Do You Need Blepharoplasty?

By Dr. Samir Shah

What Is Blepharoplasty?

Leer: ¿Necesita blefaroplastia?
At present, the word Blepharo means eyelid and plasty means plastic surgery involving a specified part of the body. According to the National Library of Medicine, the origin of the word Blepharoplasty is Greek (Blepharon – meaning eyelids, and Plastikos – meaning to mould) and was first coined by Karl Ferdinand von Gräfe in 1818 who used this technique to repair eyelid deformities caused by cancer.¹

Today, blepharoplasty is a surgical procedure to remove excess skin around the eyes and can be performed on the upper lids, lower lids, or both.

What Condition Does Blepharoplasty Treat?

Eyelid surgery may be necessary to some but is often performed for cosmetic reasons. Here are a few ways that Blepharoplasty can help:

• Excess & Sagging Skin – As people age, our bodies change and sometimes these changes can impact our quality of life. Our skin is our greatest protector, but over time our collagen and elastin production slows, and natural plus environmental factors like sun damage reduce skin elasticity which then causes our skin to sag. Excess and sagging skin is also a lower eyelid problem as we get older. We can do our best to avert the sag and wrinkles with eye creams and serums or non-surgical options like dermal fillers, chemical peels, and microneedling, but sometimes a surgical eyelid rejuvenation is the best option. An Eyelid Lift removes excess eyelid skin and tightens the remaining skin for an improved, younger appearance.
• Upper Lid Drooping – When the eyes are partially covered by folds of loose or sagging skin from the upper eyelids, it can impact a person’s ability to see. In cases where vision has been impaired, Blepharoplasty Ptosis Surgery will be performed to remove excess eyelid skin, lift the eyelid, and tighten the skin that remains, thus removing the folds that were affecting their vision.
• Lower Lid Drooping – Some individuals’ lower eyelids droop to such an extent that the white below the iris is revealed. Through a Lower Blepharoplasty, the excess eyelid skin, orbital fat, and muscle are removed or redistributed which restores tone and tightness to the area.
• Eye Bags & Puffiness – Tissue and muscles that support your eyelids weaken due to aging and cause the dreaded eye bags. As the skin begins to sag, the normal fat surrounding your eye moves below your eyes causing a bag-like appearance. Sometimes this area can also fill with fluid which increases puffiness and looks swollen. If you have chronic eye bags, it could be a genetic condition, a medical condition, or due to acquired causes like environmental allergies, among other things. Lower Blepharoplasty removes or repositions the fat and skin that has shifted to the under-eye area thus reducing the appearance of eye bags and puffiness.
• Fat Deposits – Weight gain may cause fat deposits to develop around the eyes. Even if you lose weight, fat deposits around the eyes may remain. Since you can’t exercise your eyes and there is no effective treatment to reduce these puffy fat deposits, Blepharoplasty is the most successful option. During surgery, excess fat can be removed or partially repositioned for a more youthful appearance.

Who Are Candidates For Blepharoplasty?

The best Blepharoplasty candidates typically experience hooding of the upper eyelids, have a tired look and bagginess of your lower eyelids, and are generally healthy. Usually, Blepharoplasty patients are over 30 years old. As with any surgery, candidates should be nonsmokers.

How Is Blepharoplasty Performed?

While sitting in the upright position, the excess amount of skin is marked on upper eyelid and the positions of pockets of fat are marked on the lower eyelids. Eyelid surgery can be performed under local, twilight, or general anesthesia.

Upper Eyelid Surgery – The skin incision is made in the upper eyelid crease where it will be hidden. Excess skin is removed. Many times, a strip of underlying muscle is removed along with pockets of protruding fat. Then the incision is closed with dissolvable sutures and non-absorbent sutures.

Lower Eyelid Surgery – The incision is made under the eyelashes or inside the lower eyelid. Excess fat is removed or partially repositioned to fill hollowness under the eyelid. Then the incision is closed with dissolvable sutures and non-absorbent sutures.

Blepharoplasty surgery generally takes between 1 and 2 hours depending on what type of eyelid surgery is being performed.

Care After Surgery

Patients are advised to sit with their heads elevated, keep cold wet compresses to eyes, and minimize strenuous activities. They should use topical antibiotic ointment on the suture to prevent infection and take pain relievers only when needed. Avoid ibuprofen and aspirin while recovering from surgery.

Usually there is some swelling, bruising, and minimal discomfort. Sutures are usually removed within 5 days.

Results appear gradually as you heal, and recovery is usually complete within 7 to 10 days after eyelid surgery.

How Long Do Blepharoplasty Results Last?

It varies with each individual but on an average eyelid surgery results can last up to eight to ten years as natural aging occurs.

¹Subramanian N. Blepharoplasty. Indian J Plast Surg. 2008 Oct;41(Suppl):S88-92. PMID: 20174547; PMCID: PMC2825121.