Blepharoplasty is a surgical procedure to repair excessive skin and “swelling” eyelids. It is becoming one of the most common elective surgeries performed. The apparent swelling is usually a natural result of the aging process or, less frequently, a result of a disease state that causes the muscles around the eyes to degenerate. Regardless of the cause, the face and especially the eyes are considered key to a person’s appearance. The desire to correct the cosmetically bothersome condition is very common.
The surgeon will first take pictures of your eyes, and will probably ask for pictures of you taken before the condition was present. A thorough history and physical exam to determine health status before the surgery will be taken. Sometimes only the skin is removed; at other times fat tissue is removed as well.
Certain conditions can make the procedure more risky, such as thyroid disease, dry eye syndrome, diabetes, heart disease including high blood pressure and certainly any eye disorders (cataracts, glaucoma). An ophthalmic exam will also be necessary to detect any eye disorders, and to measure vision and eye movement before the surgery.
Your surgeon will review with you the risks of performing the surgery. These include bleeding, infection, the general risks associated with anesthesia, and post-blepharoplasty risks such as:
- vision changes
- vision loss ( including blindness; rare)
- worsening of dry eye
- chronic irritation
- permanent scarring
- ectropion – the turning out of the eyelid, or the pulling away of the eyelid from the eye, making complete closure of the eyelid(s) not possible
Blepharoplasty is usually performed using local anesthesia, and is done on an outpatient basis. First, the surgeon will mark the areas of the eyelids that will be repaired. Next, the anesthetic will be injected into the skin and tissue surrounding the eyelid.
The surgeon begins removing the tissue by making incisions in the natural creases (crow’s feet) that exist around the eye. This will make the scarring almost invisible. Excess fat may be removed as deemed appropriate. The skin is then closed with tiny sutures. Topical antibiotic ointment is applied to the site, and sometimes cold compresses to reduce swelling. A bandage may or may not be applied. Due to swelling and effects from the anesthesia, you will need someone else to drive you home. Your vision may be affected for several days.
Immediately after surgery, you should keep cold compresses on the surgical site and use the prescribed antibiotic to prevent infection. Pain medication will be prescribed before you leave the medical facility. If necessary, you will need to wear glasses for vision correction for a couple of weeks – no contact lenses. Limit your physical activity until after your next doctor’s appointment. Your doctor will tell you when you can return to strenuous activities. Stitches may need to be removed within days after surgery.
Bruising should disappear in 2 to 3 weeks, and complete recovery and corrected appearance should be obtained in 4 to 6 weeks. The pink scars may not completely fade for 6 months to a year after surgery.