As a person ages, the skin surrounding the eyes tends to lose elasticity and the area under the eyes accumulates excess fat. This can cause the face to appear bloated, giving it an older appearance. In severe cases, sagging skin can hinder normal eyesight. Blepharoplasty is a surgical procedure that can restore a youthful appearance to the eye area. The upper and lower eyelids are lifted and excess fat cells or loosened skin are removed from the affected area. The procedure is limited to the eyelids and does not attempt to improve other areas of the face.

PRIOR TO SURGERY

A complete medical history and a careful examination with blood tests will be done in the initial preoperative visit to determine the general health of the patient. The surgeon will then examine the eyes and face to determine the extent of surgery and the most effective approach. An examination by an opthamologist may also be recommended. Photographs are taken before and after surgery to evaluate the extent of improvement. Moreover, the surgeon will discuss the procedure, realistic expected results, type of anesthesia to be used, and possible risks of surgery. Preoperative instructions generally include taking certain vitamins and elimination of certain drugs to minimize the possibility of excess bleeding. Antibiotics may be prescribed for the days prior to surgery to prevent infection.

THE OPERATION

Blepharoplasty can be performed in a physician’s office, an outpatient surgical center, or a hospital, depending on the patient or surgeon’s preference. Either general anesthesia, IV sedation, or local anesthesia can be used. Three variations of the blepharoplasty procedure exist each taking about two hours. One method removes excess skin from either the upper or lower lid as well as the underlying fat pad when indicated. The surgeon makes an incision along the crease in the eyelid, peels back the skin, and punctures the underlying tissue to remove the fat pad. The pad is then cauterized (heat sealed). Loose skin is removed from the exterior, if necessary, and the incision is sutured. The second procedure may benefit patients with protruding fat under the eye and minimal extra skin. It is performed by entering just inside the lining of the lower eyelids and eliminates a scar. The third type of blepharoplasty makes use of a laser instrument. The intense energy produced by the laser causes blood to coagulate, which can diminish bleeding and swelling during and after the operation. It is a relatively new procedure performed by a small number of surgeons.

AFTER SURGERY

The post-operative effects are minimal and temporary. Stitches are usually removed after five days. Minor swelling, bruising, and discomfort should disappear within two weeks. Cold compresses and oral medications for pain help to alleviate these side effects.

RISKS

Complications arising from blepharoplasty are rare but as with any surgical operation, they do exist. A “too tight” or uneven appearance can be caused by the removal of too much skin. Further surgeries can usually reverse this problem. Bleeding behind the eye or dry eyes are other complications. Carefully following the physician’s directions can decrease the risk to the patient.