Blepharoplasty, commonly referred to as an eyelid lift, is a plastic surgery procedure designed to rejuvenate the aging eye and to create a more youthful appearance. The eyes truly are the feature that most people notice first as tired and sad or refreshed and animated. Candidates for this procedure have noticed excess skin on the upper and/or lower eyelids, often with areas of puffiness that never seem to go away. Normally, everyone has a small amount of fat surrounding the eyeball. If the quantity of fat increases or the local tissues stretch and weaken, the fat begins to bulge producing “bags”. Occasionally, surgical correction is recommended when this bulging is seen in young patients because of a familial tendency.
The expectation of the surgical outcome for blepharoplasty should be of a more youthful and rested appearance of the eyes. Visual fields may be widened if excessive upper skin has blocked vision.

Procedure Description

Bay Area plastic surgeon, Dr. Hand performs the eyelid lift procedure in our accredited Marin County outpatient surgical facility. Depending on the extent of the procedure, the eyelid lift will be performed under local anesthesia with sedation or general anesthesia.

Blepharoplasty is a procedure that removes sagging skin and muscle from the eyelids, and removes “bags” by trimming away excess fat bulges. In some cases, the upper or lower lids can be treated alone. If indicated, all four lids may be treated at the same time. Excess drooping of the eyebrows and of the corners of the eyelids may also require a forehead lift to achieve the best correction. During lower eyelid blepharoplasty, Dr. Hand also performs a mid-facelift to lift and reposition the fat of the cheek area and to minimize the nasolabial folds (the folds between the nose and mouth).

The incision on the upper eyelid is placed in the lid crease. The lower eyelid incision lies just along the lash line. Both incisions may extend for a short distance slightly beyond the edge of the eyelid, in a natural smile crease. The excess fat, muscle and skin are removed and/or repositioned. Excellent healing is characteristic of the eyelid skin, and once the wounds are mature they usually become quite inconspicuous. The repetitive motion wrinkle lines will be softened, not completely erased. Most procedures are completed in one to two hours.

Recuperation and Healing

Immediately after surgery and for the rest of the day, cold saline compresses will be applied to the eyelids along with bed rest and head elevation to achieve the best result. Normal swelling and bruising will occur. Discomfort is easily controlled with oral pain medication. The following day, Dr. Hand will clean and examine the eyelids. At 4 days following surgery, all sutures will be removed. Contact lens should not be worn for 1 week but eyeglasses and sunglasses may be worn the day following surgery. Swelling and bruising usually begin to diminish 48 hours after the procedure. Normal activity or work may be resumed in 3 to 4 days using dark glasses and cover-up makeup to camouflage any swelling or discoloration. The patient will usually be presentable without dark glasses in 7 to 10 days and may resume regular exercise in 10 days.

Alternative Options

Blepharoplasty is a procedure that is often performed alone but just as often combined with other procedures that will compliment the goal of achieving the best aesthetic outcome. During consultation, Dr. Hand will make recommendations for areas of treatment based on the appearance of the eyes exclusively and the surrounding areas that may benefit from surgical correction. Very often the best result is seen when a blepharoplasty is combined with a brow lift. The eye then has a refreshed appearance and the brows have returned to a natural, youthful position. Facelift is sometimes also done with the eyelid procedures or may be done at a later time. Often, dermal fillers are injected into the nasolabial lines at the completion of the blepharoplasty to further compliment the mid-facelift that occurs during the lower lid blepharoplasty.