Eyelid surgery (blepharoplasty)
Eyelid surgery, or blepharoplasty, removes or repositions excess skin, muscle and fat in the upper eyelids, the lower eyelids or both. It can be done for cosmetic reasons or for functional ones, when upper eyelid skin limits the field of vision.
What it involves
On the upper eyelid, the incision is made in the natural crease of the lid. Through it, excess skin is removed and, where needed, fat is removed or repositioned and the muscle is adjusted.
On the lower eyelid there are two approaches. An incision just below the lashes allows excess skin to be removed and the fat behind under-eye bags to be removed or repositioned. The other is made inside the eyelid, where it stays hidden, and treats the fat without removing skin.
The upper eyelids, the lower eyelids or both can be treated in the same surgery. The incisions are closed with fine stitches or skin adhesive. The technique is decided at your consultation, based on your anatomy.
Who it is for
Eyelid surgery is for people with excess skin on the upper eyelids, which sometimes hangs over the lashes and narrows the field of vision, or with bags and loose skin on the lower eyelids. It calls for good general health, no serious eye conditions and realistic expectations about the result.
- Dry eye, thyroid problems, diabetes and high blood pressure need to be assessed and under control before surgery.
- No smoking: you will be asked to stop before surgery.
- It does not correct drooping brows or ptosis (a lid that droops because of its muscle), which need a different treatment.
- It does not stop the area from aging.
What to know beforehand
Length of surgery
Eyelid surgery usually takes 1 to 2 hours, depending on the case. It can take longer if it is combined with other procedures. The estimated time for your surgery is set at your consultation.
Type of anesthesia
Local anesthesia with sedation is the usual choice: the eyelid area is numbed and medication helps you relax. It can also be done under general anesthesia, depending on what is decided at your consultation.
Hospital stay and recovery
Eyelid surgery is usually an outpatient procedure: most people go home the same day, with someone to accompany them. Swelling, bruising, watery eyes, sensitivity to light and slightly blurred vision are normal during the first few days. Stitches, when used, are usually removed within the first week.
Most of the swelling goes down in about 2 weeks, although bruising can last up to 4, depending on the case. Most people return to work and social life 5 to 14 days after surgery. Strenuous exercise is avoided for at least 1 to 3 weeks, depending on the case, until your surgeon clears you.
Aftercare
Your medical team gives you the exact instructions for your case. These are the usual ones:
- Apply cold compresses for the first 48 hours, as instructed, to reduce swelling.
- Sleep with your head higher than your chest for the first few days.
- Use the ointment and lubricating drops you are prescribed to keep your eyes from drying out.
- Do not wear contact lenses for about 2 weeks.
- Avoid bending over, heavy lifting and straining until your surgeon clears you.
- Wear dark sunglasses and protect the area from sun and wind for the first few weeks.
- Get in touch right away if you notice new pain, bleeding or changes in your vision.
Expected results
The result shows gradually, as swelling and bruising fade. Most people look presentable 10 to 14 days after surgery, and the final result is usually visible at 3 to 4 months.
On the upper eyelid, the scar sits in the natural crease. On the lower eyelid, it is just below the lashes or inside the lid. Scars may look pink for several months before they fade. The outcome varies from person to person, depending on age and skin quality. It is long-lasting, but aging continues and, over the years, some excess skin may return.
Frequently asked questions
Can the upper and lower eyelids be done at the same time?
Yes, all four eyelids can be treated in the same surgery, or only the upper or the lower ones. It depends on where the excess skin or fat is and on what you want to improve. In some cases eyelid surgery is paired with other facial procedures, such as a brow lift or a facelift. What is right for you is decided at your consultation.
Does eyelid surgery correct drooping brows or a drooping eyelid?
Not always. Eyelid surgery treats excess skin and bags in the eyelids. If the upper eyelid looks droopy because the brow has dropped, or because of a problem with the muscle that lifts the lid (ptosis), a different treatment is needed, which is sometimes done together with eyelid surgery. That is why your consultation includes an examination of your eyelids, brows and forehead.
What are the risks of eyelid surgery?
Like any surgery, it carries risks: bleeding, infection and reactions to anesthesia. Those specific to this surgery include dry, irritated eyes, difficulty closing the eyes completely, which is usually temporary, asymmetry between the eyelids, a poorly positioned lower eyelid and unfavorable scarring. Lasting changes in vision are very rare. A touch-up is sometimes needed. Your consultation reviews the risks that apply to you.
When can I wear contact lenses again?
Generally after about 2 weeks. During that time your eyes may feel dry, watery or more sensitive to light, and these symptoms ease gradually. Dark sunglasses help protect them from sun and wind. If you wear contact lenses every day, it is a good idea to have a pair of prescription glasses on hand for those days.
What will the scars look like?
The incisions are placed where they are concealed. On the upper eyelid, in the natural crease, so the scar is seen mostly when the eyes are closed. On the lower eyelid, just below the lashes, or inside the lid, where it is out of sight. Scars may look pink for several months and then fade to a fine line.
How long do the results last?
They tend to be long-lasting: for some people they hold for many years, while in others excess skin returns over time. Surgery does not stop aging, and if the brow drops, skin can build up again on the upper eyelid. Sun protection helps maintain the result. Your consultation covers what you can expect in your case.
This information is general and does not replace a medical assessment. The timing, technique and recovery for your case are defined in consultation with the surgeon.
Let us talk about your case
Every body needs a personal assessment. Tell us what you are considering and we will review the options that suit you best.