Blepharoplasty is a procedure to remove excess fat, usually along with excess skin and muscle from the upper and lower eyelids. Blepharoplasty can correct drooping upper lids and puffy bags below your eyes-features that make you look older and more tired than you feel. However, it won’t remove crow’s feet or other wrinkles, eliminate dark circles under your eyes or lift sagging brows. Blepharoplasty can be done alone or in conjunction with other procedures.

Blepharoplasty can enhance your appearance and your self confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

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Beauty for life:
Enhancing your appearance with eyelid surgery

Cosmetic eyelid surgery, called blepharoplasty, is a surgical procedure to improve the appearance of the upper eyelids, lower eyelids, or both, and give a rejuvenated appearance to the surrounding area of your eyes, making you look more rested and alert. Specifically, eyelid surgery can treat:

  • Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
  • Excess fatty deposits that appear as puffiness in the upper eyelids
  • Bags under the eyes
  • Droopiness of the lower eyelids, showing white below the iris (colored portion of the eye)
  • Excess skin and fine wrinkles of the lower eyelid

Is it right for me?

Eyelid surgery is usually performed on adult men and women who have healthy facial tissue and muscles and have realistic goals for improvement of the upper and/or lower eyelids and surrounding area. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Good candidates are:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for blepharoplasty
  • Individuals without serious eye conditions

You must tell Dr. Foley if you have any of these medical conditions:

  • Eye disease such as glaucoma, dry eye or a detached retina
  • Thyroid disorders such as Graves’ disease and under or overactive thyroid
  • Cardiovascular disease, high blood pressure or other circulatory disorders or diabetes

What to expect during your consultation

The success and safety of your eyelid surgery procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

  • Why you want the surgery, your expectations and desired outcome
  • Medical conditions, drug allergies and previous medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Previous surgeries

Dr. Foley may also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Take photographs for your medical record
  • Discuss your options and recommend a course of treatment
  • Discuss likely outcomes of eyelid surgery and any risks or potential complications
  • Discuss the type of anesthesia that will be used

Preparing for surgery

Prior to surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

  • What to do on the night before and the morning of surgery
  • The use of anesthesia during your procedure
  • Post-operative care and follow-up

Dr. Foley will also discuss where your procedure will be performed. Blepharoplasty may be performed in our accredited office-based surgical center or a hospital.

 

You’ll need help
If your eyelid surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Procedural Steps:
What happens during eyelid surgery?

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Dr. Foley will recommend the best choice for you.

Step 2 – The incision

The incision lines for eyelid surgery are designed for scars to be well concealed within the natural structures of the eyelid region.

Droopy conditions of the under eyelid can be corrected through an incision within the natural crease of the upper eyelid allowing repositioning of fat deposits, tightening of muscles and tissue, and/or removal of excess skin.



Conditions of the lower eyelid may be corrected with an incision just below the lower lash line. Through this incision, excess skin in the lower eyelids is removed.

Step 3 – Closing the incisions

Eyelid incisions typically are closed with:

  • Removable or absorbable sutures
  • Skin Adhesives
  • Surgical tape

Step 4 – See the results

The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and surrounding region, and an alert and rejuvenated appearance.

Important facts about the safety and risks of eyelid surgery

The decision to have eyelid surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Dr. Foley will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

Possible risks of eyelid surgery include:

  • Unfavorable scarring
  • Temporarily blurred or impaired vision
  • Dry eyes
  • Difficulty closing your eyes
  • Lid lag, a pulling down of the lower eyelid may occur and is often temporary
  • Ectropion, rolling of the eyelid outwards
  • Bleeding (hematoma)
  • Poor wound healing
  • Infection
  • Fluid accumulation
  • Blood clots
  • Numbness and other changes in skin sensation
  • Anesthesia risks
  • Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required
  • Pain, which may persist
  • Skin discoloration and swelling
  • Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Possibility of revisional surgery
  • Loss of eyesight

More facts about the safety and risks

Be sure to ask questions: It’s very important to ask Dr. Foley questions about your eyelid procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with Dr. Foley.

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

Be careful

Following Dr. Foley’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing. Dr. Foley will give you specific instructions on how to care for yourself.

My recovery

After your procedure is completed, lubricating ointment and cold compresses may be applied, and in some cases your eyes may be loosely covered with gauze.

You will be given specific instructions that may include: how to care for your eyes, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your overall health, and when to follow-up with Dr. Foley.

Initial healing may include some swelling, bruising, irritation or dry eyes and discomfort that can be controlled with medication, cold compresses and ointment. Irritation at the incision sites also is possible.

Be sure to ask Dr. Foley specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

A special note: You must practice diligent sun protection and use darkly tinted sunglasses until the healing process is fully complete.

The results will be long-lasting

Your final results will appear within several weeks, but it may take up to a year for incision lines to fully refine. While eyelid surgery can be expected to correct certain conditions permanently, you will continue to age naturally. Life-long sun protection will help to maintain your results.

How much will eyelid surgery cost?

Cost is always a consideration in elective surgery. Prices can vary greatly depending on the extent of the procedure, the combination of multiple procedures, and the time involved. You will receive a detailed quote following your consultation. Talk with the Foley Plastic Surgery Center staff about your payment options.

Cost may include:

  • Surgeon’s fee
  • Hospital or surgical facility costs
  • Anesthesia fees

Your satisfaction involves more than a fee

When choosing a plastic surgeon for eyelid surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Words to know

Blepharoplasty: Eyelid surgery to improve the appearance of upper eyelids, lower eyelids or both.

Ectropion: When the lower eyelid is rolled outward after eyelid surgery; often a temporary condition.

General anesthesia:  Drugs and/or gases used during an operation to relieve pain and alter consciousness.

Hematoma: Blood pooling beneath the skin.

Intravenous sedation: Sedatives administered by injection into a vein to help you relax.

Local anesthesia: A drug injected directly to the site of an incision during an operation to relive pain.

Skin resurfacing: Treatment to improve the texture, clarity and overall appearance of your skin.

Sutures: Stitches used by surgeons to hold skin and tissue together.