Blepharoplasty is an eyelid reconstruction or surgery for droopy eyelid by removing excess skin and fat. With aging, the eyelids and eyebrow begin to droop, and the eyelid muscles weaken with or without excess fat accumulates beneath the skin of upper and lower eyelid, causing sagging eyebrows, droopy eyelids, and eye bags.
Besides making you look older, the sagging skin around your eyes may interfere with your peripheral vision. Blepharoplasty can solve the problem and help make your eyes look younger.
You should discuss with your doctor regarding your expectations as well as benefits and risks before deciding to undergo an eyelid surgery.
Why do you need an eyelid surgery?
Eyelid surgery is recommended for patients with sagging eyelids who cannot open their eyes normally or have baggy lower eyelids. Removing excess upper eyelids can improve your vision and make you look younger.
An eyelid surgery is recommended if you have
- sagging or drooping upper eyelids
- excess upper eyelid skin which reduces your peripheral vision
- excess lower eyelid skin
- baggy or puffy lower eyelid
Blepharoplasty can be done at the same time with a brow lift surgery.
Health insurance may provide coverage for surgery to correct vision impairment; however, lower eyelid surgery, considered a cosmetic surgery, is not covered.
Complications
- Infection and bleeding
- Bruise at the surgical site
- Dry and irritated eye
- Unable to close your eye or eyelid problem
- Surgical scar
- Eye muscle injury
- Skin discoloration
- Revise surgery for additional adjustments
- Blurry vision or vision loss which is extremely rare
- Other surgical risks such as allergy to anesthetic agent and blood clots
Before the surgery, talk with your doctor regarding possible risks and complications to help you grasp the fact, weigh the risk and benefits, and make an informed decision about the surgery.
How to prepare yourself
Prior to surgery, patients will have a discussion with their surgeon, ophthalmologist or oculoplastic surgeon regarding:
- Medical history: A surgeon will ask you about your previous surgeries and medical conditions such as allergies, blood circulation problems, dry eyes, diabetes, glaucoma, and thyroid disease as well as your medications, vitamins, herbal supplements, alcohol, tobacco, and substance use.
- Expectations: Discussing your expectations with your surgeon can contribute a satisfactory outcome. Your surgeon can recommend a suitable surgical procedure for you.
Before surgery
- Physical exam: Your doctor will perform a physical exam and check for tear production and measure the size of eyelids.
- Eye exam: Your doctor will examine and measure your eyesight including peripheral vision. This procedure is important for insurance claim.
- Eyelid photography: Taking photo of your eyelids from different angles helps in the planning of the surgery, assessment of postoperative side effects and is mandatory for insurance claim.
Preoperative preparation
- Pause taking anticoagulants, dietary, and herbal supplements. However, consult your personal care doctor if it is safe for you to stop taking these medications and for how long. Take medications allowed by your doctor only.
- Refrain from smoking 2-3 weeks prior to surgery. Smoking delays wound healing.
- Ask your friend or family member to drive you to and from hospital. Have someone who can assist you at home after surgery.
What to expect before actual surgery?
Before surgery
Incision line will be marked before anesthesia is given; local anesthetics with or without intravenous medications will be given to help you relax.
During surgery
- Upper eyelid surgery: excess skin, muscles, and fat will be excised, followed by incision closure.
- Lower eyelid: An incision will be made below eyelash line or inside the lower lid to remove or redistribute excess fat, muscles, or sagging skin, the incision will then be closed.
If the droopy eyelid shade over the pupil, a ptosis correction will be performed on the eyelid and muscles responsible for raising of the upper eyelids.
After surgery
You will be monitored in a recovery room and can return home on the same day.
You may experience the following postoperative conditions:
- Blurry vision due to ointment on your eyelids
- Watery eyes
- Light sensitivity
- Double vision
- Swelling and numbness of eyelids
- Bruises around the eyes
- Pain
Your doctor may advise you to:
- Apply an ice pack or cold compress on eyelids for 10 minutes every hour. Repeat it 4-5 times on the next day to help reduce swelling.
- Gently clean your eyelids and use eyedrops or ointments prescribed by your doctor.
- Avoid strenuous activities, heavy lifting or exercise such as aerobic, running or swimming for at least 1 week.
- Do not smoke.
- Do not rub your eyes.
- Do not use contact lenses for 2 weeks.
- Wear sunglasses to protect your eyelids from wind and sunlight.
- Sleep with your head raised higher than your chest for 2-3 days.
- Keep follow-up appointment for stitches removal.
- Do not take pain relievers or herbal supplements that increase bleeding risk for 1 week.
Seek immediate medical attention if you experience:
- Shortness of breath
- Chest pain
- Irregular heart rhythm
- Severe pain of the operated eye
- Bleeding
- Vision problems
Surgical outcomes
Most patients are satisfied with the surgery. The face no longer looked jaded but is younger and more confident. For some the result is durable. In others the droopy eyelids can recur.
The swelling will decrease within 10-14 days. You can resume your outdoor activities. It takes months for scars to fade. Meanwhile, avoid sun to protect your eyelids.
The swelling and skin bruises will gradually resolve within 10-14 days. You can resume your outdoor activities time by time. Anyway, the surgical wound takes several months to fade away. Meanwhile, avoid sun exposure to protect your eyelids.
