What is Blepharoplasty?
Blepharoplasty (eyelid surgery) is a plastic surgery procedure for correcting sagging or drooping eyelids. The eyelid, because its skin is much thinner than that in other parts of the face, is often one of the first facial areas to exhibit signs of aging.
Eyelids that sag or droop can affect peripheral vision, making daily activities such as driving more difficult. Blepharoplasty may become necessary when various factors, which include aging, sun damage, smoking, and obesity, cause the muscles and tissue that support the eyelids to weaken.
Benefits of Eyelid Surgery
Blepharoplasty tightens the eyelid’s muscles and tissue and removes excess fat and skin. Blepharoplasty eliminates the drooping of skin into the visual field, greatly improving peripheral vision. We also perform blepharoplasty for strictly cosmetic reasons.
Eyelid Surgery Candidates
The best candidates for blepharoplasty are those who:
- Are in good overall health
- Do not smoke
- Do not have any serious eye conditions
- Have healthy facial tissue and muscle
People with eye disease, including glaucoma or retinal detachment, thyroid disorders, diabetes, cardiovascular disease or high blood pressure are not good candidates for blepharoplasty.
Functional vs Cosmetic Blepharoplasty
Functional Eyelid Surgery
If the eyelids begin sagging into the field of vision, a functional blepharoplasty may be necessary. Medical insurance may cover the procedure if it is medically necessary. A determination of how much vision is affected is done by checking the peripheral visual field with an instrument called the Humphrey Visual Field (HVF) Analyzer.
Cosmetic Eyelid Surgery
Blepharoplasty can be on either the upper or lower eyelid, or on both, for cosmetic purposes. For a lower eyelid that needs fat removal rather than skin, we can perform a transconjunctival blepharoplasty. During transconjunctival blepharoplasty, we make an incision inside the lower eyelid, so there are no visible scars, and remove the fat. This procedure has no effect on vision, but results in a person’s looking younger.
It is important for a patient to have realistic expectations before undergoing cosmetic blepharoplasty. Although the procedure can enhance appearance and improve self-confidence, it does not radically alter the face.
Eyelid Surgery Procedure
Blepharoplasty is typically an outpatient procedure requiring local anesthesia and sedation. For anxious patients, we may use general anesthesia. Patients can choose to have this procedure on their upper or lower eyelids or both. The procedure takes anywhere from 45 minutes to 2 hours. This depends on whether we operate on both the upper and lower eyelids.
If the upper eyelid is being operated on, an incision is typically made along its natural crease. Once the incision is made, fat deposits are repositioned or removed, muscles and tissue are tightened, and excess skin is removed. For the lower eyelid, an incision is usually made just below the lash line so that excess skin can be removed.
After the procedure, we close the incisions with sutures, tissue glue or surgical tape, and usually loosely cover with gauze so the area can heal.
After blepharoplasty, patients may apply lubricating drops/ointment and cold compresses to aid in healing and minimize side effects. Most patients return to work within a few days to a week, but should avoid exercise and strenuous activities for at least 2 weeks. Your surgeon will remove stitches after 3 or 4 days. Most swelling and other side effects typically subside within 2 weeks. Patients should not wear contact lenses and eye makeup for 2 weeks after surgery. Patients should wear dark sunglasses outside or in bright light for 2 weeks to protect their eyes from the sun and the wind.
Eyelid Surgery Before & After
Risks of Eyelid Surgery
Although there may be swelling and bruising around the surgical site, they will subside on their own, and the eyelids will improve in appearance for up to a year. Uncommon side effects include infection, reaction to anesthesia, and double or blurred vision. Eyes may be dry due to a temporary change in tear distribution. Side effects such as uneven healing and permanent scarring are rare but, if they occur, may require surgical correction. The scars from blepharoplasty are well-concealed and usually fade with time until they are virtually undetectable. Although the eyelids are still subject to aging, blepharoplasty produces long-lasting results.
Schedule a Consultation
If you are interested in blepharoplasty and would like to see if you are a good candidate, call (757) 345-2275 to schedule a consultation at our office in Williamsburg, VA. Dr. Johnstuart Guarnieri serves Williamsburg, Virginia and surrounding areas.