Eyelid surgery, known as blepharoplasty, is a procedure that removes excess skin and fatty deposits from the upper and lower eyelids and tightens lax muscle and ligaments around the eye area.
Am I a good candidate for eyelid surgery?
if you have excess skin, a puffy appearance to the upper eyelid making your eyes look tired and aged, if you have bags and dark circles under your eyes, if your self-esteem would improve from this surgery, if you are in good general health then you are a good candidate for a blepharoplasty.
How is an eyelid surgery procedure performed?
Eyelid surgery (blepharoplasty) can be performed on your upper eyelids, lower eyelids, or both. Based on a pre-operative evaluation of factors such as your underlying facial muscle structure, bone structure, and the symmetry of your eyebrows, your surgeon will decide how much skin, muscle, and/or fat to remove.
- Your surgeon will make precise markings to indicate where excess tissues will be removed in your upper eyelids and in your lower eyelids.
- In your upper eyelid, your surgeon will make an incision hidden within the natural fold of the upper eyelid.
- In the lower eyelid, the incision will be hidden just below the lower lashes. Alternatively, when excess fat is being removed, the incision can be placed inside the lower eyelid (transconjunctival incision). A laser may sometimes be used in conjunction with this method to tighten lower eyelid skin.
- Your surgeon will remove tissue through these incisions using surgical instruments, including scalpels, surgical scissors, radiofrequency cutting devices, and, sometimes, cutting lasers.
- Sometimes fat may be redistributed in the lower lids to eliminate puffiness or bulges. Your surgeon may make other adjustments to correct special problems such as muscle laxity.
- He or she will then apply sutures or tissue adhesives (glue) to smooth and reconfigure areas around the eyebrows and eyelids. Sutures are invisible to the eye and are commonly self-dissolving. In most cases, there is virtually no detectable scar.
- Less tissue is removed in patients with dry eyes to avoid exposing more of the eye to the air, which can cause symptoms to worsen.
- Your surgeon also may use a laser to enhance the procedure by resurfacing skin and smoothing wrinkles in the eyelid and eyebrow area.
What are my options?
A surgeon who is board-certified in plastic surgery will choose the right procedure for you based on your physical characteristics and aesthetic concerns.
Your surgeon will place the incision line at the natural eyelid crease through which he or she will remove excess skin, muscle, and fat. Lasers may be used to remove this excess tissue to reduce swelling and bruising.
There are a number of options for performing lower eyelid surgery:
- The traditional approach places the incision just below the eyelashes, trimming, and/or repositioning excess skin and fat, and tightening the lower eyelid muscle.
- In the transconjunctival approach, effective in improving lower eyelid bags and puffiness, your surgeon places the incision inside the eyelid. Your surgeon can remove excess fat through a transconjunctival incision, but not excess skin.
- The ‘skin pinch’ blepharoplasty removes only a bit of skin. This is effective if you have strong lower eyelid support and only a little extra skin. In some patients laser resurfacing can both tighten excess skin and remove wrinkles.
- The use of hyaluronic acid (HA) fillers is a non-surgical alternative for the lower eyelids. Restylane, Juvéderm, and other soft tissue fillers can be injected into the tear trough (crescent-shaped under-eye area) to rejuvenate the appearance of the under-eye area. Results are varied and last approximately six months.
What will my eyelid surgery incisions and scars be like?
Upper eyelid surgery
Your surgeon will mark the natural lines and creases of your lids and keep your scars as hidden as possible along these natural folds. Fine sutures will be used to close the incisions, thereby minimizing scar visibility.
Lower eyelid surgery
In traditional blepharoplasty, your surgeon will make the incision in an inconspicuous site along the lash line and smile creases of the lower lid. In a transconjunctival approach, your surgeon corrects eyelid puffiness caused by excess fat by making an incision inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin.