Eyelid Surgery

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What is Eyelid Surgery (Blepharoplasty)?

Eyelid surgery, also known as blepharoplasty or "eye lift", is a cosmetic procedure. It modifies the skin on your eyelid and around your eyes. Blepharoplasty can improve your eye function and give you a more youthful appearance.

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As you age, your eyelid skin stretches. This can cause sagging eyebrows, droopy lids, and bags under your eyes. In addition to making you look older, this can reduce your peripheral vision. The surgical procedure may involve removing excess skin, muscles, and fat from around your eyes.

Doctors can perform blepharoplasty on both the upper eyelid and the lower eyelid together. However, lower or upper eyelid surgery are also options independently.

While eyelid surgery may not sound like a standard procedure, it is prevalent. In fact, according to the American Society for Aesthetic Plastic Surgery (ASAPS), blepharoplasty was one of the top five cosmetic procedures for both men and women in 2018, with more than 115,000 surgeries performed.

What Can Eyelid Surgery Treat?

The blepharoplasty procedure enhances the appearance of your eyes and the surrounding areas. But eyelid surgery can treat various eyelid problems, including:

  • Bags under your eyes
  • Drooping eyelids
  • Excess skin on the upper or lower eyelids that interferes with peripheral vision

Whether you want to improve the looks or functioning of the them, eyelid surgery can:

  • Tighten loose and/or sagging skin that creates natural creases in the eyelids, disturbs the natural contour of the eyelid, and may or may not impair vision
  • Remove excess fat deposits that make the eyelids appear as puffy
  • Remove bags under the eyes and tighten drooping lower eyelids that reveal the white of the eyes below the irises
  • Remove excess skin, wrinkles, eye bags, and other unwanted skin issues in the upper and lower lids
  • Improve skin elasticity in the eye area so that you don’t have droopy eyelids

Who is a Candidate for Eyelid Surgery?

Eyelid surgery is an option for anyone with eyelids that they want to improve. Your could have functional or cosmetic reasons. A good candidate for eyelid surgery is someone who is optimistic and realistic about results. Sometimes, eyelid revision surgery is necessary to correct the results of blepharoplasty.

Nonsmokers and those without medical conditions or serious eye conditions that could interfere with healing are ideal candidates.

What to Expect: How is Eyelid Surgery Performed?

Pre-Surgery

Eyelid surgery starts with a consultation. Your doctor will evaluate your health and any pre-existing medical conditions and potential risk factors. They will likely perform a physical examination, vision examination, and take pictures of your eyelids. Then you will discuss your surgery options, likely outcomes, potential complications, and treatment plans.

Once you have the surgery scheduled your doctor will give you instructions for preparation. They may ask you to stop taking certain prescription, OTC, or herbal medications that increase bleeding. Only take medication that your surgeon approves.

If you smoke, you'll be asked to quit several weeks before the procedure. Smoking interferes with your healing ability. You'll also have to prearrange transport from your surgeon's office.

During the Procedure

Cosmetic eyelid surgery is typically performed as an outpatient procedure. On average, it takes about 45 minutes to two hours, depending upon whether or not you get other procedures done while in surgery.

First, your surgeon will administer anesthesia. Blepharoplasty may be performed with local or general anesthesia.

Local anesthesia is a numbing agent that the doctor injects into your eyelids to numb and relax the area.

General anesthesia is medication that makes you unconscious throughout the procedure. You and your doctor will discuss which option is best for you before the procedure.

The next step is the incision lines. If you are having both eyelids operated on, the surgeon will likely start with the upper lid, followed by the lower. The incisions are made so that the scars are well-hidden within your natural eyelid structure.

Once the incisions are made, the surgeon will remove or reposition fat deposits, tighten muscles, or remove excess skin.

Once the surgery is complete, the surgeon closes the incisions. This is typically done with sutures or skin glue.

Often, the surgery is performed with other rejuvenation procedures like a brow lift, a face lift, fillers, or ptosis repair, which tightens the levator muscle that lifts the upper eyelids.

Following the surgery, you may experience puffiness and pain and swelling in the eye area. 

Eyelid Surgery Recovery Timeline & Tips

Eye surgery, though quick, is serious. After a few hours, the anesthesia will wear off. You may feel pain and experience swelling, dark circles, blurred vision, and other side effects after surgery.

The doctor may use a lubricating ointment, cold compresses, or a loose covering of gauze to protect your eyes after surgery. They will then give you instructions specific to your case to make sure your wounds heal quickly and cleanly.

Using cold compresses (like an ice pack) and keeping your head elevated while you sleep can help to alleviate some of the pain and discomfort associated with eyelid surgery. Your doctor may recommend eye drops to keep the eyes lubricated following an eyelid lift. In some cases, they may prescribe or recommend mediations to aid healing, lower infection risks, and manage pain.

Eyelid Surgery Risks & Complications

Eyelid surgery is usually quick and can typically be done in a day. However, there are risks involved with all surgeries. Eyelid surgery risks include, but are not limited to, the following:

  • Reactions to any anesthesia and/or injuries due to sedation
  • Swelling and bruising around the eyes
  • Difficulty closing the eyes
  • Bleeding from the incision lines
  • Dry eyes
  • Eye infections
  • Sensitivity to lights, including sunlight
  • Ectropion (when the lower eyelid rolls outward) or entropion (when the lower eyelid rolls inward)
  • Pain in and around the eyes
  • Changes to the skin around the eyes and lash line, including numbness or tingling sensations
  • Temporary or permanent changes to field of vision such as double vision or, in rare cases, blindness
  • Scarring
  • Lid lag (when the upper eyelid is higher than normal while you are looking down)
  • The need for eyelid revision surgery

Cost of Eyelid Surgery

The cost of eyelid surgery varies but, on average, cosmetic eyelid surgery costs about $3,000. It ranges from about $2,000 to $5,000 for all four lids. Lower eyelid surgery tends to be more expensive than upper blepharoplasty.

The cost does not include: anesthesia, operating room facilities, prescriptions, medical tests, or other plastic surgeon-specific fees.

A surgeon’s fee will depend on their experience, the type of procedure, the extremity of the case, and other related factors. Many plastic surgeons will offer patient financing plans that help make the procedure easier to pay for.

Note that most health insurance providers do not cover cosmetic surgery or any complications associated with cosmetic surgeries, including eyelid surgery.

When eyelid surgery is performed to fix skin that covers the eyelashes, it may be covered by insurance. Check your insurance plan and speak with your provider about whether or not eyelid surgery is covered.

Resources
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“Best NYC Blepharoplasty (Eyelid Surgery).” Romo Plastic Surgery, 6 Nov. 2020, www.romoplasticsurgery.com/procedures/surgical/blepharoplasty/

“Eyelid Surgery Procedure Guide.” ABCS, 16 Sept. 2015, www.americanboardcosmeticsurgery.org/procedure-learning-center/face/eyelid-surgery-guide/

Rod Rohrich, MD, et al. “Eyelid Surgery.” American Society of Plastic Surgeons, www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery

Stepko, Barbara. “Understanding Belpharoplasty, Eyelid Plastic Surgery.” AARP, 11 June 2019, www.aarp.org/health/conditions-treatments/info-2019/blepharoplasty.html.

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