Definition and Overview

Eyelid surgery, also known as an eyelid lift or blepharoplasty, is a procedure performed to remove the "bagginess" appearance of the lower eyelids or to get rid of extra skin on the upper eyelids. It is a cosmetic procedure that is very useful for those who would like to eliminate sagging skin around the eye area, which is a common and one of the earliest and most obvious signs of aging. Sagging eyelids can also cause problems with one's vision, so having an eyelid surgery can also be done for non-cosmetic purposes.

Sagging skin is one of the most difficult effects of aging. It is caused by the natural loss of skin elasticity that occurs as a person ages. Since the skin is the outermost layer of the body, this sign of aging is also easily noticeable, especially when it occurs around the face. As the facial skin loses elasticity, excess skin begins to collect especially around the eyes. Aside from being unsightly, this also causes the development of wrinkles, creases, fine lines, bulges, and other discomforts .

Who should undergo and expected results

Eyelid surgery is most commonly performed on people 35 years or older. Sometimes, however, saggy or droopy eyelids is a genetic issue, which is why some younger people also take advantage of the procedure even before they reach 30. Anyone can choose to have the surgery as long as the person is in good health and understands the benefits as well as the risks and possible complications.

People who choose to get an eyelid lift can expect a noticeable enhancement of their overall appearance. The surgery may help them look younger by many years, and this can help them regain self-confidence.

However, just like in any cosmetic procedure, it is hard to say if the result would be exactly like how the patient has envisioned it. People who are thinking about getting the surgery done must keep this in mind and be prepared for whatever the outcome may be. It is best to discuss the matter thoroughly with the surgeon who will perform the procedure to manage expectations early on.

The effects of the surgery can last for about five to seven years. Surgery done on the lower eyelid seldom requires follow-up procedures. However, it does not necessarily stop the aging process. The signs of aging will begin to progress again and will thus become visible again even after the procedure.

Also, although eyelid surgery may be the ideal solution for many problems caused by sagging skin around the eye, it does have its limitations. For one, it cannot help remove other facial problems such as crow's feet, dark circles, and wrinkles. Thus, it is common for eyelid surgery to be done alongside other procedures such as laser resurfacing, forehead lift, and filler injection.

How the procedure works

Cosmetic surgeons usually begin the surgery by working on the upper eyelids first if all four eyelids are to be done. The procedure usually takes about two hours to finish in cases that involve both the upper and lower eyelids. It is done with the use of local anesthesia with oral sedation.

The procedure begins with the surgeon making a cut following the natural creases of the eyelids. Using these cuts, the surgeon will remove the underlying tissue from the skin as well as excess skin, muscle, and fat. After this is done, the surgeon will close the incisions on the upper eyelids with stitches that will need to stay for about three to six days.

For the lower lids, surgeons usually make a cut that does not require stitches. They may use several techniques on how this may be done. One technique would be to make the cut inside the lower eyelid so that the fat can be accessed and removed. Since the cut is inside the lower eyelid, it is not visible. To make the lines softer, the surgeon may make use of an erbium laser or C02. Another way of removing excess skin, muscle, and fat is to make cuts along the eyelash margin. Cuts of this kind naturally fade after some time.

After the procedure, surgeons often suggest laser resurfacing, which can make the effects of eyelid surgery more natural-looking.

Possible risks and complications

All types of surgeries carry the risk of complications, but with eyelid surgery, they are very rare and do not occur very often. The possible risks, however, are the following:

  • Infection
  • Bleeding
  • Dry eyes
  • Loss of vision
  • Abnormal folding of the eyelid
  • Abnormal coloring of the eyelid
  • Inability to fully close the eyes

If these symptoms are experienced, it is best to seek medical help immediately so appropriate follow-up procedures can be performed at the soonest possible time.

References:

  • Codere F, Tucker N. Cosmetic blepharoplasty and browplasty. In: Duker JS, Augsburger JJ, eds. Ophthalmology. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 12.16.
  • Fratila A, Moody BR. Blepharoplasty and brow lifting. In: Robinson JK, Hanke CW, Siegel DM, Fratila A, eds. Surgery of the Skin. 2nd ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 39.
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