A blepharoplasty is another name for surgery of the eyelids, it refers to removing and repositioning excess skin, fat and sometimes muscle to rejuvenate the area around the eyes. The beauty of the eyes not only involves excess skin (even though is usually the most common complaint). The “bags” that appear under the eyes have two origins, there is either excess fat behind the eyes (herniated fat) or swelling of the lower lid/cheek area (aka malar bags). The fat can be usually either excised or repositioned to restore the youthful look between the eyelid and cheek. The tissues around the eyes may also need to be modified to enhance the shape or the appearance of the eyes (eg. lid tightening procedures or a brow lift). For example a lift may be needed to raise the brow at the outer corners of the eye or modify or partially remove the frown muscles in between your eyes (the corrugators); these can be done through the incisions on the upper lids done to take out the excess skin; or you can treat with a neuromodulator (botox, dysport or xeomin) to lift brows and soften the appearance of wrinkles. In addition our plastic surgeons may discuss other adjunctive procedures such as a mid or full face lift, chemical peels, laser resurfacing, fat transfers, neuromodulators or fillers to achieve a more natural and rejuvenated look.
The surgery for an eyelid lift may be done with local anesthesia but will usually require sedation for the procedure, especially if multiple procedures are being considered.
Most commonly an incision is done on the upper and / or lower lid and the excess skin is removed after the area is injected with local anesthesia, there are certain fat pads that create bulges that are removed or sometimes repositioned to improve the outer contour. The recovery consists of head elevation, cold compresses, lubrication and eyes drops to keep the eyes comfortable and minimize swelling and bruising. Recovery time varies per patient but you can expect to have swelling and bruising of your eyelids and cheek area for about a week.
In addition there are certain internal or external sutures that are used to add support during the postoperative healing period and help avoid complications. This is routinely done by our surgeons who want to ensure your safety.
In selected cases the lower lid surgery can be done through the inside of the lower lid (transconjuctival approach) to remove the fat. This minimally invasive approach can treat the bags under the eyes with no visible incisions.