Eyelid surgery or blepharoplasty is a procedure that will re-shape and rejuvenate the upper or lower eyelids, resulting in a more alert, youthful, rested appearance. While in the past many surgeons performed an aggressive excision of tissue during eyelid surgery, Dr. Farris’ philosophy is to re-contour and replenish the eyelids and perform only a conservative excision of excess skin, muscle and fat. This avoids further rapid aging associated with tissue loss. The area around the eyes can be further rejuvenated with additional procedures like a brow lift, fat transfer and injectables.
Who is a candidate for eyelid surgery?
If you feel that your eyes make you look tired or sad and you have excess hanging skin associated with your eyelids, a puffy appearance, or bags and dark circles under your eyes, you may be a good candidate for eyelid surgery. If you have thyroid problems, dry eyes, glaucoma, diabetes or high blood pressure, you should check with your eye or medical doctors before proceeding with surgery.
How is eyelid surgery performed?
The eyelid surgery is typically performed under limited anesthesia and lasts about 1-2 hours. Before the procedure begins, Dr. Farris will mark your eyelids while you’re sitting. For the upper eyelids, the incision is placed at the natural eyelid crease and provides access to remove the excess skin, muscle and fat. The incision at the lower eyelid is placed just below the lash line. At times, the tissue of the lower eyelid is tightened with a “lateral canthopexy.” For situations where there is excess fat without excess skin at the lower eyelid, a transconjunctival approach can be utilized by making an incision on the inside of the lower eyelid without any external incisions. Incisions are closed meticulously with fine sutures.
What to expect after surgery?
Dr. Farris and his staff will provide specific instructions regarding your eyelid surgery. There is minimal postoperative pain. Tearing or dry eyes and tightening of the eyelids often occur immediately after surgery and resolve over time. The bruising and swelling should subside by 1-2 weeks. Apply cold compresses around your eyes for the first few days and keep your head elevated above your chest while sleeping for the first week. Dr. Farris will prescribe eye drops and ointment for specified use. If non-absorbable stitches were used, they will be removed by the fifth day. You may apply make-up after that. Use dark sunglasses to protect your eyes for the first 2 weeks. Avoid strenuous activity or exercise for the first 3 weeks. The scars from blepharoplasty tend to heal very well and are often inconspicuous.
- Where are the scars placed for eyelid surgery, and are they visible?
Because of the thin skin of the eyelids, scars tend to fade very well and become imperceptible. The upper eyelid scar is placed within a natural crease and the lower eyelid scar is just below the lash line; both may extend into natural creases laterally.
- Will an eyelift affect the appearance of my eyebrows?
An upper eyelid surgery removes the excess redundant skin between your brow and lash line. If this excision is too aggressive, it may lower the position of your brow. Furthermore, your brow position should be evaluated independently and may require a brow lift or non-surgical treatment to improve position.
- At what age is it appropriate to have an eyelid surgery?
There is no “usual age” to have eyelid surgery. Since the area around the eyes tends to be one of the first areas to demonstrate the signs of aging, the youngest patients tend to be in their upper 30s or early 40s. Also, there are some people who put it off until later.
- What is the downtime after eyelid surgery?
Expect to have bruising and swelling up to 2 weeks. This may be shorter but depends on each individual. Swelling tends to peak around the third day and then begins to subside afterwards. Scars are initially reddish and noticeable but fade very well and become imperctible as you heal. After 5-7 days, you can use concealer makeup like Dermablend. To be safe, do not plan any important social event or appointment within the first 2 weeks.
- Is there anything I can do to reduce the swelling and bruising after eyelid surgery?
It is crucially important that you keep your head elevated as much as possible and apply ice packs or cold compresses around your eyes. When sleeping, prop your head up with 4 pillows. You often hear to use ice packs for the first couple of days – I’ve found much benefit if you keep using the ice packs up to 5-7 days after surgery. Also, use Arnica Montana supplement before and after your surgery to help reduce the swelling and bruising. Refrain from any strenuous activity or heavy lifting for 3 weeks after your surgery.
- What causes lower eyelid malposition?
When excessive skin is resected from the lower eyelid, it can lead to the eyelid being pulled down and out (ectropion) due to scarring. This can also occur if the portion of the orbicularis muscle closest to the lash line is damaged. In this situation, you would see the white part of the eye (sclera) between the lower eyelid lash line and your pupil. This condition typically requires surgical correction. Occasionally after surgery, swelling in the eye may push out the lower eyelid causing some malposition as well. However, this situation is reversible and improves with resolution of the swelling. In this case, it would be important to maintain moisture of the eye, tape the lower eyelid upward for support, massage the lower eyelid upwards and apply steroid eye drops for the swelling. Dryness of the eye can contribute to swelling so it’s important to maintain moisture with eye drops or lube.
- Will an eyelift get rid of wrinkles (crow’s-feet) lateral to the eyes?
If the eyelid incision is extended laterally, this will address the crow’s feet but also leave a longer scar. Instead, an excellent option to treat the fine wrinkles at crow’s feet would be either Botox or Dysport neurotoxin injection.