As we age, the collagen that gives our face volume and tautness diminishes. As a result, the skin of the eyelids lose elasticity and the structures that support them weaken, leading to excess skin that may hang over the edge of the brow and cause the eyelids to droop or become hollow. Age can also cause the muscles and the fat of the lower eyelids to bulge. Known to many as "bags," this occurs when the fat that is normally behind the eye bulges in front of the eye muscles.
Blepharoplasty is a surgical procedure that improves the appearance of the skin around the eyes, as it corrects sagging skin and/or removes bulging fat. Traditionally, this procedure involves stripping away excess skin of the upper lids as a way of restoring sharp eyelid creases and giving the upper eyelids a smooth appearance. For those with bulging fat, the procedure involves excising the excess fat.
Upper eyelid blepharoplasty is done in an outpatient clinic using local anesthetics. A sedative may also be administered to help you relax during the procedure. Prior to surgery beginning, your surgeon will examine the upper eyelids and then mark the area that will require treatment. A local anesthetic is then injected into the upper eyelids to numb it. Once fully numbed, a scalpel, laser, or radiofrequency device is used to cut through the skin and separate the various tissues of the eyelid. If drooping is the problem, the excess skin will be removed and sutures will be put in place to give the eyes a lift. If bulging fat is the problem, the fat is removed and sutures are used to close the wound.
Following the procedure, you will need a ride home. Your eyelids will be lubricated and, in some cases, bandages will be placed over them. When the anesthetic wears off, your eyelids may feel tender and tight. To help with discomfort, pain medication is prescribed, and it should be filled prior to blepharoplasty. Bruising is another side effect of the procedure; it will peak around a week post-op and continue for up to four weeks. Swelling tends to last one to two weeks, but can last months in some. Adhering to your surgeon's after-care instructions will help. They may include:
- Keeping the eye area clean
- Using eye drops or ointment
Most activities can be returned to within five days.
Talk to your surgeon before undergoing this procedure to understand the risks involved. The most common complaints are asymmetry and removal of too little skin.