Cosmetic Eyelid Surgery

Eyelid surgery is one of the most commonly requested cosmetic procedures. Also known as blepharoplasty, it can do many things:

  • Improve the appearance of the eyelids (both upper and lower).
  • Make you look more awake, less tired.
  • Remove extra skin and fat.
  • Get rid of bags or puffiness under the eyes.
  • Lift the upper eyelid to appear more alert and improve vision.
  • Give a more youthful appearance.
  • Better define the upper eyelid crease.
This procedure can be done for either men or women. Both sexes show age signs around the eyes, including changing shape of the eyelids and extra fat deposits around the eyes as we age.

Since our eyes are more expressive – even without trying – than other parts of the body, changing them can have a dramatic impact in the way we look. Eyelid surgery can easily restore a more youthful look, and it typically has an easier recovery than some other procedures.

The Consultation

When considering eyelid surgery, schedule a consult with Dr. Michael J. Brown. Be ready to talk about:

  • Your goals for the surgery
  • Any past surgeries
  • Any problems with the eyes, such as dryness, infections, or allergies
  • All medications you are taking
  • Whether you wear contacts, and whether you have ever had any difficulties with contacts
  • Your medical history, including any ongoing or previous conditions (remember that some conditions can affect the surgery—don’t leave anything out)

You may also be wondering whether this type of surgery might be covered by health insurance. This is possible if the procedure is done for problems with vision. However, when the procedure is for purely cosmetic purposes, usually insurance does not cover it. Even when it is covered by insurance, payment may be required in advance and reimbursed by insurance later.

How is it done?

Eyelid surgery can be performed on either the upper or lower or on both eyelids. It be combined with other procedures for a comprehensive change, such as:

  • A forehead or brow lift
  • Facelift
  • Skin resurfacing
  • Nose reshaping
  • Neck lift
  • Botox injections

The exact details will vary by person, depending on your needs and goals. Especially if you want to reduce wrinkles or correct other skin conditions at the same time, it might be good to combine procedures.

An example of eyelid surgery is shown in the video below. (Note: it contains some graphic images). The surgery can involve removing excess skin, fat, and muscle. This reduces eyelid droop. It can also improve vision for some patients if the excess skin was causing vision issues. After the procedure, patients can go home the same day.

Eyelid Surgery Recovery

Results will gradually improve over several weeks as the body heals and the swelling resolves. The healing process varies per person. In general, you should expect:

  • Mild discomfort. This can be treated with medication. However, remember that some medications, like aspirin, are off-limits. Listen to the surgeon’s advice on the medications to take.
  • Swelling (which may cause a feeling of tightness) and bruising. This can be treated with a cold compress.
  • Watery eyes, or, conversely, dry eyes.
  • Blurry vision. This may remain for the first few days.
  • Light sensitivity. This should be temporary.

Possible Problems During and After

It is always important to have realistic goals. This is true for the cosmetic outcome of the surgery. It is also true for the process and healing. This surgery has risks and possible complications, such as:

  • Reactions to anesthesia This can occur with any surgery. It is possible with either local or general anesthesia. These reactions can be severe, even including death.
  • Infection: While extremetly rare, it does occur. If it does, this will require additional treatment. This may include antibiotics or another surgery.
  • Allergic reactions: Various aspects of the process can cause unexpected reactions. For example, some people may have a bad reaction to: the stitches, tape, ointment, or medications.
  • Scarring: Eyes heal quite well. However, scars may occur either on the eyelid or in the other tissues. When this happens, the scars may be quite visible. They may be a different color to the other skin in the area. The stitches used also may cause marks or cysts to form. If any of these happen, new treatments may be required.
  • Dry eyes: The tear ducts may get damaged. This causes the eyes to be dry at all times. This is rare, and it cannot be predicted. If you already have dry eyes, give extra thought to this risk before having eyelid surgery.
  • Delayed healing: Combined with any other risk or alone, sometimes the wounds from surgery do not heal as quickly as they should.
  • Corneal exposure: Dry eyes can cause other problems with the cornea as well. This can mean that patients cannot properly close their eyes. If this happens, more treatments may be needed.
  • Bleeding: This can occur during or after the surgery. It can be in the eyelid or even around the eye itself. If this happens after surgery, it may require emergency care or more surgery. Patients should know that some medicines, such as aspirin, can increase this risk. High blood pressure also increases this risk. If blood accumulates under the skin or around the eye, the blood may need to be removed. Finally, bleeding after the surgery can cause more scarring or it can delay healing.
  • Damage to the eye structures: The eye contains nerves, muscles, and blood vessels. These could all be affected. The level of risk here depends on the specific changes being made to the eye. If damage is done to any of the other structures, it may go away on its own or it may be permanent.
  • Blindness: While very rare, blindness can be a result of bleeding around the eye. If you do have bleeding, seek medical care right away.
  • Asymmetric results or other poor result: Our eyes are not identical before surgery, and may not be so after. It is also possible that the surgery itself will cause visible defects. It could also cause patients to lose the ability to use the eye properly, or to lose feeling in the area. Sometimes a second surgery is needed to correct the problems caused by the first. If the result is not what is expected, sometimes a different surgery – such as a brow lift – might be a better option.
  • Displacement of the lower eyelid: It is rare, but the lower eyelid can pull away from the eye. If this happens, another surgery might be needed to fix it.
  • Eyelash loss: Especially on the lower eyelid, eyelashes may be lost due to the surgical process. If this happens, it may only be temporary or they might not come back.
  • Chronic pain: Sometimes eyelid surgery leaves patients with ongoing pain. This is also rare.

As with any surgery, be sure you understand the risks. The list here is an overview. Consult with Dr. Michael J. Brown for more information. You may also visit the downloads page to review and print out the consent form. There are a lot of actions you can take to minimize these risks. One prime example is to stop smoking, as smoking can greatly increase surgical risks and it can slow the healing process. Some medications can affect both the surgery and healing as well; be sure to follow the instructions provided in terms of what medicines cannot be taken in the days and weeks leading up to the surgery.