Blepharoplasty (Eyelid Surgery)

Definition

Blepharoplasty, also known as eyelid surgery, is a procedure designed to correct signs of aging in the upper and lower eyelids, such as sagging, puffiness, and excess skin. Because eyelid skin is the thinnest on the face, it loses elasticity early, making the eye region one of the first areas to show aging.

Blepharoplasty removes redundant skin and fat deposits, tightens surrounding tissues, and restores a youthful, refreshed, and natural periocular appearance. Beyond aesthetics, it can also improve functional vision when drooping eyelid skin obstructs the visual field.

Indications

Blepharoplasty is indicated for patients with:

Upper eyelid dermatochalasis: Skin laxity causing drooping of the upper eyelids.
Lower eyelid bags: Fat herniation and tissue laxity leading to puffiness under the eyes.
Visual field obstruction: Upper eyelid sagging narrowing peripheral vision.
Aged or tired appearance: Excess eyelid skin and fat pads giving a fatigued look.

Ideal candidates are generally age 35 and older, but younger individuals with hereditary eyelid changes may also benefit. Patients should be in good health, non-smokers, and have realistic expectations.

Surgical Technique

Blepharoplasty is typically performed under local anesthesia with sedation or general anesthesia, lasting about 1–2 hours. It can be performed on the upper eyelids, lower eyelids, or both

Upper Eyelid Surgery: An incision is made within the natural eyelid crease. Excess skin, muscle, and fat are removed or repositioned. The scar remains hidden in the natural fold.
Lower Eyelid Surgery: An incision is made just below the lash line (subciliary) or inside the eyelid (transconjunctival). Fat is reduced or repositioned, and skin is tightened, improving under-eye bags and wrinkles. Scars are concealed along natural lines.

The result is a smoother eyelid contour and a rejuvenated eye appearance.

Preoperative Considerations

General health evaluation: Underlying conditions and medications should be reviewed.
Smoking cessation: Quit at least 2 weeks before surgery to optimize healing.
Discontinue blood thinners: Aspirin and anticoagulants must be stopped under medical supervision.
Expectation alignment: A detailed preoperative consultation is essential to establish realistic goals.

Postoperative Course

Recovery from blepharoplasty is usually fast and well-tolerated.

Swelling and bruising: Common during the first week, typically resolving within 7–10 days.
Sutures: Removed within the first week, accelerating healing.
Dry eyes: Temporary dryness can occur; lubricating eye drops may be prescribed.
Eye protection: Sunglasses are recommended to shield from sunlight and external irritants.
Restrictions: Patients should avoid heavy exercise, eye strain, and direct trauma during recovery.

Most patients return to normal activities within 1–2 weeks, with final results visible after several months.

Risks and Complications

While generally safe, blepharoplasty carries certain risks, including:

Infection
Bleeding or hematoma
Delayed wound healing
Dry eyes
Transient or rare vision disturbances
Eyelid asymmetry

When performed by an experienced surgeon, complications are minimal and manageable.

Outcomes

Blepharoplasty restores a youthful, rested, and alert eye appearance, reduces functional problems caused by excess skin, and enhances overall facial aesthetics. Results are long-lasting and contribute to improved confidence and quality of life.

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