Of all the features on our faces, our eyes are the most prominent indicators of our mood, energy level, and youth. Sagging, drooping, or tired-looking eyes can make us look older than we really feel. Eyelid surgery, or blepharoplasty, is a plastic surgical procedure designed to improve the message our eyes send to those around us.
Patients who would benefit from a blepharoplasty include those who experience:
- Excessive, sagging, or wrinkled upper or lower eyelid skin.
- Excess upper eyelid skin that interferes with vision.
- Loss of your natural upper eyelid crease
- If you have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance.
- Orbital Rim Show: visibility of the bone under the eye sometimes contributing to a dark ring or shadowing.
Normally, everyone has a small amount of fat around the eyes. If the quantity of fat increases or the local tissues stretch and weaken, the fat begins to bulge producing “bags.” Occasionally this bulging is seen in young patients and is an inherited family trait, and not a result of aging. These changes have a profound effect on one’s appearance giving a tired or haggard appearance. An attractive face with these early signs of aging can affect a patient’s self-image, attitude and sense of well-being.
A blepharoplasty is a procedure designed to improve the appearance of the eyelid area. This may involve removing excess skin and if needed tightening the surrounding muscle resulting in a more youthful, refreshed appearance. This procedure can treat both the upper and lower eyelids depending on the unique needs of the patient.
The incision in the upper lid usually lies in the lid crease. The incision in the lower lid lies just below the eyelashes and parallel to the lid edge. Both incisions may extend for a short distance beyond the eyelids, toward the temple. In certain cases if any excess fat pads are the problem (e.g. younger patients), lower lid incisions may be made inside the lid (transconjunctival incision). In many cases a small triangle of muscle is removed in the upper eyelid by the outside corner of the lid to help elevate the brow called the “California Lid Lift.” This is useful when only to remove excess fat and eliminate external skin incisions. Excellent healing is characteristic of eyelid skin, and once the wounds are mature they usually become quite inconspicuous. The outer part of the incision – the part extending toward the temple – is the slowest to mature, and is sometimes noticeably pink for some months after the operation. The stitches used are dissolvable so removal is not necessary.
The operation is usually done in our office or in an outpatient surgical facility. A friend or relative should be available to take you home and stay with you for at least 24 hours after surgery.
Local anesthesia with oral sedation, intravenous sedation, or general anesthesia may be used depending on the patients’ health or personal preference.