Your eyes are often the first thing people notice about your face and are an important aspect of facial attractiveness. The eyelids protect one’s eyes in addition to adding to their cosmetic appearance.
Unfortunately, over time your upper and/or lower eyelids may become “droopy” or “baggy” because the eyelid skin stretches, muscles weaken, and fat pockets bulge and become more prominent around the eyes. This most commonly occurs because of the aging process but also there may be a hereditary predisposition that runs in your family. Your eyebrows also may sag or droop as part of this same process.
People look tired due to drooping of the upper lids and excessive skin as well from the puffiness of lower lid bags.
Aesthetically, such conditions may detract from the overall attractiveness of one’s eyes and cause a “tired” or older appearance. When severe, these conditions also may cause functional problems, such as impaired field of vision due to excessive skin folding over the lashes obstructing vision.
Surgery
Eyelid surgery to improve the appearance of the eyelids is termed “blepharoplasty.” Blepharoplasty surgery is usually an outpatient procedure performed under local anesthesia, with sedation if desired.
The goal of this eyelid surgery is to reduce the “baggy” or sagging tissues, which may include skin, muscle, and fat pockets. In upper eyelid surgery, typically all three types of tissue are removed. In lower eyelid surgery, sometimes only the fat pockets need to be removed, or the skin and muscle also may need to be included.
During surgery, incisions are made in the natural folds of the eyelid (in the crease of your upper eyelid and just below the lashes in your lower eyelid) so that they are virtually unnoticeable after the tissues have healed. Sometimes the upper lid crease can be repositioned if desired.
After the excess tissue is removed, the incisions are closed with fine sutures which are left in place for 7-10 days.
If only fatty tissue needs to the removed from the lower eyelids and not any skin, the surgery can be performed behind the eyelid. This is known as “transconjunctival blepharoplasty.”
In cases where the eyebrows are also droopy, a procedure to elevate the eyebrows may be appropriate. This procedure, known as a brow or forehead lift, may be done directly above the eyebrows, within the forehead creases, or by approaching the brows from the hairline or just behind the hairline as a “coronal brow lift.” Often times small incisions are utilized, and an endoscopic approach is utilized.
After Surgery
Following surgery, cold compresses are applied to the eyelids to reduce swelling and bruising. The eyes do not need to be patched shut. During the first week, antibiotic ointment is applied to the eyelids, and strenuous activity should be minimized.
Aspirin products and “blood thinners” should be avoided before and after surgery because of their tendency to increase bruising.
After surgery, one may temporarily experience minor discomfort, tightness of the eyelids, swelling, bruising, numbness, and dryness of the eyes. These will usually resolve as the wounds heal. Excessive pain, bleeding, infection, or loss of vision in the period following surgery are extremely rare. In the unlikely event that such a problem should occur, you should notify your physician promptly.
Complications that may occur include slight asymmetry in eyelid appearance or eyelid position. These problems occur infrequently and may require additional surgery to correct.
Blepharoplasty surgery can provide both cosmetic and functional improvement with minimal risk of serious problems. Most patients are very pleased with the results of their eyelid surgery.
