What is Blepharoplasty?
Blepharolplasty is cosmetic eyelid surgery in which excess skin, fat, and muscle from around the eyes are removed to correct droopy eyelids and bagginess under the eyes. The goal of the surgery is to create a more rested appearance and the illusion of larger, more alert eyes. Sometimes, blepharoplasty is performed to improve vision problems, particularly when excess upper eyelid skin begins to interfere with peripheral vision. The surgery can be performed on the upper and lower lids, at the same time, or separately. It is important to know that blepharoplasty will not remove “crows feet” nor will it alter rough or darkened skin around the eyes.
Upper eyelid blepharoplasty not only enhances the rested and refreshed facial appearance, but in women, provides a platform above the lashes for more convenient make-up application. The technique of upper eyelid “supratarsal fixation” more reliably assures this result. This technique also allows the cosmetic surgeon the ability to “westernize” the oriental eyelid if requested.
Lower eyelid blepharoplasty eliminates the bags which are the result of herniation of the fat pads away from the orbital rim. This occurs because of genetics and aging. When present, these bags create a fatigued or exhausted appearance. If excess lower eyelid skin is present, then excision of the redundancy can be performed.
How is the procedure performed?
Blepharoplasty can be safely performed in the office under local anesthesia. For upper eyelid surgery, the surgeon excises an elliptical configuration of skin and may remove some muscle. The herniated fat pads are then removed. The wound margins are then sutured together and may be reinforced with Steri-strips. For lower eyelid surgery, the surgeon may choose to cut in the eyelid magin itself, or directly below it. In cutting below the eyelid margin, redundant skin as well as fat pads can be removed. The wound margins are then sutured together and may be reinforced with Steri-strips.
What happens preoperatively?
Preoperative evaluation includes a thorough history, blood tests to evaluate any bleeding difficulties, and an ophthalmologic exam which includes testing for visual acuity, peripheral fields of vision, and tear production.
What happens postoperatively?
Oral and topical antibiotics are taken and applied twice a day for the week following surgery. Cool, gel-like compressions are applied continually for the first 24-48 hours after surgery. It is important for the patient to keep his or her head in an upright position for the first 24 hours after surgery. This helps to reduce swelling and bruising. Pain medications are taken for several days after surgery. Finally, dry eyes are treated with ointment at night and eye drops during the day. This typically resolves within 3-4 weeks.
- Make-up should not be applied until a couple of days after the sutures are removed.
- Contact lenses should be avoided for at least two weeks following the surgery.
- Driving should be avoided until vision has returned to normal.