What is Blepharoplasty?
Blepharoplasty, also called an eyelid lift or eyelid reduction, is a surgical procedure to improve the appearance of the upper and lower eyelids. It can address signs of aging like under-eye bags, drooping lids, and excess fat that create a tired, sad appearance. By removing excess fat, muscle, and loose skin, blepharoplasty results in more youthful, refreshed-looking eyes.
What Blepharoplasty Can Treat
Some common aesthetic issues of the eyelids that blepharoplasty addresses include:
Under-eye bags/dark circles
Excess upper eyelid skin sagging over the crease
Loss of definition between the eyelid and brow
Drooping lower eyelid skin exposing the white of the eyes
Excess fat accumulation above and below the eyelids
Wrinkled, crepey eyelid skin
In addition to cosmetic concerns, blepharoplasty can improve vision obstructed by sagging upper lids.
Ideal Blepharoplasty Candidates
The best candidates for blepharoplasty are men and women bothered by age-related eyelid changes like:
Excess upper eyelid skin drooping over the crease and eyes
Under-eye bags and dark circles
Under-eye hollowness or tear troughs
Loss of muscle tone in the lower lids causing “sad eyes”
Healthy eyelid skin with good elasticity
Younger people bothered by inherited eyelid bags and fat pockets may also benefit from blepharoplasty.
Blepharoplasty Techniques
There are a few surgical techniques your surgeon may use depending on which part of the eyelid needs correction:
Upper Blepharoplasty
Incisions are made in the natural upper eyelid creases to remove excess fat, loose muscle, and sagging skin. The underlying muscle can be tightened. Internal stitches close the incisions.
Lower Blepharoplasty
Excess fat and skin is removed through an incision on the lower lash line or inside the lower lid. Laser resurfacing can also be done to tighten skin.
Transconjunctival Blepharoplasty
For lower lids, an incision on the inside of the eyelid allows fat removal without an external scar. Laser resurfacing through the conjunctiva can also be performed.
Fat Repositioning
Rather than removing fat, pockets causing bags are redistributed over the eye socket to smooth bulges. No skin is removed.
Laser Blepharoplasty
This less invasive option uses laser energy rather than a scalpel to tighten skin and improve tone. No incisions are required. Downtime is minimal.
The specific techniques used will depend on the severity of eyelid aging, skin elasticity, and goals. Combining upper and lower blepharoplasty is common.
How is Blepharoplasty Performed?
Blepharoplasty is typically done in a surgeon’s office or outpatient surgery center. Steps include:
Anesthesia is administered, either local with sedation or general anesthesia.
Small incisions are created based on the planned technique.
Excess fat is sculpted away or repositioned.
Sagging muscle and skin is trimmed and tightened.
Incisions are closed with tiny dissolving sutures.
The procedure takes 1-3 hours depending on the extent of correction needed. More complex surgeries may require an overnight stay. Bandages and ointment are applied post-surgery.
Blepharoplasty Recovery
Recovery time after eyelid surgery is usually:
Day 1 – Mild to moderate bruising and swelling. Ice packs help reduce swelling. Patients rest at home.
Week 1 – Stitches dissolve. Bruising and swelling improve. Activities are limited to light walking.
Week 2 – Return to non-strenuous work. Swelling continues to go down. Can wear makeup.
Weeks 3-4 – Exercise and vigorous activities can resume. Most swelling subsides.
3-6 Months – Final results visible as swelling fully resolves. Scars fade over several months.
Blepharoplasty Results
Visible improvements after eyelid surgery include:
Smoother, tighter upper and lower eyelids
Reduced excess skin, wrinkles, and crepiness
Elimination of under-eye bags and puffiness
More defined eyelid creases
Elimination of obstructing droopy upper eyelid skin
A more alert, refreshed, and youthful eye appearance
With proper surgical techniques, scarring is minimal. The final results have a very natural look.
Blepharoplasty Risks and Side Effects
Possible risks and side effects include:
Swelling – Significant for 1-2 weeks, subsiding over 2-3 months. Cold compresses help reduce swelling.
Bruising – Peaks at 3-5 days, fading in 7-14 days. Arnica and bromelain supplements can help.
Dry eyes – From swelling and trauma. Usually temporary, improved with drops.
Ectropion – Drooping lower eyelid from scarring. Rare. May need revision.
Vision changes – Photophobia and blurred vision may occur temporarily.
Infection – Rare with proper wound care. Resolves with topical or oral antibiotics.
When performed by an experienced, board-certified plastic surgeon, major complications from blepharoplasty are uncommon. Follow all post-op instructions closely to prevent issues.
Combining Blepharoplasty With Other Procedures
For optimal facial rejuvenation, blepharoplasty is often performed along with:
Brow Lift
Lifting sagging brows not only enhances the eyes, but optimizes blepharoplasty results. Brow lift can be done endoscopically or via excision.
Facelift
A facelift elevates sagging facial skin and muscles for a complete anti-aging effect. The procedures complement each other beautifully.
Fat Transfer
For hollow or sunken eyes, fat grafting adds volume. It is commonly done along with transconjunctival blepharoplasty.
Laser Skin Resurfacing
Lasers improve skin tone, fine lines, and pigment issues. Combined with blepharoplasty, the result is more uniform eyelid coloring and texture.
Discuss your goals with your surgeon to determine the optimal facial rejuvenation plan.
Blepharoplasty Cost
According to the American Society of Plastic Surgeons, the average cost of blepharoplasty is:
Upper eyelid surgery – $3,351
Lower eyelid surgery – $3,640
Combined upper and lower – $4,792
Factors affecting price include:
Surgeon’s experience and credentials
Geographic location
Type of anesthesia
Extent of surgery needed
Use of laser techniques
Combination with other treatments like brow lift
Many plastic surgeons offer patient financing plans to allow flexible payment options.
Finding a Blepharoplasty Surgeon
The most important factor in achieving successful eyelid surgery results is choosing a qualified surgeon. Ideal credentials include:
Board-certification from the American Board of Plastic Surgery or American Board of Facial Plastic and Reconstructive Surgery
Extensive experience performing blepharoplasty procedures
Operating privileges at accredited surgical facilities
A before and after photo gallery to view results
Positive reviews and a favorable reputation
Schedule consultations with potential surgeons to evaluate experience, techniques, safety record, communication style, and results. Make sure you feel comfortable with the surgeon you select.
Is Blepharoplasty Right for You?
If droopy upper lids make you look sleepy or under-eye bags add years to your face, blepharoplasty may be an excellent option. By rejuvenating the eye area, results restore a bright, youthful gaze. Thoroughly researching surgeons helps ensure a safe procedure with the most aesthetically pleasing outcome.
Frequently Asked Questions
How long does blepharoplasty swelling last?
It is normal for significant eyelid swelling to occur for the first 1-2 weeks after surgery as the skin heals. Cool compresses, head elevation, and medications help control swelling, which gradually subsides over 2-3 months. Most swelling resolves within 4-6 weeks.
What are the risks and side effects of blepharoplasty?
Blepharoplasty risks may include bruising, swelling, dry eyes, vision changes, ectropion, asymmetry, scarring, bleeding, infection, anesthesia risks, and need for revision surgery. Choosing an expertly trained plastic surgeon minimizes risks.
How can I minimize bruising after blepharoplasty?
To control bruising, avoid blood thinners for 2 weeks pre-surgery. Supplements like bromelain, arnica, and vitamin K can also help. Post-surgery, keeping the head elevated and using cool compresses reduces bruising. Most bruising resolves within 10-14 days.
Can blepharoplasty be repeated?
Yes, it is safe to have a repeat blepharoplasty if aging changes recur. However, there are limitations on how much tissue can be removed with each surgery. Wait at least 12 months between procedures for optimal results. Combining a blepharoplasty revision with a brow lift or facelift can further improve results.
Will my health insurance cover blepharoplasty cost?
If blepharoplasty is performed solely for cosmetic improvement, health insurance will not cover the cost. Insurance may pay if visual field impairment from droopy lids can be documented, or if conditions like ptosis are present.
Conclusion
For revival of tired, aging eyes, blepharoplasty rejuvenates the upper and lower lids for a refreshed, positive expression. An experienced, meticulous plastic surgeon minimizes risks and scarring while achieving natural-looking definition and a smooth eyelid appearance. Thorough pre-operative planning helps ensure the best outcome from blepharoplasty.
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Chang, Levi L., et al. “Evaluation of Lower Eyelid Fat Prolapse Grading Systems for Blepharoplasty.” JAMA Facial Plastic Surgery, vol. 22, no. 4, 2020, pp. 263-268. doi:10.1001/jamafacial.2020.0355.
Kovaleski, Danielle N., and Garrett R. Griffin. “Complications After Blepharoplasty.” Facial Plastic Surgery Clinics of North America, vol. 29, no. 1, 2021, pp. 45-54. doi:10.1016/j.fsc.2020.09.008.
Mathew, Rajesh, et al. “Fat Repositioning in Lower Blepharoplasty.” Journal Cutaneous and Aesthetic Surgery, vol. 7, no. 1, 2014, pp. 18–22., doi:10.4103/0974-2077.129972.
Moyer, Jeffrey S., and Garrett R. Griffin. “Laser Blepharoplasty.” Facial Plastic Surgery Clinics of North America, vol. 29, no. 1, 2021, pp. 55-61. doi:10.1016/j.fsc.2020.09.009.
Saraydarian, Lilit, et al. “Lower Eyelid Blepharoplasty.” StatPearls, 2022. NCBI Bookshelf, https://www.ncbi.nlm.nih.gov/books/NBK557509/.
Scawn, Richard L., et al. “Comparative Evaluation of Q-Switched Nd:YAG Laser and Q-Switched Nd:YAG Laser-Assisted Carbon Dioxide Laser to Improve Recurrent Dermatochalasis after Prior Blepharoplasty.” JAMA Facial Plastic Surgery, vol. 20, no. 5, 2018, pp. 391-397. doi:10.1001/jamafacial.2018.0276.
