Blepharoplasty (eyelids)

The eyes are one of the first places to show the effects of aging. The eyelid skin is very thin, with less support, and fewer oil glands. As a person ages the skin surrounding the eyes tends to lose elasticity while the area under the eyes accumulates excess fat cells. Over the years, bags and wrinkles begin to form. Stress, fatigue, sun exposure, and heredity all play a part in this aging process.

Blepharoplasty is the surgical procedure that removes drooping skin around the upper and lower eyelids. Droopy skin may partially obstruct vision. Loose eyebrows can cause the brow to drop over the upper eyelid area. Loose skin can let the lower eyelid turn outward, causing tearing or eye dryness. The surgical procedure, blepharoplasty, removes excess fat, muscle, and loose skin from the upper and lower eyelids to correct defects of the eyelids. For adults, the procedure also restores a youthful appearance to the eye area.

Eyelid problems are not limited to adults. Surgery to correct drooping upper lids in children is usually done in the preschool years and is not considered cosmetic surgery. It expands the child's vision, so he can stop tilting his head to see well.

Usually, the surgery is performed as an outpatient procedure. It can be done in a surgery center, hospital, or at a surgeon's office- based facility. Upper eyelid surgery usually takes between 1 and 3 hours. The surgeon marks individual lines around the eyelids before surgery starts. These lines are placed in the natural creases of the face or close along the lash line to prevent scars from showing. The incision is made on these lines where the excess fat, muscle, and loose skin will be removed. Tiny fine stitches are used to close the incision.

Usually an ointment is used on and around the stitches to prevent dryness of the eye area. Cold compresses and keeping the head elevated when lying down are needed to help with healing and reduce swelling and bruising that occurs from surgery. Small sterile bandages may be placed over the stitches. Eye drops are used to keep the eye moist. Your surgeon or nurse will show you how to clean the eyes, which may feel gummy for a week.

Complications that have been noted are temporary vision problems, such as double vision or blurred vision. These symptoms usually go away in a few days. Some patients have difficulty closing their eyes when they sleep. In very rare cases, this may become permanent. A common symptom is swelling and bruising. Sometimes tiny white heads (pimples) may appear after the stitches have been removed.

The incision lines may be tight, firm, and red for about 5 weeks. Scar tissue turns white and softens in 4 to 5 months. For the first few weeks, there may be excessive tearing and increased sensitivity to light.

Puffiness in the lower eyelid that is caused primarily by excess fat may be corrected by a procedure, called transconjunctival blepharoplasty. Excess fatty material is removed by an incision made inside the lower eyelid. Sutures closing this incision are invisible to the eye, self-dissolving, and do not show a visible scar.

Eyelid surgery generally gives a brighter and happier appearance. Health insurance may cover this surgery if it is related to improving vision, eye deformity, or injury. Be sure to check with your insurance company before scheduling any elective procedure.

Eyelid surgery can be done alone or in combination with other facial surgeries. Surgery options and techniques should be discussed with a board certified plastic surgeon to determine the best procedure for you. It is important that you have realistic expectations and clearly understand what the procedure can do for you.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File COSM4357.rf2 VRS# 4357 Data Version 7.0 Copyright 1998, 2002-2003 McKesson Health Solutions LLC. All rights reserved.