Overview and video
Blepharoplasty is a common cosmetic surgical procedure that helps to improve the look of the eyes and give a rejuvenated and youthful appearance to the peri-orbial area. At Prima Center for Plastic Surgery in Duluth, blepharoplasty is performed to improve the contour of the upper or lower eyelids or both. The basic surgical procedure involves removing drooping or loose skin from the upper eyelid, lower eyelid, or both. Patients who are concerned about aging of the lower eyelids often complain of darkness, sagging skin and bags. For the lower eyelids the procedure may involve a repositioning of the fatty deposits of the lid and repositioning them to fill in the tear trough and upper malar zone. This eases the transition between the lower eyelid and the cheek. By repositioning the fat and re-suspending the muscle of the lower eyelid this youthful fullness and contour can be re-established to help you look as good as you can for your age. In some cases the fatty deposits which cause the bags will be removed. It is vitally important that each patient is carefully evaluate in regards to the town of the lower eyelid and the overall contour of the peri-orbital zone. Overzealous removal of fat is to be avoided since it can lead to a hollowing out of the lower lid. During the consultation, patients will be thoroughly evaluated and a physical examination will be performed. Together we will discuss your concerns and how these surgical procedures can help reverse some of the most visible signs of aging. Our doctors will use this this time to discuss specific procedure options and goals. After this surgery, patients look refreshed and report feeling that they look younger and revitalized.
A blepharoplasty may either be performed on the upper eyelid only or the lower lid, or both. The procedure can be performed either under local anesthesia or general anesthesia. Many patients prefer to be pre-treated with oral sedation prior to surgery. Others may prefer being put completely asleep under a general anesthetic. There will be a difference in approaches when it comes to the upper and lower eyelids. In consultation with your plastic surgeon you will have the opportunity to learn about the operation,what it can and can not accomplish. The entire procedure will be described in detail. An upper eyelid blepharoplasty generally involves a removal of the redundant skin of the lid as well as any fat bulges. The incision is placed in the crease just above the lash line (supratarsal crease) and will be well hidden. If there is hooding of the lateral upper eyelid this can be also removed. It is important to evaluate the position of the brow since a low brow will crowd the upper eyelid and may need to be corrected for a patient to achieve their best result. For the lower eyelids attention will be placed to remove any loose skin or tissue, and extracting or repositioning the fat deposits. There will also be a separate incision for the lower eyelid. This incision is placed just below the lash line in the subcillary position. The skin of the lower eyelid is thin and heals quite nicely in most patients. It is important to understand that a blepharoplasty will not help with other cosmetic issues such as crow’s feet, wrinkles or dark circles. The results of an eyelid surgery are fairly isolated within the upper and lower lid section only. There are other procedures that can be combined, for example the use of BOTOX® or laser resurfacing to create a more rejuvenated outcome.
Upper Eyelid Surgery
During your consultation your upper eyelid and brow will be examined. The most common problem with the upper eyelid is excess skin that droops and hangs over the eyes. Not only does this look unappealing, but it can also obstruct vision for a patient. Your plastic surgeon will create an incision along the natural fold of the eyelid and remove any excess fat and tissue to remove any bulges. Once done, excess skin will also be trimmed and the incision will be closed with fine sutures. There are cases when fat tissues are only repositioned instead of excised. A youthful appearing upper eyelid has a well positioned brow with fullness. Overzealous excision of fat is always avoided since this can create a sunken in appearance. The results of an upper eyelid blepharoplasty can be expected to last 7 to 10 years or more with proper care.
Lower Eyelid Surgery
There are two options for incisions when it comes to lower eyelid surgery. You will discuss with your plastic surgeon the best option to help you achieve your goal and to meet your expectations. A lower eyelid blepharoplasty will improve the appearance of bulging and sagging below the eye. The most common incision is made just slightly below the lash line and excess fat will either be repositioned to fill in contour deficits such as the tear trough or fat can be meticulously removed and sculpted next the muscle can be re-suspended in a more youthful position and excess skin will be carefully excised. If the skin has retained good elasticity, a transconjunctival incision may be an option as the incision is made inside the lower eyelid, which effectively makes any resulting scar concealed. A lower lid lift does not necessarily improve the dark circles that may occur under the eyes. Your plastic surgeon may recommend combining a lower blepharoplasty with another procedure such as a laser resurfacing or an injectable filler soft tissue filler such as Juvederm Ultra™. With a good clinical skin care program combined with the use of sunscreens you can expect a lower eyelid blepharoplasty to last 7 to 10 years or more.
Eyelid surgery can be performed either under local anesthesia or under general OR local anesthesia in our accredited in office operating room suite. On average, it takes 1.5 to -2.5 hours to complete the operation. The patient will be discharged home when stable. There are six things that can be done to reduce bruising and swelling:
- this includes keeping your blood pressure under control
- avoiding the use of aspirin and ipuprofen for a week prior to surgery and for one week after surgery
- Avoid activities that can increase your blood pressure including straining and exercise for the first 36 hours
- Using cool compresses for the first 36 hours
- Consider using Arnica after surgery
- Keep your head elevated on two pillows
For the first few days, there will be swelling and discoloration around the area. It is advised that the head is elevated for the first few days. Pain medications and antibiotics will be prescribed to manage the initial discomfort. Strenuous activities must also be restricted. By adhering to your post-operative instructions you can expect to have a smooth and uneventful recovery. For women the bruising can be covered using camouflage make up, purple covers yellow and yellow cover purple.
Plan Your Procedure
- Average Cost
- $3,000 - $7,000
- Recovery Time
- 1-2 weeks
- Average Procedure Time
- 1.5-3 hours
- Post-op Follow-up
- 5-7 days
- Procedure Recovery Location
Eyelid Surgery FAQs
Eyelid surgery, whether upper or lower, generally does not cause visible scarring. This is because the surgeon takes great care to ensure that the incisions are made within the natural lines and folds of the eyes. Once the surgical healing has passed, the incisions will not be noticeable even to the naked eye.
Wrinkles and Crow's Feet?
Crow’s feet and forehead wrinkles are better treated with procedures such as a facelift, browlift or a cheek lift as the results of the eyelid surgery are confined to the eyelids only. Eyelid surgery can also be combined with a nonsurgical procedure such as BOTOX, which combats wrinkles on the forehead and around the eyes. An injectable filler can also be effective because it adds volume to hollow areas for a softer, smoother appearance.
Complications and irritations after surgery are rare. Patients must strictly adhere to care instructions prescribed by the surgeon to minimize any risks of infection as the eyes can be sensitive after surgery. Patients must always take precaution of protecting the eyes from the sun and wind during the first few weeks of recovery.
Blepharoplasty not only corrects a cosmetic issue, but a functional one as well. Many patients with excess hanging skin on their upper eyelid are able to regain normal vision after surgery. For many, simply applying makeup without maneuvering around the excess skin is refreshing in and of itself.