The eye area is one of the first areas of the face to show signs of aging. An eyelid tuck, or “blepharoplasty” can be used to restore the youthful look of the eye area. Blepharoplasty surgery can be performed on either the upper or lower eyelids – or both. It may be safely combined with a facelift or forehead lift if needed, depending on your individual situation.
Dr. Fiala will carefully look at your eyelid anatomy, analyzing it for loose skin, fat deposits, asymmetries, and lower lid support. Based on this, he’ll recommend some options for the upper and lower lids. Some of these may involve traditional surgery; other options include chemical peels, fractional laser resurfacing and injectables.
Is Eyelid Surgery Right for Me?
Most blepharoplasty patients are in their 40’s or 50’s, but sometimes patients in their late 30’s have the procedure done if they have the early appearance of droopy eyelids or prominent bags under the eyes. Patients should be healthy, have realistic expectations, and not have any major diseases of the eye.
How is an upper-lid blepharoplasty surgery performed?
In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. Care is taken to map out the excess skin accurately, prior to surgery. After the patient is asleep, the incision is made, and excess fat is removed, and then the loose skin is removed. Fine sutures are used to close the incisions. Incisional scars usually heal very well, and are barely visible after healing.
How is a lower-lid blepharoplasty surgery performed?
There are several options, depending on the patient’s anatomy. If Dr. Fiala feels there are fatty pockets to be removed, he will typically use a “trans-conjunctival” approach to the fat. This uses an incision on the back side of the eyelid, and no external scar.
If Dr. Fiala feels there is extra skin on the lower lid, then an incision to remove this skin is typically performed, just beneath the eyelash area. The scar typically heals very well.
These two approaches can be combined to deal with combinations of extra fat and loose skin.
What is a canthopexy?
Sometimes, as the eye ages, the support of the lower lid gets weaker. This results in a lower lid that is more floppy or stretchy. If surgery is performed on a lower eyelid with weakened support, there is a higher risk of a pulled-down or “hound-dog” eyelid that doesn't sit at the correct level. An internal suture suspension, known as a canthopexy, can reduce this risk. If Dr. Fiala feels that your eyelid falls into this category, he will recommend a canthopexy be performed at the same time as the blepharoplasty surgery.
When is a fractional laser or chemical peel used for eyelid treatment?
If the lower eyelid skin has fine lines and textural changes, these resurfacing methods can work well to make the skin smoother and more youthful looking?
What kind of anesthesia is used for a blepharoplasty?
For the upper lids by themselves, Dr. Fiala gives patients a choice of a light general anesthesia or IV sedation by an MD anesthesiologist. If the lower lids are being treated, usually general anesthesia is preferred, also under the care of one of our expert MD anesthesiologists.
I’ve had LASIK done. Can I have a blepharoplasty?
Yes. However, LASIK tends to make the eye more dry – you will likely need to use some artificial tears after surgery for a few months to make sure the eye stays nicely lubricated.
Does blepharoplasty surgery change my eyebrow position?
No. A separate operation, called a forehead lift or browlift, is needed to elevate low eyebrows. Dr. Fiala will advise you if this might be helpful for you.
Can blepharoplasty surgery fix my crow’s feet?
No. This issue is best treated by using Botox or Dysport.
Can I have a facelift in the future if I get my eyes done now?
Certainly. Many patients have a blepharoplasty in their 40’s or 50’s, and do the facelift 10-15 years later.
Is the recovery after blepharoplasty difficult?
For most people, it’s an easy recovery, with minimal pain, and minimal bruising and swelling. Cool compresses are helpful for the first 2-3 days to minimize swelling. Most people are back to their normal activities after about a week, and can return to the gym or other physical activities by 3 weeks after surgery. The incisions typically heal very nicely, and are invisible at conversational distances by 3 months after surgery, on average. Patients who require a canthopexy typically have more swelling, so their recovery may take a little longer.