Blepharoplasty / Eyelid Surgery

Blepharoplasty

A blepharoplasty is a surgical procedure that rejuvenates the eyelids, restoring the lively, youthful appearance you desire. Blepharoplasty can be done to repair both upper and lower eyelids.

Upper Eyelid Surgery
Upper eyelid surgery is usually done to remove the redundant skin that overhangs the upper eyelid crease. During the procedure, an incision is placed at the eyelid crease, and excess skin is removed. The incision is closed with a tiny continuous stitch that is placed inside the skin to ensure optimal healing.

Lower Eyelid Surgery
Lower eyelid surgery is usually done to provide a smooth lower eyelid contour that blends with the cheek. An incision is made either inside the eyelid or just underneath the eyelashes to remove the fat pockets that cause “bags” under the eyes. After excess fat is removed, the eyelid muscle is tightened, allowing the contour of the eyelid to blend with the cheek. The incision is likewise closed with a tiny continuous stitch that is placed inside the skin to ensure optimal healing.

For lower eyelid surgery, a fat transfer may also be done to blend the eyelid-cheek junction to make it as smooth as possible, and it may be used to fill the tear-trough (which runs from the inner corner of the lower eyelid to the cheek) as well.

What Causes the Eyelids to Sag and Droop?

There are several factors that play a key role in the aging process of the eyelids, including:

  • Excess and sun-damaged skin
  • Bulging fat
  • Loss of volume
  • Heredity

As a result, sagging ligaments around the eyes and dark circles and fine lines around the lower eyelids can accentuate a tired and sad facial appearance.

Who Are Ideal Candidates for Blepharoplasty Surgery?

Both men and women are ideal candidates for blepharoplasty surgery if they have upper eyelid droopiness or lower eyelid “bags” or wrinkling of lower lid skin.

What Can You Expect During a Blepharoplasty Consultation?

Following a thorough discussion of your medical history and cosmetic concerns, Dr. Pero will perform a thorough facial and eyelid examination:

  • He will examine your upper eyelid for skin redundancy and the eyebrow for its position. A brow that has descended may mimic upper eyelid redundancy. If that is the case, the patient may be counseled about a brow lift instead of upper eyelid surgery.
  • He will examine the lower eyelid for fat herniation as well as the strength of the lower eyelid. If the lower eyelid is especially weak, he may plan to do an additional lid tightening procedure.

After a thorough examination, Dr. Pero will develop a treatment plan and explain all of your options. This is a time for you to ask all your questions about the procedure(s), so you have a clear understanding of what to expect and an informed decision can be made.

Are there any Preoperative Considerations?

Patients with dry eye symptoms may require a consultation with an Ophthalmologist or Medical Optometrist to assess the likelihood of worsening of these symptoms after surgery.

How Should Patients Prepare for Blepharoplasty Surgery?

Dr. Pero requests that his patients obtain pre-operative labs several weeks before surgery. Other requirements may include

  • Patients older than 45 years of age with medical conditions will need to obtain medical clearance prior to surgery.
  • Patients will need to stop taking any anticoagulation medications, aspirin, non-steroidal anti-inflammatory products (e.g., naproxen, ibuprofen), vitamin A, ginkgo biloba, and St. John’s Wort, at least 10 days before surgery, as they can interfere with blood clotting and cause bruising.
  • Patients should not drink alcohol at least 2 days before surgery to decrease swelling and bruising.
  • Patients should take Arnica montana, an herbal supplement, at least 2 weeks before surgery to minimize swelling and bruising. This is available over-the-counter or through Dr. Pero’s office.

Also, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Are There Risks Associated with Blepharoplasty Surgery?

The risks associated with blepharoplasty surgery include:

  • Reaction to anesthesia
  • Hematoma (less than 1 percent)
  • Chemosis (swelling of the inner lining of the eyelid, occurs less than 1 percent of the time)
  • Millia (small cysts that form on the incision)
  • Infection (rare)

Blepharoplasty FAQs

For blepharoplasty surgery, the results may not be completely evident for 2 to 3 months after surgery. When completely healed, the results of blepharoplasty last anywhere from 8 to 10 years. Dr. Pero will give you before and after pictures at the time for you to keep.

Women can use eye make-up within 2 weeks after blepharoplasty surgery.

Yes, you can have upper and lower eyelid surgery done at the same time. Doing so provides excellent rejuvenation of the eyelid and cheek area, giving the patient a more rested and healthy looking appearance.

Once the upper or lower eyelid is completely healed, the blepharoplasty scar will be nearly imperceptible.

Seventy percent of the swelling dissipates within 2 weeks after surgery. The remaining swelling may take up to 8 to 12 weeks to completely resolve.

Patients will need to avoid strenuous exercise up to 3 weeks after surgery.

You may return to work 1 week after surgery.

After surgery, a mild amount of bruising is possible and should be completely resolved by 10-14 days. Stitches are usually removed within 5-7 days after the procedure.

Before you are discharged home, you will be given aftercare instructions from Dr. Pero, which may include:

  • Following a liquid diet within the first 12 hours after anesthesia
  • Taking Tylenol and over-the-counter pain medications to relieve any pain and discomfort
  • Elevating the head using two pillows to help reduce swelling of the face
  • Following care instructions for the surgical site
  • Reporting on any changes to your general health
  • Scheduling a follow-up appointment with your facial plastic surgeon

The incision(s) may be placed inside the lower eyelid or in a naturally occurring skin crease in the upper or lower eyelid. This aids to camouflage the scar postoperatively.

A blepharoplasty procedure may take 1-2 hours to complete.

The type of anesthesia used for a blepharoplasty depends on several factors:

  • If the patient is having an upper blepharoplasty alone, the procedure can be done with local anesthesia and light oral sedation or IV sedation anesthesia.
  • If the patient is having a lower blepharoplasty or the upper and lower done at the same time, the procedure can be done with IV sedation or general anesthesia.
  • If the patient is having a blepharoplasty in combination with a facelift or other procedure, then either IV sedation or general anesthesia may be required.

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If you are interested in blepharoplasty surgery, please contact us at (214) 382-5100 to schedule a consultation with Dr. Pero.