Since the beginning of time, images of our eyes have permeated our art, literature and culture. It defines us in many ways. It is therefore understandable why we are so focused on the aging of our eyes. Changes in the appearance of our eyes are often the first external sign that we are getting older.
In my practice, a blepharoplasty is an essential tool to maintain and enhance one’s facial beauty. I really enjoy this procedure, as well as providing the service to Denver area residents. It requires a delicate touch, an artistic approach and a full understanding of the local anatomy. More importantly, our patients are really pleased with the results as it is transformative and has the potential to last for decades. But a blepharoplasty must be approached with care. The eyelids are complex structures that are very unforgiving. Therefore it is extremely important to seek out an expert who has experience with these types of procedures.
A blepharoplasty is one of the most common in office procedures that we perform. It avoids the need for an operating room and general anesthesia, which my patients appreciate. Using a small amount of local anesthesia, the procedure takes less than 1 hour to complete and has a fairly painless recovery period. Furthermore, it works very well as combination procedure with laser treatments and fat transfer.
- The most common complaint in my clinic involving the upper eyelids and brows is “heaviness”.
- The upper eyelids and brows are easily rejuvenated in the office under local anesthesia. This minimally invasive procedure takes less than 1 hour to complete and has a fairly painless seven-day recovery period. The incisions utilized for these procedures heal very well and the scars are rarely visible.
- The results of a blepharoplasty are improved with the addition of laser treatments around the eyes and face.
- Although bagginess and crepe skin of the lower eyelid is slightly more difficult to treat, many treatment options exist.
- The excess ‘herniated’ fat of the lower eyelid, which leads to the baggy appearance, is removed from inside the eyelid. This is called a transconjunctival blepharoplasty and avoids having any visible scars on the eyelid.
- In a more advanced procedures, I often re-use the removed lower eyelid fat to augment (plump up) the tear trough area. This allows for a permanent change in this deep crease near the nose and decreases the need for fillers after surgery.
- The crepe skin of the lower eyelid is addressed with either a skin tuck, a laser treatment or both combined. These surgeries are either completed in the office or the operating room.
- As with the upper eyelid rejuvenation procedures, the recovery time for lower eyelid procedures is around seven days. If lower eyelid fat is also transferred to the tear trough area, bruising may occur and therefore may delay return to more public activities. In general, patients have only mild discomfort from these procedures and the swelling and bruising is drastically reduced if ice is applied to eyes for 24 to 48 hours after surgery.
- Eyelid procedures are often combined with other facial rejuvenation procedures. For example, a majority of my patients who chose to undergo a mini-facelift procedure also address their eyelids at the same time.
Frequently Asked Questions
1. What is the recovery like for a blepharoplasty of the upper eyelids?
This is surgery is very easy to facilitate as it is completed in my office. It takes less than 1 hour and the use of local anesthesia avoids the unwanted after effects of general anesthesia like headaches and nausea. The procedure is painless and the recovery is very manageable. The most common finding post-operatively is swelling and bruising which is contained and is easily covered with sunglasses. In general, swelling and bruising will completely resolve within 7 days if ice is applied to the eyes on a regular basis after the procedure. The sutures are removed 5 to 7 days after surgery. After that time, make up can be applied to the area of surgery. Most patients return to normal activities like work within 3 to 7 days of the procedure. Exercise activities are initiated at 2 weeks. Pain is present for the first 2 to 3 days after surgery but is well managed with oral pain medications. The discomfort resolves quickly and most patients discontinue the pain medication 4 to 5 days after surgery. To decrease the bruising post-operatively, we use a combination of homeopathic medications (Injury) and LED light treatments. When combined with ice application, the time of bruising and swelling can be reduced to less than 5 days and in our office averages less than 4 days.
2. What is the recovery like for a lower eyelid blepharoplasty?
There is a lot of similarities between upper and lower eyelid surgery eyelid. In my practice, a majority of the lower eyelid blepharoplasties are completed in the office with local anesthesia (greater than 60%). The more complicated procedures, the ones that require stabilizing techniques and fat transfer, are completed in the operating room with I.V. sedation or general anesthesia. The recovery time is very similar, as most patients return to normal activities within 5 to 7 days of the surgery. The swelling and bruising tends to be more pronounced after surgery on the lower eyelid. Therefore, the post-operative bruising treatment protocol that we have implemented in our office (see #1) is extremely important to quicken recovery.
3. How do the scars look after this procedure?
With a correctly orchestrated blepharoplasty, the scars are nearly invisible. This is especially true for the upper eyelid, where the scar is placed in the natural crease. As for my lower eyelid cases, a majority have no external scars. I preferentially complete the case from inside the eyelid (transconjunctival approach) thus avoiding external scars and decreasing the tendency of the lid to pull down after surgery.
4. What do you do if the eyelids for each eye look different?
Eyelid asymmetry is normal and very common. Often I have patients that have one eyelid that hangs over much more than the other. These asymmetries have many causes and often involve other structures like the eyebrow. But, patients should feel re-assured that fixing asymmetries is standard procedure with a blepharoplasty and in a majority of cases the asymmetry can be completely removed.