Eyelid Surgery (Blepharoplasty)

  • Medical Author: Adam J. Cohen, MD FACS
  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is eyelid surgery (blepharoplasty)?

An eyelid lift, or blepharoplasty, is a procedure to remove skin and to add or remove fat from the eyelids. The term "eyelid lift" is a misnomer because the eyelid is not truly lifted during surgery.

Upper blepharoplasty surgery uses incisions to allow for removal of skin and fat. A thin stitch is then used to bring the skin together to allow for a creation of an eyelid crease.

Lower eyelid surgery can involve skin incisions directly below the lash line or an incision on the inside of the eyelid, called a transconjunctival approach. The transconjunctival approach allows for access to the eyelid without visible incisions, making this technique perfect for patients who need fat removed or added. This approach can be combined with laser resurfacing of the eyelid skin to reduce lines and wrinkles.

Why is eyelid surgery performed?

Upper eyelid excess skin and fat can create a heavy looking eyelid, aged appearance, puffiness, and sometimes block the upper field of vision. Upper blepharoplasty is performed to remove excess skin and fat and can improve the field of vision.

Double eyelid surgery, also called Asian eyelid surgery, is performed to create or enhance an upper eyelid crease. This type of surgery is performed on Asian people to "westernize" the appearance of the eyelid.

Lower blepharoplasty can be performed to remove excess skin and improve the contour of the eyelid by adding or removing fat. Sometimes tightening the eyelid is needed to correct sagging, while laser skin resurfacing can be used to improve wrinkles and skin texture.

Who is a good candidate for eyelid surgery?

Those individuals with realistic expectations who are in good health are suitable for eyelid surgery.

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Blepharoplasty Before and After Pictures

About 14 million cosmetic procedures are performed annually in the U.S.

See before and after pictures of common cosmetic surgery procedures such as blepharoplasties, rhinoplasties, and facelifts.

How does one prepare for eyelid surgery?

Prior to eyelid surgery, the patient should have a detailed examination and discussion about blepharoplasty and potential risks and benefits associated with the procedure. The patient should follow the doctor's preoperative instructions carefully and thoroughly review the postoperative instructions before the day of surgery. This will allow the patient to have any medications for pain relief or necessary items such a gel packs, artificial tears, and gauze at home prior to their return from surgery.

A physical may be required to have your medical doctor "clear" you for surgery if intravenous sedation or general anesthesia is used.

How long is the recovery time for eyelid surgery?

Patients usually have a short recovery time after blepharoplasty. Although bruising and swelling is usually worse on the day after surgery, they quickly begin to disappear. During the first 48 hours, the use of cool compresses can greatly reduce bruising and swelling around the eyes and face. Light activity such as walking will also help speed healing. Thin bandages are usually placed over the incision sites and removed in several days, while the stitches can remain in the skin for about a week. Sometimes self-absorbing stitches are used that do not require removal.

Most people return to normal activities after seven to 10 days following blepharoplasty. By two weeks after eyelid surgery, the majority of the bruising and swelling will resolve.

What are the potential risks and complications of eyelid surgery?

As with any surgery, there are potential risks and complications of blepharoplasty. The major risks include infection, bleeding, scarring, inability to close the eyes, dry eye, abnormal eyelid position, double vision, and loss of vision.

How much does eyelid surgery cost? Does insurance cover the cost of blepharoplasty?

The cost of eyelid surgery depends on the type and complexity of the procedure performed.

Insurance carriers will only cover the cost of upper eyelid surgery if the patient has obstruction of their visual field. This must be documented during an examination with formal visual field testing and photographs. Some insurance carriers require submission of the visual fields and photographs before approving the blepharoplasty as a medically indicated procedure.

REFERENCE:

"Eyelid Surgery: Blepharoplasty," American Society of Plastic Surgeons.

Last Editorial Review: 4/26/2016

Reviewed on 4/26/2016
References
REFERENCE:

"Eyelid Surgery: Blepharoplasty," American Society of Plastic Surgeons.

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