Eyelid Surgery (Blepharoplasty)
Eyelid surgery, or blepharoplasty, can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and/or lower eyelids. The eyelid, because its skin is much thinner than that in other parts of the face, is often one of the first facial areas to exhibit signs of aging and hence blepharoplasty is a very common procedure.
The Blepharoplasty Procedure
Blepharoplasty is typically performed as an outpatient procedure. The upper eyelids are very easy to do simply under a local anesthetic. For the lower eyelids (or a combination of the two), I prefer a general anesthetic or local plus sedation.
In the upper eyelid, an incision is made along its natural crease. Once the incision is made, excess skin and often a strip of muscle are removed. The fat deposits are then inspected, evaluated and possibly removed to improve the crispness of the eyelid crease.
For the lower eyelid, an incision is usually made just below the lash line so that excess skin and often muscle can be removed. Similarly, the fat pads are inspected and either removed or repositioned. Often, on the medial side (ie. closer to the nose) the fat is repositioned over the cheek bone and under the tear trough to improve the indent in that region. Depending on the overall "tone" of your lower eyelid, supplementary measures (such as sutures and tapes) may be utilized to give support to the lower lid in the early postoperative period.
Recovery After Blepharoplasty
After blepharoplasty, patients may be advised to apply lubricating drops/ointment and cold compresses to aid in healing and minimize side effects. Most patients should expect a bit of swelling and possibly "black eyes" for 7-10 days postop. Stitches are usually removed after 7 days. Contact lenses and eye makeup may not be worn for 2 weeks after surgery. Patients are typically advised to wear dark sunglasses outside or in bright light for 2 weeks to protect their eyes from sun and wind.
In general, moving around and walking is permitted and encouraged early on. Walks for exercise are possible at about the 2 week mark. Jogging and more vigorous exercise is allowed at about 4 weeks. At 6 weeks, there are essentially no restrictions. However, Dr. Wanzel will guide you through a customized recovery depending on your exact surgery and how the recovery process is progressing.
Risks of Blepharoplasty
Although there may be swelling and bruising around the surgical site, they will subside on their own, usually in 7-10 days. Complications following a blepharoplasty are thankfully quite rare. The most common complication (and happily it is exceedingly rare) in the first day or two is a hematoma (ie. a collection of unwanted excess blood). Other complications include, but are not limited to infections, asymmetries and a possible change to the shape of the lower eyelid (or scleral show). Rarely, due to limited strength and/or tone of the lower eyelid, the lid itself can pull off of the globe (called ectropion). This will often improve once the swelling dissipates.