Eyelid Surgery Facts
Medical Name: Blepharoplasty
Common Name: Eyelid Surgery
Estimated Cost: €3,000
Type of Anesthesia: Local / General
Length of Procedure: 1 to 3 hours
Time in Hospital:
Day-case or overnight stay
Down Time: 1 to 2 days
Recovery Time: 2 weeks
Discomfort Level: Mild to Moderate Pain, expect some discomfort; significant pain is unusual. Swelling settles
over several days; cold compresses may help
Procedure Location: Office, Clinic, Hospital
With age skin and underlying muscle of the eyelids loosen. This may result in skin folds forming in the upper eyelids and deep skin wrinkles in the lower eyelids.
Slackening of the muscle allows fat, which is normally found in the eye-socket, to project forwards and produce eyelid bags.
Blepharoplasty removes excess skin, muscle and fat to produce a more youthful looking eye. In most instances the operation is
cosmetic; however in some people the skin is so loose that it hangs over the eyelashes and obstructs vision.
The operation may remove skin only; skin and muscle; skin, muscle and fat or just fat.
Anaesthetic - General or local anaesthetic
Technique
For upper eyelid blepharoplasty a cut is made in the main fold of the eyelid; the cut is carried into the crow’s feet area. For lower lid surgery the cut is made just below the eyelashes; again it is carried out into the crow’s feet. Sufficient skin and muscle is removed to correct any excess.
Protruding fat can be removed through the same incision. If there is fat excess in the lower lids, without excess skin, then it can be removed via an incision on the inside of the lower lid (transconjunctival blepharoplasty).
The skin can be cut with a scalpel, laser or special electrode - the operations are essentially the same.
The skin cuts are stitched up; most surgeons use stitches that need to be removed.
Blepharoplasty operations can be combined with operations to lift the brow (brow-lift) and with facelifts. Laser resurfacing can be combined with transconjunctival blepharoplasty to treat fine wrinkles and to provide some skin tightening.
Length of Operation - Bilateral upper eyelid blepharoplasty takes about 40 minutes to one hour; bilateral lower lids a similar amount of time. Combining upper and lower lids about one and a half hours.
Time in Hospital - Day-case or overnight stay.
Postoperative Discomfort/Limitations
Expect some discomfort; significant pain is unusual. Swelling settles over several days; cold compresses may help.Stitches are removed after 3 - 5 days. At first closing the eyes appears tight and the lids may gape 2-3mm this settles over a few days.
If the eyes do not close at night then eye-ointment should be used at bed-time. Bruising is common and takes 1-2 weeks to settle - it can be hidden with dark glasses or make-up. Watery eyes, due to swelling around tear-ducts, may take a few weeks to settle. Scars become red before fading over a period of weeks and months; in most people scars are excellent, almost invisible.
Blepharoplasty does not remove cheek bags (festoons), fine wrinkle lines nor crow’s feet. Dark eye-lids are not improved by blepharoplasty. It is important for the surgeon to assess the position of the eyebrow before performing blepharoplasty - a descended brow contributes to upper eyelid deformities. If the brow is descended then a brow lift should be considered instead of, or in addition to, upper lid surgery.
Blepharoplasty may be inappropriate in patients with thyroid eye disease, water retention due to kidney & heart disease; patients with facial weakness, patients with eyelid or eye disease/injury; patients with dry eyes and in patients on aspirin and non-steroidal anti-inflammatory drugs. If there is any concern about eye-disease, visual problems or dry-eyes the opinion of an ophthalmologis should be sought.
Time off Work - one to two weeks.
Risks and Complications
There is a long list of potential complications after blepharoplasty; fortunately most are extremely rare. The following list covers some of the more common problems, most are unusual if the operation is performed appropriately:
Bleeding; infection; dry-eyes; conjunctival swelling; turning
Last Editorial Review: 22/2/2010
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