Blepharoplasty is a procedure to remove excess skin and trim or reposition orbital fat to eliminate redundant skin and bag or puffiness of the upper and/or lower eyelids. The surgery aims to give the eyes a more youthful, energetic appearance.
At the same time as upper and lower blepharoplasty, other procedures may be performed. Of the upper eyelids, ptosis repair may be necessary to increase eye opening (the distance between upper and lower eyelash line), as blepharoplasty alone does not change eyelid function and thus how widely an eye can open. Ptosis repair tightens the eyelid muscles that are responsible for opening the eye and thus provides more tension in the muscles to pull the eyelid up. Ptosis repair may be performed without blepharoplasty if there is no excess skin present.
Of the lower eyelids, lateral canthoplasty and/or sub-orbiculares oculi fat (SOOF) elevation may be performed along with lower blepharoplasty. Lateral canthoplasty is a procedure to tighten the eyelid horizontally and gently pull the eyelid up especially in the outer corner of the eyelid. This procedure restores a more almond-shape of the eye after there has been some sagging and thus rounding of the lower eyelid. SOOF elevation is concurrently performed when there is more significant sagging of the lower eyelid, wherein lateral canthoplasty alone cannot elevate the lower eyelid. This procedure entails placing a suture in the cheek fat and suspending it to the periosteum, the lining of the bone, at the lateral canthus, the outer corner of the eye, and thus relieving some of the weight of the cheek fat from pulling on the lower eyelid and allowing it to come up more. These procedures may be performed without blepharoplasty if there is no excess skin of the eyelid to be removed. What to expect after surgeryThe skin of the eyelid is the thinnest of the body, which means the incision is unlikely to leave visible scarring. Furthermore, the incision is placed in the eyelid crease and hidden by the eyelid fold.Blepharoplasty is ordinarily performed under local anesthesia or sedation on an outpatient basis. Most patients are able to undergo the surgery under local anesthesia right in the office. It is generally recommended that patients plan on staying home for three days after the procedure and apply ice to the eyelids to reduce bruising and swelling. It typically takes about 2-3 weeks for the bruising and swelling to subside, although bruising can be effectively covered with makeup or sunglasses after the second week. Minimal restrictions are placed regarding exercise, bending and heavy lifting for one week to prevent more bleeding or swelling than necessary. Sutures are removed 7-10 days after the surgery, once the skin heals. Although the skin incision heals within a week, the deep tissues under the skin take at least four weeks to heal some and 3-4 more months to heal completely. Final results are evident once internal swelling and scarring settle down.
