Everything you need to know about eyelid surgery - or Blepharoplasty

What is Blepharoplasty?

Very simply put, blepharoplasty is a surgical operation that removes small amounts of excess skin from the upper eyelid. Eyelid surgery can be performed for a variety of reasons - from correcting defects or disfigurations of the eyelids, to modifying the region for aesthetic purposes. It can be a very effective way to improve sight in older patients whose upper eyelids get in the way of their vision.

Surgery can be performed on both the upper (removing excess skin) and lower (reducing bagginess) eyelids, although the upper is much more common. Eye lifts, however, will not eliminate dark circles under the eyes, reduce crows feet, or improve wrinkles.

We often combine eyelid surgery with other procedures like laser resurfacing, Dysport, and Fillers to help achieve a more youthful look. 

What is the cause of excess upper eyelid skin?

Typically, sagging eyelids are the natural result of the aging process. Ptosis is the medical term for drooping of the upper eyelid - a condition that may affect one or both eyes. Some people are born with this condition, and some get it later in life. The tendon muscle responsible for lifting the eyelid stretches, and the eyelid falls. Eyelid surgery is performed to repair the stretched tendon and lift the eyelid. 

How is the surgery performed? 

A blepharoplasty procedure usually is performed through external surgical incisions made along the natural skin lines (creases) of the upper and the lower eyelids, which creases then hide the surgical scars from view, especially when effected in the skin creases below the eyelashes of the lower eyelid. 

The procedure usually requires 1–3 hours to complete and oral sedatives can be provided if desired. 

After the procedure, a type of stitch known as a canthopexy is placed near the outer corner of the lower eyelid, which is inside the tissue. This allows the eyelid's position to remain fixed during the healing process. The canthopexy is dissolved after four to six weeks of use. For particular patients, a mid-face elevation may be required to rejuvenate the lower eyelid-cheek complex.

Am I a candidate for upper eyelid surgery / blepharoplasty?

The best candidates for an eye lift are people who are in good health and who have realistic expectations. Most are 35 years or older, but if baggy eyelids or droopy eyelids run in your family, you may decide to have the surgery done sooner.

If you aren't sure that you are a candidate for blepharoplasty, schedule an appointment with your eye doctor, who can evaluate you for any medical problems related to your eyelids.

If you don't have a medical reason for a blepharoplasty procedure, you can discuss with Dr. Janowski any concerns or interest you might have regarding cosmetic eyelid surgery.

You might consider blepharoplasty if you have excessive drooping and sagging of skin around eyes, which often is due to normal aging. Sagging skin also can be exaggerated when you have other conditions such as puffy eyes caused by eye allergies or edema.

Smokers are at increased risk of surgical complications because they heal more slowly. If you are a smoker, your surgeon may advise you to quit smoking for at least several weeks prior to a procedure.

Is upper eyelid surgery painful?

How long does it take to recover from blepharoplasty?

Bruising and swelling may be present for up to one week.  Stitches are removed at 5-7 days.  Mild soreness may be present in the first 1-2 days.

Eyelid surgery pre-operation instructions: 

  • Do not take any medicines that may contribute to bleeding, for one week prior, such as:  Ibuprofen, aspirin, naproxen, Aleve, Advil, Celebrex, alcohol, fish oil, vitamin E
  • Discuss with the doctor any medications you are on to see if they should be avoided before the procedure
  • Arrange for a ride home from your procedure
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    Eat a normal breakfast/lunch prior to the procedure
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    Shower the morning of the procedure.  Do not apply any facial creams after showering
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    Do not apply makeup the day of the procedure
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    Have all prescriptions provided by the doctor filled before the procedure and bring them with you

Eyelid surgery post operation instructions:

Do:
  • Keep head elevated while resting/sleeping for first two nights
  • Apply lubricating eye drops every 2-4 hours or as desired
  • Apply Tobradex eye drops every 6 hours while awake for one week
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    Apply cold water compresses liberally
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    Return in 5 days for suture removal
Don't:
  • Do not exercise for at least one week
  • Do not bend forward do any heavy lifting
  • Do not take any medicines that may contribute to bleeding, for one week, such as:  Ibuprofen, aspirin, naproxen, Aleve, Advil, Celebrex, alcohol, fish oil, vitamin E
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    Do not attempt to remove stitches
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    Do not apply eye-make up or creams to the area

Upper lid blepharoplasty FAQ's

Is it a big operation?

No.  It is a simple one-hour office procedure done under local anesthesia.  Oral sedatives can be provided if desired.

Does it hurt?

The procedure is completely painless.  One quick pinch of local anesthetic on each side is all you will feel.

Will there be a scar?

The scar is buried in the natural eyelid crease and is virtually undetectable once healed.

How long is the recovery?

Bruising and swelling may be present for up to one week.  Stitches are removed at 5-7 days.  Mild soreness may be present in the first 1-2 days.

Will I look unnatural like some of those movie stars?

No.  People look just like themselves, with a bit more of their natural upper lid showing.  Unnatural looks come from other procedures such as eyelifts and browlifts.

How long do results last?

Typically 10 years

*Results may vary from patient to patient