Blepharoplasty removes excess skin and fat and tightens the muscles and tissues of the eyelid. It reduces the skin that droops into the visual field to improve peripheral vision.
Types of Blepharoplasty
There are two types of blepharoplasty: functional and cosmetic.
Functional Blepharoplasty
A functional blepharoplasty removes the excess skin that obscures your field of vision. If the procedure is determined to be medically necessary, it may be covered by medical insurance. Testing your visual field with a Humphrey Visual Field Analyzer will determine how much vision is affected.
Cosmetic Blepharoplasty
Cosmetic blepharoplasty can be performed on either the upper or lower eyelid, or both. Depending on the type of lower eyelid blepharoplasty, either excess skin in the lower eyelid is removed, or redistribution or removal of excess fat is performed.
You should have realistic expectations before undergoing a blepharoplasty. While the procedure can improve the appearance of your eyelids, it does not dramatically alter your face.
Candidates for Blepharoplasty
If you are considering a blepharoplasty, you should be in good overall health and not smoke, not have any serious eye conditions, and not have facial tissue and muscle that are unhealthy.
Procedure
Blepharoplasty usually is performed in an outpatient setting and requires local anesthesia and sedation. The procedure can take anywhere from 30 to 60 minutes, depending on whether you have the procedure on both the upper and lower eyelids.
Botox injections can help lift the eyebrow, improving the appearance of hooded eyesDermal fillers can help lift the eyebrow and tighten the skin around the eyeThe prescription eye drops UPNEEQ (oxymetazoline hydrochloride ophthalmic solution) can help lift droopy eyelidsRadiofrequency treatments use electromagnetic current to tighten the skin and lift the eyebrowsThread lifts are temporary sutures that slightly lift the eyebrows
If your upper eyelids are being operated on, the incision lines are typically made along the natural crease lines of your eyelids. Once the incisions have been made, fat deposits and excess skin are removed. A strip of the orbicularis oculi muscle surrounding the eyelids may also be removed to deepen the lid crease.
If you have surgery for the lower eyelids, an incision may be made either just below the lower lash line or on the inside of the lower eyelid. Depending on the method, excess skin in the lower eyelid is removed or fat is redistributed or removed.
After the procedure, your incisions are closed with either removable sutures, skin adhesives, or surgical tape.
Recovery
After blepharoplasty, you will be given specific instructions, including for the medications you should apply or take orally and a date and time when you should see your surgeon for a follow-up examination. Your healthcare provider will also inform you of any symptoms or signs you should watch for, which would mean you should follow up sooner.
Healing
You may experience some swelling, bruising, irritation, or dry eyes, but if these symptoms occur, they are generally very mild. Most of the swelling subsides within two weeks. You will not be able to wear contact lenses or eye makeup for two weeks after surgery.
Your stitches will usually be removed by the third or fourth day after surgery. It may be recommended that you wear dark sunglasses for the next two weeks to protect your eyes from the sun and wind. You can return to work in a few days to a week but will need to avoid exercise and strenuous activities for at least two weeks.
Potential Risks
Blepharoplasty is usually very well tolerated. After the surgery, there may be swelling and bruising around the surgical site. This will eventually subside on its own.
Complications are not common but may include infection, a granuloma, reaction to anesthesia, and double or blurred vision. Your eyes may experience irritation and dryness due to a temporary change in tear distribution.
Your scars from a blepharoplasty will usually be well-concealed and will fade with time. Make sure to talk to your healthcare provider about any concerns related to your specific symptoms and any possible complications that may occur.
Summary
Blepharoplasty is a surgical procedure used to treat ptosis, drooping or sagging eyelids. The procedure can change the cosmetic appearance of the eyelids. Eyelids that droop into the visual field can be treated to improve the amount of visual field, which can be life-altering.
A Word From Verywell
If your eyelids droop or distort your vision, seek a consultation with your eye doctor to see if blepharoplasty is an option. While every procedure has risks, blepharoplasty is generally well-tolerated and can dramatically improve vision.
If hooded eyelids are only a cosmetic concern and do not hinder your vision or cause other problems, it is considered cosmetic surgery and not typically covered by insurance.
Before having the surgery, talk to your healthcare provider and insurance company to determine if your plan will cover any part of the procedure.
