incisions are then closed with small sutures. If the lower lids have redundant fat but thicker more elastic skin, a "transconjunctival" blepharoplasty can be done through an incision on the inner part of the lower eyelid.

After surgery, head elevation and cold compresses help minimize swelling and bruising. Patients may be given eyedrops and antibiotic ointment to use during the first week. Sutures are removed during the first week following surgery. Light sensitivity, tearing, and blurred or double vision are common during the first few weeks. Bruising may take three weeks to resolve.

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