Patient Education

A growing library of easy-to-read informational pages about a host of common eye problems.


Blepharoplasty

Diagram of a Blepharoplasty

A blepharoplasty, or eyelid surgery, is a surgical procedure that can help improve the functional and aesthetics of the eyelids. A blepharoplasty is performed for many reasons,
which can include:

  • Ptosis, or droopy upper lids with saggy skin that can impair or block vision (can be congenital from birth, or age-related)
  • Difficulty reading due to lids that close while looking down
  • Excess fatty deposits in the upper and lower lids (can appear to be puffy)
  • Wrinkles or excess skin of upper or lower lids
  • Bags under the eyes
  • Saggy lower lids

In children, this impairment can permanently affect the vision and prevent normal development of the visual cortex. This can lead to amblyopia and should be addressed as soon as possible by your ophthalmologist.

Who Are the Best Candidates for This Surgery?

Most people can undergo this surgery safely. However, the best candidates include:

  • Patients who are otherwise healthy or have non-life threatening conditions
  • No use of anticoagulants
  • Non-smokers
  • No other ocular comorbidities

However, rarely, ptosis (droopy eyelids) can signify a serious medical condition, especially if sudden-onset or asymmetric. You should have your ptosis evaluated by your Eye M.D. (ophthalmologist) immediately if this occurs.

How is the Surgery Done? What Kind of Anesthesia is Used?

Blepharoplasty Video
Click to Watch Blepharoplasty Video

Typically, this surgery is done under local anesthesia with some intravenous sedation to help the patient relax during the case. Additionally, local anesthetic is applied in the area so that the procedure has minimal pain. The procedure steps are as follows:

  • Anesthetic – a local anesthetic is used to numb the area.
  • Marking – the process of making precise measurements and markings so that the eyelid will have a natural contour after surgery, and so that scars are concealed after surgery.
  • The Incision – The eyelid is incised along the natural crease of the eyelid, which can allow for tightening of muscles, removal of excess skin, and removal of fatty deposits.
  • Lower Eyelid Work – These are often corrected with incisions just below the lash line, so that excess fat and skin can be removed.
  • Closing the Incisions – typically done with sutures, which can be absorbable or removable.
  • “Blausen 0085 Blepharoplasty-EyeLift” by BruceBlaus

What Can Be Expected Afterwards?

The recovery period from eyelid surgery can include normal signs of initial healing: some bruising, swelling, or irritation and dryness of the eyes. However, these symptoms are transient and can be ameliorated by using lubricating or antibiotic ointment, cool compresses, and medications to help with pain or reduce the potential for infection.

What Are the Risks of Surgery?

Although this is a typically well-tolerated surgery, risks can occur any time a surgery is performed. Your ophthalmologist will discuss these risks with you and will help you to make a proper decision. However, this decision is personal, so you will have to decide which risks are acceptable to you in order to obtain your goals.

The major risks can include: bleeding, infection, an asymmetric or unbalanced appearance, scarring, difficulty closing the eyes (which may cause damage to the underlying corneal surface), double vision, tearing or dry eye problems, inability to wear contact lenses, numbness and/or tingling near the eye or on the face, and, in rare cases, loss of vision. You may need additional treatment or surgery to treat these complications. Your ophthalmologist will talk to you about these risks before surgery.