The Goal of a Blepheroplasty:
A blepheroplasty is designed for beautification of eyelids. Youthful eyelids are smooth, and lay nicely over the contour of the eyes, and the eyelashes gently curl out. With age these features change. The following changes take place:
1. Excess skin develops in the upper and lower eyelids.
2. Upper eyelid skin tends to form a skin fold at the natural crease of the upper eyelids.
3. Fatty bulges start forming in the eyelids.
4. Eyelid skin starts appearing crinkly and irregular.
5. Crow’s feet start developing.
6. Eyelashes start curling down and lose their lushness.
A blepheroplasty aims to address these changes.
How a Blepharoplasty is Done:
Surgery is the only option to get rid of excess eyelid skin and fatty bags of the eyelids. It is done as follows:
Upper Eyelid Blepheroplasty.
This is done with an incision made precisely in the upper eyelid creases. The excess skin that is not needed for closing eyelids is measured, marked and then removed along with a thin strip of underlying orbicularis muscle. The upper eyelids have a medial and a central fat pocket. These pockets are opened. Excess fat is precisely removed, and the base of fat pockets is cauterized. Then the incision is precisely closed with fine sutures of the surgeon’s choice.
Lower Eyelid Blepheroplasty.
This is done with a fine incision just below the lash line with a small extension into the crow’s feet. The skin and muscle layer are lifted to expose the fatty bags. Lower eyelids typically have three distinct pockets of fat named; medial, central and lateral fat pockets. Fat in each pocket has distinct characteristics. These pockets are opened. The exact fat excess is analyzed, removed, and its base is cauterized. The eyelid skin is then gently draped. A precise determination of the skin excess is done. The excess skin is removed. Gentle closure of incision is done with fine stitches of the surgeon’s preference.
Anesthesia for Blepheroplasty:
We prefer to do our surgeries under general anesthesia. Sometimes sedation alone may be used. However, an anesthesiologist is always responsible for the administration of anesthesia and patient monitoring in our surgical center.
Recovery after a Blepheroplasty:
A blepheroplasty is done as an outpatient surgery. Patients go home after surgery. Cold compresses or cold packs on the eyelids are recommended to keep swelling and bruising to a minimum. The patient sleeps with their head elevated by 20-30 degrees.
Pain is minimal. Mild pain medication may be needed in some cases.
Patients can wash their face one day after surgery or take a shower.
Eye ointment is used on stitches a couple times per day for 2-3 days.
Stitches are typically removed in 3-5 days depending upon individual healing.
Make up can be used after stitches have been removed.
Most swelling subsides in three weeks.
The final outcome is achieved over the next 3-4 months. At that time, post- operative photos are taken.
Eyelid Chemical Peels:
We treat skin crimples of the eyelids with a Phenol/Croton oil peel. We prefer these peels over any lasers because of their predictability, safety and superiority in results.
Cure for Crow’s Feet:
Botox/ Dysport/ other neurotoxin preparations are used for temporary relief from crow’s feet lines. Such injections need to be repeated every 3-4 months to maintain correction. Such treatments are good adjuncts to surgery.
Restoring Lush eyelashes:
Latisse solution is prescribed when needed to restore lush eyelashes to eyelids.
Can Eyelid surgery be combined with other facial surgeries?
A blepharoplasty is often combined with a brow lift and forehead lift. These surgeries complement each other’s effectiveness. This is because brow ptosis often compounds the aging appearance of the eyelids. Some of excess eyelid skin can actually be from the sagging eyebrows. Doing a brow lift at the same time as a blepharoplasty corrects both issues.
A face and neck lift is done at the same time as a blepharoplasty to enhance the overall facial appearance.
How long does Blepheroplasty Last?
A blepheroplasty only corrects existing eyelid changes. Aging is an ongoing phenomenon. Aging continues, and some corrections are undone with the passage of time. New fat bags can conceivably develop in the eyelids. These will need another blepharoplasty overtime.
What are the risks of a Blepheroplasty?
A blepheroplasty generally is a safe procedure. However, all surgeries carry small risks related to anesthesia and healing. There is a small risk of bleeding. Rarely risk of blindness has been reported with a blepharoplasty.
I have dry eyes, will Blepheroplasty make them worse?
Dry eyes are common after the age of 40 in all people. This condition is progressive with or without surgery. Symptoms of dry eyes may be exacerbated with a blepheroplasty.