Introduction: What is Eyelid Surgery?
Eyelid surgery is also called blepharoplasty. It is done to correct the puffiness, sagging and drooping of upper eyelids. It is also used to remove excess skin and bags under the lower eyelids. A combination of skin and fat are usually removed. Blepharoplasty improves the appearance of your eyelids and the area around it to give you a younger and more relaxed look. Upper eyelid lift or blepharoplasty can also help to improve your visual fields for a functional result if your vision is currently impaired by a veil of sagging skin.
Eyelid surgery can also be done to improve drooping of the upper eyelid itself, if your lash margin hangs over the colored portion of your eye. Lastly, eyelid surgery can be done to improve the position of the lower lid, if it is falling away from the globe of the eye, or if the lashes are turned in and irritating the eye.
Who is an Ideal Candidate for Eyelid Surgery?
You are a surgical candidate if you are healthy without any significant comorbidites that would impair wound healing, a non-smoker and if you have realistic expectations of what eyelid surgery can do for you.
Risks increase for people with diabetes, dry eyes, glaucoma, high blood pressure, thyroid problems, heart, and vascular diseases or if you are on blood thinners.
Preoperative Assessment
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and about significant medical conditions, allergies and previous surgeries if any.
Photographs will also be taken during pre-operative consultation, to be used in surgical planning and for before and after comparison. Pictures may also be used for insurance purposes if your eyelid surgery is for functional reasons. Your goals will be discussed, and realistic expectations will be set. After discussing surgical options, we will make an individualized surgical plan together that best suits your goals. This is the best time to ask all your questions so that you can feel comfortable and confident going into surgery.
Procedure of Eyelid Surgery
During the procedure, you will be administered either local anesthesia and sedation or general anesthesia as felt appropriate by your surgeon. The incision on the upper eyelid is made such that after the procedure the scars are hidden in the natural creases of the upper eyelid. The fat or extra skin is removed. For lower eyelids, the incision is either made just below the lower lash line or inside the lower eyelid. The excess skin is removed and/or the fat may be removed or redistributed as required. The incisions are closed with sutures, surgical tape or skin adhesives. Medications and ointment are prescribed to help with faster healing and to prevent infection after the procedure. Note you must wear sunglasses until healing is complete.
The swelling and bruising seen after the procedure go away in a few weeks. The scars of the incisions fade away in a few months to reveal beautiful eyes with well-defined smooth eyelids to give you a younger and rejuvenated look.
Risks occur rarely but may include infection, scarring, temporary blurred vision or double vision and dry eyes. Loss of vision may occur in very rare cases.
Risks and Complications of Eyelid Surgery
Eyelid surgeries are relatively safe. However, as in any surgery, there are chances of potential complications including:
- Anesthesia risks
- Bleeding
- Difficulty closing your eyes (lagophthalmos)
- Delayed healing
- Dryness of the eyes
- Ectropion
- Lid lag
- Numbness or changes in skin sensation
- Asymmetries or suboptimal aesthetic results
- Recurrence of loose skin
- Sensitivity to sun or bright light
- Scarring
- Swelling/ bruising
- Temporary or permanent change in vision and a very rare chance of blindness
- Infection
- Possibility of revision surgery
Recovery after Eyelid Surgery
After eyelid surgery there will be some temporary pain, discomfort, and swelling. Medications will be prescribed to relieve pain. You will be advised to rest after surgery and specific post-operative care instructions will be given. You may come out of the operating room with ice packs over your eyes. Most patients can undergo a eyelid surgery as an outpatient procedure unless there are extenuating circumstances. Ice packs, lubricating ointment and head elevation will be key after surgery for your healing and recovery. If you do have sutures in place they may either be dissolvable or they may need to be removed in a week. Strenuous physical activity and heavy lifting over five pounds is discouraged for at least the first 2-4 weeks or while you still have swelling post-operatively – details of this limitation will be discussed with you specific to the surgery that you will be having. You will likely be able to resume work in 1 to 2 weeks depending on what kind of job you have and how you are feeling. Full recovery may take a couple of months and you need to have follow-up appointments to ensure a positive surgical outcome.
Summary
Eyelid surgery is a wonderful way to reveal beautiful eyes with well-defined smooth eyelids to give you a younger and rejuvenated look. The swelling and bruising seen after the procedure go away in a few weeks. The scars of the incisions fade away in a few months to be nearly imperceptible.
