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Got tired eyes or bags under the eyes? You might want to consider eyelid surgery, also referred to as an eye lift. This procedure, called blepharoplasty is a surgical procedure that reduces bagginess from lower eyelids and removes excess skin from the upper eyelids.

The procedure involves the removal of excess skin, muscle, and underlying fatty tissue. While it is primarily a cosmetic procedure, an eye lift is also an effective method for improving sight in older patients whose sagging upper eyelids obstruct their vision.

An eye lift will not eliminate dark circles under the eyes, remove crow's feet, or other facial wrinkles. It is often performed in conjunction with other procedures such as laser resurfacing or forehead lifts.

The Eyelid Aging Process

As skin ages, it gradually loses its elasticity. A lack of elasticity, combined with the constant pull from gravity causes excessive skin to collect in the upper and lower eyelids. Excess skin on the lower eyelid causes wrinkles and bulges and on the upper eyelids an extra fold of skin forms which can hang over the eyelashes and obstruct vision.

Bulges in the upper and lower eyelids can also be caused by the fat that cushions the eyeball from the skull. The thin membrane that holds the fat in place weakens with age, allowing the fat to protrude into the lids.

Who Is a Good Candidate for Eyelid Surgery?

The best candidates for an eye lift are individuals with good physical and mental health who have realistic expectations. Most are 35 years or older, but if baggy eyelids or droopy eyelids are hereditary, you may decide to have the surgery at a younger age.

Eyelid surgery can enhance your appearance and help build your confidence. However, it may not result in your ideal look or cause people to treat you any differently. An eye lift will not alter your facial structure. It is important to know your face well before you decide to have surgery. Think carefully about your expectations and discuss them with your surgeon.

Will the Results of Eyelid Surgery Be Permanent?

An eye lift will not stop your eyes from aging. However, the procedure is usually very long lasting. Upper eyelid surgery can last anywhere from five to seven years to an entire lifetime, while lower eyelid surgery rarely needs to be done more than once.

If your lids are once again sagging, the proper procedure is oftentimes a forehead lift, not another eye lift.

How Should I Prepare for Eyelid Surgery?

You will need to have another person drive you home after your surgery. You should also have someone stay with you the night of the procedure.

Expect and plan to stay home from work and limit your activities for several days after surgery to give your eyelids a chance heal. Some patients experience dry eyes after surgery, but the condition rarely lasts more than two weeks. If you have dry eyes lasting more than two weeks, contact your doctor.

At home, you should have the following items readily accessible:

• Ice cubes



• Ice pack or you can use freezer bags filled with ice, frozen corn or peas.



• Small gauze pads



• Eye drops or artificial tears (ask your doctor to recommend the proper type to meet your particular needs)



• Clean washcloths and towels



• Over-the-counter painkillers (which your doctor can recommend). Advil, Motrin, Naproxen, Aleve, and aspirin should be avoided due to the increased risk of bleeding.

How Is Eyelid Surgery Performed?

An eye lift usually takes about two hours if both upper and lower eyelids are done together. Your doctor will most likely use local anesthesia (a painkiller injected around the eye) with oral sedation.

If you are having the procedure completed at a hospital or surgical center, you will most likely receive intravenous sedation.

If you're having all four eyelids done, the surgeon will probably work on the upper lids first. The surgeon will usually make incisions following the natural lines of your eyelids. Through these incisions, he or she will separate the skin from the underlying tissue and remove the excess fat, skin and muscle. The incisions are then closed with very small sutures. There will be sutures in both upper lids that will remain for three to six days. The lower lids may or may not require sutures depending upon the technique used.

Surgery on the lower eyelids may be done using one of several techniques. The transconjunctival technique is performed by making an incision inside the eyelid. No incision is visible following surgery. Through the incision, fat may be removed to correct baggy lower eyelids. Then, fine lines in the skin can be softened using a C0₂ or erbium laser.

Another method, called the transcutaneous technique requires an incision along the eyelash margin. Through the incision, excess skin, loose muscle and fat can be removed. The incision line fades after a short time.

After either of these procedures, laser resurfacing may be recommended.