Eye Lid Surgery (Blepharoplasty)

Eyes speak out, they are the area of the face that exhibits the signs of aging around the eyes. The formation of eye bags and sagging upper eyelids may develop with age and it will give the most undesirable, inappropriate appearance. That can be corrected through cosmetic eyelid surgery which is also popular as Blepharoplasty. This is relatively minor cosmetic surgery that can produce a rejuvenating, fresh appearance of the face and leave us looking a few years younger.
A cosmetic eyelid surgery is accomplished by removing the excess skin and pockets of fat from the upper and lower eyelids to get rid of drooping eyes. Often surgeon prefers combining blepharoplasty or eyelid surgery with other cosmetic procedures like brow lift to get rid of drooping eyebrows and various other cosmetic dermal fillers to treat the appearance of crow’s feet.

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The eyelid surgery helps people to get rid of certain undesired conditions that make people feel conscious about their appearance. People undergo eyelid surgery to get rid of conditions like puffy upper eyelids, tired looking eyes, removal of excess upper eyelid skin. People with overhanging eyelids will no longer have to experience any issues with overhanging eyelids. The best part of the procedure is that, any scars from the previous eyelift procedure may be hidden within the natural contours making them almost imperceptible.

While there are several different techniques that a surgeon can use to alter the appearance of the eyes, the standard surgical technique usually involves removing or redistributing fat deposits, as well as removing excess skin and muscle from regions of the upper and lower eyelids. Depending on the specific problems that need correction, we may treat the upper eyelids, lower eyelids, or both sets of eyelids. We will help you determine which treatment is best for you.

Upper Eyelid
The incision is taken in the fold of the upper eyelid following the natural contours of the eyelid making the resulting scars will be as inconspicuous as possible.

Using a variety of surgical instruments, the layer of excess skin from the upper eyelid is excised, exposing the underlying muscle layer. In some cases a small strip of muscle from the upper eyelid, may also be excised.

To gain access to the two fat deposits in the upper eyelid, very small incisions are made in the orbital septum. By pressing on the upper eyelid, the fat deposits are exposed through each of the incisions. A portion of each fat deposit is removed to reduce the puffy appearance in the upper eyelid.

The incisions are closed with non-absorbable or absorbable sutures.Small sterile bandages may be applied to keep the incisions moist and promote proper healing.
Lower Eyelid
The incision is taken in the fold of the lower eyelid following the natural contours of the eyelid making the resulting scar as inconspicuous as possible.

To gain access to the orbital fat, a small incision is made in the muscle layer. The skin and muscle are dissected away from the underlying orbital septum. This allows the surgeon to pull the skin and muscle layers away from the orbital septum and subsequently expose the orbital fat in the lower eyelid.

To sculpt the orbital fat, the orbital septum is opened to expose the three orbital fat deposits of the lower eyelid. Each fat deposit is removed reducing the appearance of bags and puffiness in the lower eyelid.

If you have excess skin in the lower eyelid, a small amount may be removed. The skin incision is closed with sutures.
Thro Lower Eyelid
We use a retractor to carefully pull the lower eyelid away from the eyeball and expose the conjunctiva, which is a thin membrane that lines the inside of the eyelid. A shield may be applied to your eyes in order to protect them during the procedure.

A small incision is made in the conjunctiva by guiding a cautery device along the conjunctiva, exposing the three orbital fat deposits.

To sculpt the orbital fat, each fat deposit is carefully removed thus, reducing the appearance of bags and puffiness in the lower eyelid. After sculpting the fat deposits, the incisions will be allowed to close on their own.

  1. To begin with, the procedure the surgeon first administers medication for anesthesia or intravenous sedation to ensure that the patient experiences no pain or discomfort while ongoing procedure. The incision lines for the eyelid surgery are designed in such a way that the resultant scars are usually concealed within the natural folds of the eyelid region. The upper eyelid can be rectified through an incision within the natural creases on the eyelid. This allows the removal and repositioning of the fat deposits and tightening of the underlying muscles and excision of the excess skin.
  2. For the correction of the lower eyelids, the incisions are made just below the lower lash line and through these incisions, the extra skin and excess fat can be removed carefully from the lower eyelid. Often surgeons may use an alternative technique that is usually made on the inner side of the lower eyelid which instead of removing. Redistributes the excess fat. Skin excision is excluded in this procedure.
  3. Finally, at the end of the procedure, the eyelid incisions are typically closed with sutures and these sutures are removed within a week. Often the areas of incisions may appear discoloured for which the surgeons may suggest a laser or chemical peel to reduce this discolouration.

The final results of the eyelid surgery are observable progressively after the swelling and bruising have subsided and the smooth, better-defined eyelid and an overall rejuvenating appearance will finally be visible.

While the recovery period of the eyelid surgery a lubricating ointment and cold compress may be applied on the eyes may also be covered up with a loosely bound gauze after the completion of the procedure. The candidates are provided with sets of post-operative instructions that will contain the post-operative care in details, about all the medicines that must be applied or taken orally to fasten the recovery. The initial healing may contain some swelling, bruising, irritation, dry eyes and discomfort that may be controlled with medication, cold compress, and ointment. Irritation at the incision sites is normal. The incisions of both the upper and lower eyelids are usually removed within a week and the candidate can resume normal activities within a week or two. But strenuous activities must be resumed after the surgeon’s green signal only.

The final results usually take time to appear after the surgery. The candidates, following the procedure, will more likely experience some bruising and swelling and the incisions may be itchy too. The eyelid surgery may be combined with a brow lift that will give the best results. Since the procedure is a delicate process, it may include complications and unwanted results due to certain side effects like bleeding, infection, dry eyes, abnormal colouring of the eyelids, eyelid skin that folds in or out abnormally or may not be able to pull down the lower lid. In extreme cases, the patients may also lose vision but that is just too rare and to avoid such circumstances it is important to choose an experienced surgeon.

After the completion of the initial consultation, the candidates should start preparing for the surgery. The candidates are analyzed and their medical history is reviewed to find if they are perfect for the procedure or not. The advantages, disadvantages, risks and everything regarding the surgery are brought to light so that they can keep a realistic expectation from the surgery. The surgeon also instructs to the patients to stop taking certain medications that may interrupt the healing or increase the chances of rising complications.
On the day of the surgery, the surgeon provides the general instructions that will help to execute the procedure smoothly. After undergoing the procedure, the surgeons or their concerned clinic may arrange for a drop to home after the completion of the procedure. The postoperative instructions must be followed minutely to relish the best desirable results.

Procedure FAQs

QHow much scarring is involved in Blepharoplasty?

Scarring is normal with any surgical procedure but in eyelid surgery, the scarring is minimum and practically not visible after several months of healing.

Q At what age Blepharoplasty can be performed?

Normally this puffiness under eyes and overhanging extra skin above the eyes appears at a later stage. Though for some people they may appear at an early age by heredity. So any adult can undergo the procedure.

Q Will eyelid surgery help to remove wrinkles?

No, this surgery is not designed to remove wrinkles at the outer corners of the eye and neither can it fix sagging brows.

Q When will the results be visible?

The results will be visible after few weeks when the swelling and bruising disappears. The procedure usually gives long-lasting results but aging may affect the results.

QAt What Age Blepharoplasty Can Be Performed?

Normally this puffiness under eyes and overhanging extra skin above the eyes appears at a later stage. Though for some people they may appear at an early age by heredity. So any adult can undergo the procedure.

QWill Eyelid Surgery Help To Remove Wrinkles?

No, this surgery is not designed to remove wrinkles at the outer corners of the eye and neither can it fix sagging brows.

QWhen Will The Results Be Visible?

The results will be visible after few weeks when the swelling and bruising disappears. The procedure usually gives long-lasting results but aging may affect the results.

Sameer Karkhanis, MD

Board-Certified Mumbai Plastic Surgeon

Chief Plastic Surgeon & the Director at CCRS is a qualified Aesthetic Plastic and Reconstructive Surgeon. He is Board Certified, with the qualification of DNB Plastic Surgery (Diplomate of National Board). He is an active member of the International Society of Aesthetic Plastic Surgery.

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