Eyelid surgery to remove or reposition redundant tissues in the upper or lower eyelid is referred to as “blepharoplasty”. Upper eyelid blepharoplasty involves removal of skin, muscle, and/or fat and is one of the most common cosmetic surgical procedures performed in the United States. Functional upper eyelid blepharoplasty is performed to help restore the superior field of vision that is impaired by the redundant upper eyelid tissues. Lower eyelid blepharoplasty is nearly always considered cosmetic and emphasizes removal and/or repositioning of the lower eyelid fat (“fat bags”). Blepharoplasty Surgery is different than ptosis surgery which is performed to raise or elevate a droopy eyelid.
A blepharoplasty is performed in an outpatient setting under sedation. Patients are not put under general anesthesia but are monitored by anesthesia personnel and have a IV placed. Pain is controlled with local anesthetic as well as IV pain medication if required. A small incision is made in the crease of the upper eyelid (or just below the lash line in the case of a lower lid blepharoplasty) and excess skin is removed. The incisions are closed with suture and/or surgical glue, and the patient is discharged shortly after completion of the procedure.
Most patients will feel well enough to be on their feet the afternoon of the surgery. Ice packs are recommended for the first 48 hours following the procedure to reduce swelling. Bruising can range from severe to very mild depending on the patient’s natural tendency to bruise. Antibiotic ointment is to be applied three times per day for one week to prevent infection of surgical sites. Most patients will experience transient dry eye as more of the eye is now exposed to the air, and the blink rate is temporarily decreased. This is generally managed with artificial tears and is usually temporary. Patients can often drive the next day after surgery and can return to work within 3-7 days depending on the type of work they do (no heavy lifting for one week).
“Functional” blepharoplasty is performed when the eyelid skin has become droopy enough to impair a patient’s vision. This type of surgery is frequently covered by insurance, and results are excellent in restoring the top portion of the visual field.
“Cosmetic” blepharoplasty is performed when a patient has no impairment of vision but is unhappy with the appearance of excess eyelid skin/fat/lines. This is not covered by insurance, but can frequently restore a younger, more rested facial appearance.