Blepharoplasty is the name of the surgery to improve the appearance and/or function of the eyelids
The aesthetic appearance of the eyes and the vision can be affected in time by aging, environmental (sun, pollution) and genetic factors. Laxity of eyelid skin, muscles and excess fat tissue around the eyes lead to the settlement of wrinkles and eye bags on the eyelids, giving a tired look for the patient.
What is upper eyelid blepharoplasty ?
Upper eyelid blepharoplasty is one of the most commonly performed functional as well as cosmetic facial plastic surgical procedures. It deals with the contours of the upper eyelid space, mainly the region between the eyebrow and the eyelashes.
Upper eyelid blepharoplasty can be performed for any of the following reasons,
- Hereditary factors and involutional changes can cause a drooping of skin and the tissues under the skin with protrusion of fat causing the ¨heavy eyelid¨ look.
- The appearance of the eyelids may be asymmetrical and blepharoplasty may be performed to improve symmetry
- Saggy eyelid skin can obstruct the visual field (you may not be able to see the full extent of your lateral vision) so blepharoplasty is performed to relieve this obstruction
Could I benefit from upper eyelid blepharoplasty ?
You may be an appropriate candidate for an upper eyelid blepharoplasty if;
- You are bothered by the dropping of your upper eyelids which may give you an old and tired looking
- There is asymmetry between your eyelids
- Some young patients need this procedure because of congenital characteristics that displease them
- You notice obstruction of your visual field from drooping of the upper eyelid skin. The consequent obstruction of your visual field can stimulate eyebrow elevation to relieve visual field, which may cause headaches as well.
How is upper eyelid blepharoplasty surgery done?
Blepharoplasty surgery is most often performed under local anesthesia. Sedation or general anesthesia may be utilized in appropriately selected patients. Experience and expertise are required to execute the procedure. First, the blepharoplasty incision is measured and marked. Subsequently variable amounts of skin, soft tissue and fat are removed to achieve a pleasing and youthful appearance of the eyelid and to improve the visual field. After the desired amount of excision is accomplished skin incisions are closed with sutures.
How do I find a surgeon who is right for me?
An excellent result in a happy patient of course speaks for a good surgeon and you may rely on word of mouth advertisement. In addition, you should discuss your wishes in great detail and explicitly ask the surgeon about the chances of precisely obtaining the desired outcome.
Your surgeon should be able to show you pre- and postoperative photographs of results e has obtained himself. You will have found the right surgeon, if all your questions have been answered in a pleasant atmosphere of mutual understanding, if the surgeon precisely knows what you expect and you are well informed about the chances of getting the result you want.
EAFPS.org will help you to find a European Academy of Facial Plastic Surgery member near you.
Can I see what I will look like after the operation?
The best way to learn what blepharoplasty accomplishes, and therefore what an individual patient might expect, is by examining preoperative and postoperative photographs of blepharoplasty patients . Some doctors offer computer imaging and others don’t. Those who are in favor of imaging find that it helps to precisely plan the operation and it is greatly appreciated by the patients. Those who dislike imaging are worried about raising unrealistic expectations. Compared to other procedures, such as rhinoplasty, computer imaging is relatively less reliable for upper eyelid blepharoplasty.
Remember that the result will almost always differ somewhat from the computer generated outcome, regardless of the surgeon’s expertise.
What can I expect before surgery?
Blepharoplasty can be performed for aesthetic or functional purposes (impairment of vision). Your surgeon will ask you about your past medical history, including medications you are taking, allergies, smoking habits, previous surgery and more. At least 2 weeks prior to the surgery, any patients who are taking aspirin or warfarin sodium (coumadin) are instructed to discontinue these medications. Patients may also be instructed to cease smoking for a given period before and after the procedure.
Your surgeon may also question you about any dryness or watering of your eyes you may have, he/she may ask for some extra tests to eliminate any problems with your tear functions.
Your physician will talk about the various options of correcting your upper eyelids. Added procedures that may be performed in combination with an upper eyelid blepharoplasty are discussed. These include injection of the “crows feet” wrinkles with botox or application of fillers to smoothen lines. If drooping of the eyelids is present, this should be taken into consideration and an eyebrow lift may be recommended. Laser treatments and chemical peels of other facial areas may also be performed during an upper eyelid blepharoplasty procedure.
Your surgeon will also talk to you about the risks, benefits and possible complications of an upper eyelid blepharoplasty procedure. Your surgeon will also talk to you about results, realistic expectations, and what the limitations of the procedure are.
What can I expect after surgery?
You can typically get up and walk around the evening of the surgery or the following morning. You should be prepared for moderate swelling and bruising of the skin. The degree of swelling and bruising differs markedly from patient to patient. Either way the swelling and the bruising both subside within 1-4 weeks, after which time it is typically hardly notable that you just underwent surgery.
Will I have a bandage or dressing after surgery?
A bandage is usually not needed after the surgery. Some surgeons prefer to use small strips to cover the incision site. Following the completion of the procedure, ointment may be applied over theincisions for approximately 1 week. Artificial tear drops can be prescribed to prevent the dryness at early postoperative period. Ice packs are applied over the operated area for 24 to 48 hours.
Do you need to remove the sutures?
Non-absorbableskin sutures are removed 5 to 7 days, Absorbable sutures dissolve within 1-3 weeks. Both types of sutures have advantages and draw backs and your surgeon should explain to you which suture material she / he recommends.
How long will I be off from work?
Generally speaking the recovery period after upper eyelid blepharoplasty is usually short and you may start doing your daily routines as soon as the following day. The swelling and ecchymosis vary among patients, but rarely last longer than 3 weeks and almost never limits patient mobility.
Will I be able to use make-up after the surgery?
Your surgeon may ask you to refrain from applying make-up for a certain time after the surgery.
What are possible risks and complications of upper eyelid blepharoplasty ?
Failure to meet the patient’s expectations, residual excess skin, asymmetry or scarring may necessitate additional treatment or a secondary operation.
Overcorrection may cause upper eyelid retraction which may result in the inability to close the eye. Topical lubricants and massage may be helpful for managing mild situtations. Injectable steroids can be used. Severe cases may require a secondary operation.
Eversion of the eyelids inwards or outwards is a rare complication and may also require a secondary procedure for correction.Very rarely double vision may occur due to injury of eye muscles.
Is it possible that I will need revision surgery?
Although the result of an upper eyelid blepharoplasty may be expected to last for years, aging will continue and drooping of the eye lids may recur. This should not be regarded as a complication of the procedure, but as a result of the continued aging process. A second procedure may be desired.
How do I ﬁnd a surgeon that performs upper eyelid blepharoplasty?
Members of the EAFPS who perform upper eyelid blepharoplasty can be found through the find a member link.