Excess skin on the eyelids, drooping, and bagginess of the lower lids can make a person look more tired and older than they are. Blepharoplasty is the surgical procedure applied to the upper and lower eyelids to correct these problems. This article is for people who are bothered by changes around the eyes and want to learn about their options.
The difference between upper and lower eyelid surgery
In upper eyelid surgery, excess skin and, if needed, a small amount of muscle and fat tissue are removed. Because the incision is placed in the natural crease of the lid, the scar usually goes unnoticed when the eye is open. If excess skin hangs down to the lashes, the operation can also make your field of vision more comfortable.
In the lower eyelid, the problem is usually fat pads bulging forward, that is, under-eye bags. The fat can be removed, or spread into the hollow area below the eye to smooth the transition. The incision is made just below the lash line or on the inner surface of the lid; the second method leaves no visible external scar, but it may not be suitable if excess skin needs to be removed.
Both lids can be done in the same session, or only one can be planned. If the brow is drooping, upper eyelid surgery alone may not be enough; in that case a brow lift is also discussed.
Who is it suitable for?
- People with excess skin on the upper lid that covers the crease or makes the gaze look heavy
- People with under-eye bags on the lower lid that do not go away with rest
- People in good general health who tell the physician about conditions such as dry eye, glaucoma or thyroid-related eye disease
- Non-smokers, or those who can quit throughout the period of surgery
- People with realistic expectations, who know that crow’s feet or dark circles will not disappear completely with this operation
If a drooping lid is caused not by excess skin but by weakness of the muscle that lifts the lid (ptosis), a different operation is needed. This distinction is made at the examination.
The surgery process
Assessment and plan
A specialist physician reviews your photos; the amount of excess skin, fat bags, brow position and eye health information are assessed together. The plan for the upper lid, lower lid or both is sent to you in writing.Day of surgery
Upper eyelid surgery is usually done under local anesthesia and sedation; when the lower lid or both lids are planned together, general anesthesia may be preferred. The procedure usually takes one to two hours, and most patients go home the same day or the next day.The first days
Swelling and bruising around the eyes are expected. Cold compresses, resting with the head raised and the drops or ointments recommended by the physician help recovery. The eyes may water and be sensitive to light in the first days.Stitches and checkup
Stitches on external incisions are usually removed within the first week. At the checkup, wound healing and the closing of the lids are assessed.A stay of 5-7 days is usually enough for eyelid surgery. The first checkup is done the day after surgery or within a few days, stitches are usually removed within the first week, and the flight is planned after this checkup. The exact duration varies according to the physician’s plan.
Recovery and what to watch for
Most of the bruising usually clears within two weeks; fine swelling and the softening of scars can take months. Heavy exercise, bending forward and rubbing the eyes are not recommended in the first weeks. Contact lens wearers should wear glasses until the physician allows lenses. Sunglasses and sunscreen are important for keeping scars from darkening. Desk work is usually resumed at around one week; the physician’s permission is awaited for eye makeup. Blood thinners and herbal supplements should be reported to the physician before surgery and should not be stopped without the physician’s instruction.
Possible risks include temporary dry or watery eyes, the eye not closing fully for a while, asymmetry between the two sides, bleeding and infection. In the lower lid, the lid turning downward (ectropion) can rarely develop and may require an additional procedure. Serious bleeding that affects vision is very rare; if there is sudden pain and blurred vision, the physician should be reached immediately.
Commonly confused points
Under-eye darkness and dark circles are often caused by thin skin or pigmentation; blepharoplasty does not always correct them. Filler or fat injection may be more suitable for under-eye hollows. Sagging around the brow can be perceived as excess in the upper lid; the examination clarifies this distinction. Laser or radiofrequency treatments tighten the skin slightly, but they do not take the place of surgery when there is marked excess skin.
You can get a free initial assessment by sending your photos and health information; a specialist physician reviews your eyes from the photos and sends the plan to you in writing. This article is for general information only; a definitive diagnosis and treatment plan are determined by a specialist physician’s examination.
