What to Expect with Eyelid Surgery

What You Need to Know With Eyelid Surgery

Eyelid surgery is called blepharoplasty.  Since there are upper and lower eyelids, there are upper and lower blepharoplasty procedures.

When you look in the mirror, do you have concerns about the puffiness or sagging of your eyelids? Aging signs such as eyelid puffiness and sagging can add years to your appearance and leave you looking much older. Fortunately, there are safe surgical options.

With a blepharoplasty, you can refresh your appearance by treating aging issues of the eyelids. Since eyelids have  relatively thin skin, they are more prone to the effects of aging. Loss of skin elasticity leads to wrinkles and sagging that can cause the eyes to look tired. The blepharoplasty rejuvenates your appearance by removing excess skin and puffiness.

Upper Eyelid Surgery

For the upper lid, excess skin is called hooding.  In severe cases of hooding, the visual field can be obstructed.  In milder cases, hooding just looks “tired” and “old”.  Upper eyelid skin can be removed rather easily in the office under local anesthesia.  However, the goal is never to remove as much skin as possible.  Removing too much skin will impart an aged, hollowed-out appearance and be terribly counterproductive.

Often, conservative skin resection is the goal to preserve fullness of the upper lid.  In fact, plastic surgeons frequently inject fat into the upper eyelid sulcus to restore the fullness present in youth.  Combination of skin excision and fat injection can be powerful in restoring beauty to this area.

Lower Eyelid Surgery

Lower lids are a bit more complicated.  A combination of excess skin and fat may be the culprit in creating that tired or old look that you have grown to hate.  Skin excision of the lower lid can be treacherous territory.  The unfortunate reality is that skin in the lower lid does not heal as predictively as skin in the upper lid.  Too much skin excision can result in an ectropion, which is a scar contracture of the lower lid.  While sometimes this condition resolves, other times it may require surgery, such as a canthopexy to tighten the lower lid.

When there is protruding fat from the lower lid, fat removal can improve the appearance drastically.  Cosmetic surgeons perform fat removal with or without conservative skin excision.   Or, rather than removing fat,  a plastic surgeon may instead transpose fat to cover the rim  of the eye. This tissue then blends into the lid-cheek junction to fill out hollowing.  This procedure is called fat repositioning blepharoplasty. Lower eyelid surgery is a bit more invasive than upper lid surgery. Therefore, plastic surgeons almost always perform it under sedation or general anesthesia.

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