What Is Blepharoplasty?

You might have heard blepharoplasty described as “eyelid surgery” or “ eyelid lift.” As those names suggest, blepharoplasties involve removing eyelid fat and skin. People get them for cosmetic reasons, and sometimes to improve their vision.

Blepharoplasties do not take a long time. You should also recover quite quickly from this procedure, which has a high satisfaction rate. However, it is very important to find properly trained surgeons for a blepharoplasty. Doing so is key to lowering the risk of complications.

Overview

Andrea Kossler, MD, an associate professor at Stanford University in California, describes blepharoplasty as a “common procedure” with a “very high satisfaction rate.” Patients who undergo a blepharoplasty often “look and feel better,” and can sometimes “see much better as well.”

Why Is a Blepharoplasty Done?

Research shows that many people who undergo a blepharoplasty do so for cosmetic reasons. In such cases, surgeons often remove excess or redundant skin. They might also remove excess eyelid fat.

How Is a Blepharoplasty Performed?

1. Making a cut along the eyelid crease, a natural fold of eyelid skin
2. Removing excess fat, skin or muscle
3. Closing the cut, usually hiding the scar in the natural fold of the eyelid

For a lower eyelid blepharoplasty, surgeons typically follow these steps:

1. Making a cut on the inside of the lower eyelid, or just below the lower eyelashes
2. Moving or removing fat from the bags under the eyes, sometimes alongside a small amount of skin
3. If required, supporting the muscles and tendon of the eyelid
4. Closing the cut

• Precision scalpels
• Forceps
• Disectors

How Do I Prepare for a Blepharoplasty?

Preparation for a blepharoplasty can vary from person to person. However, Dr. Kossler says that the following tips can be helpful:

• Stopping blood thinners before surgery
• Not smoking cigarettes, as this can decrease wound healing
• Going into surgery with a clean face, no makeup, and no fake eyelashes
• Keeping any preexisting health conditions under control

Thomas Hagopian, MD, of Hagopian Plastic Surgery in Atlanta, notes that contact lens wearers should plan to wear glasses while recovering from blepharoplasty. You should also consider a sleeping setup that allows you to sleep in a slightly upright position. This can help reduce swelling after surgery.

What Should I Expect During a Blepharoplasty?

A blepharoplasty can take place under local or general anesthetic. You should speak to your doctor about which, because this can make a difference to how you prepare. For instance, having a general anesthetic might require you to fast for some time before surgery.

What Are the Potential Risks Associated With a Blepharoplasty?

Any operation carries some common risks. Research shows that a blepharoplasty comes with the following generic operative risks:

• Excessive bleeding
• Blood clots
• Infections
• Allergic reactions to the anesthetic

What Type of Care Is Needed Following a Blepharoplasty?

• Strenuous activity
• Swimming
• Smoking
• Wearing contact lenses
• Rubbing your eyes

Follow any advice from your doctor about steps to improve recovery. These might include:

• Propping your head up with pillows when resting
• Gently cleaning your eyelids with prescribed ointment or eye drops
• Applying a cold pack to your eyelids
• Wearing sunglasses in sunny or windy conditions
• Taking acetaminophen or other pain medication, as needed

What Are the Possible Complications and Side Effects of a Blepharoplasty?

• Blurred vision
• Double vision
• Your eyes looking uneven or asymmetrical
• Noticeable scarring on or around the eyelids
• Reduced or increased eyelid sensitivity

Less commonly, a blepharoplasty can result in the following complications:

• Injury to the muscles of the eye
• Ectropion
• Bleeding in the eye socket
• Visual impairment, which may improve in the long term

Blepharoplasties may also cause the following temporary side effects:

• Puffy or numb eyelids, which you might struggle to close
• Irritated, sensitive, or watery eyes, which might last for several weeks
• Bruising
• Scars, although these should eventually become almost invisible

• 2.47 percent for upper eyelid blepharoplasty
• 3.97 percent for lower eyelid blepharoplasty
• 4.68 percent percent combined blepharoplasty

What’s Next

Dr. Hagopian explains that usually “surgeons will see their patients within one week of surgery to make sure everything is going well and to remove sutures.” There may be further follow up “within the first month, and then usually again by three months and again by six months” after surgery. Some surgeons may want to see their patients annually after this time.

Kossler emphasizes that when performed well, a blepharoplasty is effective and complication-free. However, she also says: “If too much skin is removed or a surgeon removes excess muscle, then patients can have problems with eye function, or even closure of the eyelids. I have to deal with a lot of revising or improving results of previous surgery.” Kossler urges anyone considering a blepharoplasty to seek out specialists in eye or eyelid surgery.

The Takeaway

A blepharoplasty involves removing excess fat and skin from the eyelids. You might be considering this procedure to improve your vision, the appearance of your eyelids, or both.

Blepharoplasties are highly effective. However, they do require around two weeks of recovery time. Like any surgery, they also carry certain risks and complications, ranging from blurry vision to permanent, noticeable scarring. Seek out the most qualified professionals for the best results.