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Blepharoplasty (Eyelid Surgery)

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Updated April 16, 2014

What Is Blepharoplasty?:

Blepharoplasty is more commonly known as an eye lift or eyelid lift, and is the third most popular cosmetic procedure in the U.S. today. It can include the upper lids, lower lids, or both, and its goal is a more alert, rested appearance of the eyes.

Who Is a Good Candidate?:

As with all surgical procedures, the best candidates for eyelid surgery are non-smokers who are in generally good health and who have realistic expectations about their surgical outcome. Patients that benefit most from this type of surgery include people who have excess or sagging skin around the eyes, including those with hooded eyelids. Blepharoplasty can also be very effective in removing the “bags” underneath the eyes about which so many people complain, as well as improving or removing lines and wrinkles around the eye.

Pre-Operative Considerations:

Your surgeon will almost certainly order some type of lab tests to confirm your health status before operating. You will be examined and asked to answer questions concerning vision, tear production, use of contact lenses, and past surgical procedures. Your surgeon may also require that you adjust, cease, or begin taking certain medications in the week or two before your surgery. It is also very important that you avoid aspirin, many anti-inflammatory drugs, and herbal supplements in the 2 weeks prior to surgery, as all of these can increase bleeding. Talk to your surgeon about everything you may be taking.

Recovery and Downtime:

You should keep your head elevated for the first few days, and avoid any straining, bending or lifting for at least 3 to 4 days, after which any permanent stitches will be removed. For the first 7 to 10 days, your eyes may feel sticky, dry, and itchy, and your surgeon will show you how to clean the eye area. In addition, eye drops may be recommended.

Most patients will be able to resume normal activities within 10 days. Your vision may still be slightly blurry, and contact lenses should not be worn for 1 to 2 weeks. These guidelines can vary, so follow your surgeon’s recommendations.

Risks & Complications:

Risks and possible complications include: unfavorable scarring, excessive bleeding or hematoma, skin loss (tissue death), blood clots, numbness or other changes in sensation or intense itching, anesthesia risks, skin discoloration, persistent edema (swelling), asymmetry, eye irritation or dryness, temporarily blurred or impaired vision, dry eyes, difficulty closing your eyes, ectropion (a rolling of the eyelid outwards), loss of eyesight, skin contour irregularities, skin discoloration and swelling, recurrent looseness of skin, unsatisfactory aesthetic results, and the need for additional surgery.

The Results:

Bruising should subside in 5 to 10 days and swelling should subside in 2 to 4 weeks. Final results may appear in 1 to 2 months, although scars will continue to refine and fade for up to 1 year, and will usually become nearly undetectable.

Costs:

The average total cost for an upper and lower blepharoplasty performed together at the same time is around $5,000, although fees can range from $2,500 to $7,500, depending in large part on the geographical area. Total costs include your surgeon’s fee, anesthesia fees, facility fees, lab fees, and medications. In cases where hooded eyelids are significantly obscuring vision, insurance may pay for the cost of that portion of the surgery which is done purely for corrective purposes.

Complementary Procedures:

Eyelid surgery is often done in conjunction with other surgeries to enhance the patient’s results. These complementary procedures can include a face lift to correct sagging of the lower face, brow lift to correct drooping brows, forehead creases, and frown lines, or skin resurfacing procedures (laser resurfacing or chemical peels) to improve the overall look and feel of the skin.

How It’s Done:

  1. Anesthesia is administered. Eyelid surgery can be performed either under IV sedation or general anesthesia, according to the recommendations of your surgeon.

  2. Incisions are made. Most commonly, incisions for an upper blepharoplasty are made in the natural crease of the eyelid. Because of this placement and the nature of the skin in the area, scars are nearly undetectable. For lower eyelid surgery, the incision may be placed right at the lash line if there is excess skin to be removed.

  3. Excess skin and/or fat is removed. A small sliver of excess skin is removed. It is important for the surgeon to do this with great care, as removing too little skin can provide an unsatisfactory aesthetic result, while removing too much skin can actually cause problems with fully closing the eye. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty, in which case the incision is made from the inside of the eyelid only, leaving no visible scar at all. The incision in this case is made inside the lower eyelid, and excess fatty material is removed.

  4. Incisions are closed. Delicate sutures (often dissolvable) are used to close the incisions and hold the thin eyelid skin together during healing. A special ointment and tiny sterile bandages may be applied at this time.

    Sources:

    Eyelid Surgery (Blepharoplasty), Consumer Information Sheet, American Society for Aesthetic and Plastic Surgery: http://www.surgery.org/public/procedures/eyelid_surgerysix

    Blepharoplasty (Eyelid Surgery), Consumer Information Sheet, American Academy of Facial Plastic and Reconstructive Surgeons: http://www.aafprs.org/patient/procedures/blepharoplasty.html

    Eyelid Surgery, Consumer Information Sheet, American Society of Plastic Surgeons: http://www.plasticsurgery.org/patients_consumers/procedures/Blepharoplasty.cfm

    Management of the Aging Upper Face, Grand Rounds Presentation, UTMB, Dept. of Otolaryngology. December 5, 2001, Edward Buckingham, MD, Karen Calhoun, MD, Francis B. Quinn, Jr., MD and Matthew W. Ryan, MD

    2006 Average Surgeon/Physician Fees - Cosmetic Procedures, Consumer Information Sheet, American Society of Plastic Surgeons, http://www.plasticsurgery.org/media/statistics/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=23761

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