Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the eyelids.

Upper eyelid excess skin and fat can create a heavy looking eyelid, aged appearance, puffiness, and sometimes block vision. Upper blepharoplasty is performed to remove excess skin and fat and can improve vision.

Double eyelid surgery is performed to create an upper eyelid crease. Double eyelid surgery is also called Westernization of the eyelid.

Lower blepharoplasty is performed to remove excess skin, reduce wrinkles, and improve the shape of the lower eyelid by removing skin and fat. Sometimes tightening the eyelid is needed to correct droopiness or sagging. Adding fat is done to improve a "hollowed" appearance

Whether you want to improve your appearance or are experiencing functional problems with your eyelids, eyelid surgery can rejuvenate the area surrounding your eyes.

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 eyelids
• Bags under the eyes
• Drooping lower eyelids that reveal white below the iris
• Excess skin and fine wrinkles of the lower eyelid

In general, good candidates for eyelid surgery include:

• 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 eyelid surgery
• Individuals without serious eye conditions

Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to relaxation of the forehead skin and eyebrow. Sometimes a drooping eyelid is caused by stretching of one of the upper eyelid muscles.

Your plastic surgeon will evaluate your anatomy thoroughly to determine the causes of your eyelid appearance and what procedures might best remedy them.

Prior to eyelid surgery the patient should have a detailed discussion about blepharoplasty and potential risks associated with the procedure. The patient should follow the doctor's pre-operative instructions carefully and thoroughly review the post-operative instructions before the day of surgery. This will allow the patient to have any medications for pain relief or necessary items such a gel packs, artificial tears, and gauze at home prior to their return from surgery. It may be required to have your medical doctor "clear" you for surgery if intravenous sedation or general anesthesia is used.

During your eyelid surgery recovery, lubricating ointment and cold compresses may be applied, and in some cases your eyes may be loosely covered with gauze, after your procedure is completed.

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 your plastic surgeon.

Although bruising and swelling is usually worse on the day after surgery, they quickly begin to disappear. During the first 48 hours the use of cool compresses can greatly reduce bruising and swelling around the eyes and face. Light activity such as walking will also help speed healing. Thin bandages are usually placed over the incision sites and removed in several days, while the stitches can remain in the skin for about a week. Sometimes self-absorbing stitches are used that do not require removal.

Most people return to normal activities after 7 to 10 days following blepharoplasty. By 2 weeks after eyelid surgery, the majority of the bruising and swelling will resolve.

Be sure to ask your plastic surgeon 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?

Eyelid surgery recovery & sun protection

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

The results of eyelid surgery 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.

Satisfaction with your new image should continue to grow as you recover from surgery. As swelling and bruising subside, the results of eyelid surgery will reveal a smooth, better-defined eyelid and surrounding region and an alert and rejuvenated appearance.

Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your surgeon's instructions is essential 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.

Your doctor will give you specific instructions on how to care for yourself.

The decision to have surgery is personal, and you'll have to decide if it will achieve your goals, and if the potential risks of eyelid surgery are acceptable.

Be sure you understand the surgery and recuperation completely, and don't hesitate to ask your plastic surgeon questions.

As with any surgery, there are potential risks and complications of blepharoplasty. These risks include infection, bleeding, scarring, inability to close the eyes, dry eye, abnormal eyelid position, double vision, and loss of vision

During your consultation be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies, and previous medical treatments and specifically any problems you have had with your eyes
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries

Your surgeon will also:

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

Use this checklist of as a guide during your eyelid surgery consultation:

• Am I a good candidate for this procedure?
• What will be expected of me to get the best results?
• Where and how will you perform my procedure?
• What surgical technique is recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• How can I expect my eyes to look over time?
• What are my options if I am dissatisfied with the cosmetic outcome of my eyelid surgery?
• Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?