Blepharoplasty, or cosmetic eyelid surgery, is performed to enhance the appearance of the eyes by precisely addressing issues such as skin laxity, hooding and puffiness associated with orbital fat protrusion that can result with aging. The position of the brow and facial volume loss can also affect the overall appearance of the eyes and are addressed independently with brow lifting procedures and volume augmentation, respectively.
Upper eyelid blepharoplasty often involves a limited excision of redundant skin and rarely muscle, as well as targeted removal of protruding medial orbital fat from the upper eyelid. Incisions are designed to be concealed in the eyelid crease and over time are barely noticeable.
Lower eyelid blepharoplasty can be performed through a variety of techniques. Dr. Roy prefers the transconjunctival approach (incisions on the inner surface of the eyelid so not visible) for removal of protruding orbital fat, as the risk of visible lower eyelid scarring and asymmetry is much lower. This approach is often concomitantly performed with lower eyelid fat transfer or skin resurfacing to address lower eyelid hollowing and wrinkling.
This is an outpatient procedure. For upper blepharoplasty, the procedure can be performed with oral sedation and local anesthetic. Sutures are removed in 1 week, and most patients are social by then with the majority of swelling and bruising resolved. Patients can return to low impact activities after 2 weeks. High-impact activities (like running) should be avoided for 3 weeks. The final result will be most evident after 6 weeks to 3 months. For lower blepharoplasty, the procedure is typically performed with IV sedation. There are no sutures that need to be removed and patients are typically social by day 7. Same activity restrictions apply.
Frequently Asked Questions
1. What kind of anesthesia is used for blepharoplasty eyelid surgery?
Isolated upper blepharoplasty is typically performed under local anesthetic, with mild oral sedation if desired by patient. Lower blepharoplasty requires IV sedation. General anesthesia is not necessary or required.
2. How does Dr. Roy perform blepharoplasty eyelid surgery?
For upper blepharoplasty, Dr. Roy typically removes redundant skin through an incision that is hidden within the upper eyelid crease. A small amount of medial eyelid fat is also removed through the same incision to improve the appearance of the eyelid. For lower blepharoplasty, Dr. Roy almost exclusively uses the transconjunctival technique (no external incisions) for removal of lower eyelid excess fat. Rarely, a small amount of redundant skin on the exterior surface of the lower eyelid will be removed in the same setting.
3. Where are the incisions for blepharoplasty eyelid surgery and will there be visible scars?
The incision for upper blepharoplasty is hidden within the natural upper eyelid crease, and is barely perceptible. The incision for lower eyelid blepharoplasty is on the inside of the eyelid, so not visible.
4. Will blepharoplasty surgery be painful?
The use of local and oral anesthetics/analgesics in preparation for the surgery allows the actual surgery itself to be performed without pain for the patient. For procedures under IV sedation, there is no intra-operative pain. Most patients are surprised at how tolerable post-operative discomfort is and many transition to extra-strength Tylenol only after 1-2 days. A sense of tightness of the upper eyelid can be experienced. Post-operative pain medication is prescribed but seldom used by patients after the first couple of days.
5. What is recovery like after blepharoplasty eyelid surgery?
After upper blepharoplasty, sutures generally remain in place for 6-7 days. There are no sutures involved with lower blepharoplasty. Bruising and swelling typically lasts for 7-10 days, by which time patients generally resume social activity. Improvement in incision appearance and swelling will continue beyond this time frame. Low impact activities can typically be resumed after 2 weeks, while more high impact activities (running, jumping etc) is permitted after 3 weeks.
6. How much time off work will I need after blepharoplasty eyelid surgery?
This is generally dependent on the patient. Some patients with limited swelling and bruising are able to work at least a partial day (assuming a non-physical job) after 4-5 days. If discretion is sought, than probably a period of 7-10 days is more appropriate.
7. When can I exercise after blepharoplasty eyelid surgery?
Light walking can be resumed after about 1 week after blepharoplasty. Low impact activities (such as elliptical, weight lifting, exercise bike etc) can begin after 2 weeks while high impact activities need to be restricted for 3 weeks.