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Blepharoplasty

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Blepharoplasty is surgical modification of the eyelid. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery.

 

BLEPH 3ABLEPH 3BBlepharoplasty is often done as an elective surgery for cosmetic reasons. Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid "bags" and reduce the wrinkling of skin.

Asian blepharoplasty or double eyelid surgery is a special type of blepharoplasty that creates a crease in the upper eyelid. This "supratarsal fold" is common in many races but absent in about half of Asians. Surgery can artificially create this crease and make a 'single-lidded' patient appear 'double-lidded'. It is the most popular form of cosmetic surgery among those of east and southeast Asian background.

Blepharoplasty is sometimes needed for functional reasons. When an advanced amount of upper eyelid skin is present, the skin may protrude over the eyelashes and causes a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision.

Blepharoplasty is usually performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids. Incisions may be made from the inside surface of the lower eyelid (transconjunctival blepharoplasty); this allows removal of lower eyelid fat without an externally-visible scar, but does not allow excess skin to be removed. External skin resurfacing with a chemical peel or carbon dioxide laser may be performed simultaneously. This allows for a faster recovery process.

The operation typically takes one to three hours to complete. Initial swelling and bruising resolve in one to two weeks but at least several months are needed until the final result becomes stable. Blepharoplasty's effects are best appreciated by comparing before and after photos of surgical patients.

Frequently Asked Questions

  • What are the goals of blepharoplasty?

    A properly performed blepharoplasty procedure will brighten the face and restore a more youthful appearance. In some patients the procedure will improve vision by removing the excessive skin of the upper eyelids which can hang down and interfere with peripheral vision.
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  • How is the procedure performed?

    Eyelid surgery is usually performed using local anesthesia and light intravenous sedation. It is commonly done in a doctor's office, outpatient surgical center or, in some cases, in a hospital. The procedure is most often performed on an outpatient basis.
  • Are there scars from the blepharoplasty procedure?

    Scars are a result of any surgical procedure. The incisions made to accomplish the goals of the procedure are barely visible after several months as they are placed within the normal creases and folds of the upper and lower eyelids. In patients who only need removal of fat from the lower eyelids, the incision can be made on the inside of the eyelid, and will therefore result in an invisible scar.
  • Will the fine wrinkles around my eyes go away after blepharoplasty?

    As the skin tightens, many wrinkles go away. Some fine ones may not. Other wrinkles are the result of natural interaction of the skin and the underlying muscles and are part of normal expressions. There are skin treatments that can minimize fine wrinkles that can be done in conjunction with blepharoplasty.
  • What about my sagging eyebrows and dark circles under my eyes?

    The blepharoplasty procedure will not eradicate the wrinkles around the eyes (crow's feet) nor will it elevate droopy eyebrow. There are other procedures designed for these purposes. Dark circles under the eyes may improve a bit if this is related to large bags , but most often the dark appearance of the lower eyelid skin remains.
  • Can anyone have a blepharoplasty?

    The best patients are those who are healthy, psychologically stable and well motivated. Some medical conditions may increase the risk of blepharoplasty surgery such as thyroid disease, high blood pressure, and patients who do not make sufficient tears to keep their eyes well lubricated.
  • What are the risks involved with this procedure?

    Fortunately, when performed by a competent plastic surgeon, complications are infrequent and minor. All patients will experience some bruising and swelling for a few days after the surgery. In addition, a temporary problem with closure of the eyelids is usually seen. Some may have temporary blurring of their vision, usually due to the ointments applied to the incisions post operatively. In rare instances, the lower eyelid may be pulled down causing an ectropion. If this does not resolve on its own, further surgery may be necessary. The theoretical complications of any surgical procedure, such as bleeding, infection, wound disruption and heavy scarring are also possible, but rare.
 

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