Adults of all ages can benefit from blepharoplasty. Patients in their 20s or 30s might improve their inherited traits that can make them look older or tired. Patients with excess skin or puffy appearance on the upper eyelids, excess skin, bags and dark circles on the lower eyelids.
The eyelid procedure can be designed according to the problem. If only the upper eyelids are affected there is no need to operate on the lower eyelids, and vice versa. If the problem is only caused by excess fat, with no skin excess, there is no need to remove skin. If excess skin is the problem, there might not be necessary to remove fat. Usually, however, with a patient in their forties of fifties, there is usually the need to correct the drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. Sometimes a forehead lift is recommended if the upper eyelid condition is accompanied by sagging of the eyebrows. A chemical peel can be necessary if there is dark pigmentation forming circles around the eyes. Crow`s feet can be treated simultaneously through laser resurfacing.
Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you`re having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.
In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow`s feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.
If you have a pocket of fat beneath your lower eyelids but don`t need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.
Eyelid surgery (blepharoplasty) can take one or two hours to complete.
There is usually no pain, just temporary discomfort, swelling, bruising, itching of eyes, tearing and sensitivity to light for a few days.
Reading: 2 or 3 days. Back to work: 7 to 10 days. Contact lenses: two weeks. Exercising about 3 weeks. Bruising and swelling may take several weeks to disappear, but usually with makeup or dark glasses the aspect is almost normal.
You should be able to read or watch television after two or three days. However, you won`t be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while.
Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor`s instructions, you`ll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.
Your surgeon will probably tell you to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. It`s especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol, since it causes fluid retention.
Hematoma (accumulation of blood under the skin that may require removal), infection and reactions to anesthesia. Temporary blurred or double vision. Bleeding, dry eyes, slight asymmetry in healing or scarring. There might be a temporary difficulty in closing eyes completely (rarely permanent). If there is a pulling down of the lower lids it may require further surgery. Blindness is extremely rare.
Besides the normal pre-operative exams you will be asked to do an eye test. The first evening after surgery, you should rest quietly with your head elevated. You should apply cold compresses to your eyelids to increase comfort. Stitches are usually removed after five to seven days.