ALL ABOUT EYELID SURGERY (BLEPHAROPLASTY)
Eyelid surgery, also called blepharoplasty, is the best option to get rid of droopy or sagging eyelids. These unflattering facial features can give you a tired appearance. Also, they can prevent your eyes from opening completely.
As we get old, the eyelid skin shows the earliest signs of aging. Your eyelids stretch, and the muscles weaken. As a result, excess fat may accumulate in your eyelids, causing droopy upper lids and heavy bags under your eyes.
Another result of aging is the descent of the midface. A youthful lower eyelid usually makes a smooth transition to the cheek contour. However, as years pass by, the lower lid often becomes disjointed from the cheek, making us appear haggard.
Other patients may present with added problems. Aside from aging, genetics could cause the eyelids to be asymmetric. And blepharoplasty may be performed to improve this situation.
Of course, eyelid surgery can make your eyes appear younger and more alert. However, besides making you look older, sagging skin around your upper eyelids can reduce your side vision, turning into a medical problem.
Nevertheless, before making the decision, you must understand what’s involved in this surgery, including the benefits and risks.
Hence, we are here to help you decide if this procedure is a good option. Although, eyelid surgery is generally considered a safe and effective cosmetic treatment.
Medically reviewed by Dr Osama Bahsas Zaky
Written by Joaquín Pineda
Updated on August 3, 2021
WHAT IS EYELID SURGERY?
Eyelid surgery, also called blepharoplasty or eye lift, is one of the most common cosmetic procedures performed during the Covid-19 period.
This surgical procedure involves cutting along the creases of your eyelids to remove excess skin and muscle. It also reduces or repositions the excess underlying fat.
An eye lift is effective in treating eye bags and drooping eyelids. However, it is useless against dark circles under the eyes, crow’s feet, fine lines, or wrinkles.
The surgery is planned according to the needs of each patient. It can be done on the upper or lower eyelids, or you could get double eyelid surgery too. This should give you a fresh look and a more alert appearance.
Besides, blepharoplasty can be performed in combination with other cosmetic procedures, such as a brow lift or traditional facelift, to rejuvenate all your facial features.
An eyelift usually takes up to 2 hours if both upper and lower eyelids are done together. It can be done under local anaesthetic plus IV sedation. Hospitalization is not necessary.
Whichever is your case, eyelid surgery requires a plastic surgeon with wide experience. For the entire face to look harmonious and beautiful, the eyelids need to be balanced with the rest of the face. Here is where good plastic surgeons stand out, or better said, oculoplastic surgeons.
For some patients, blepharoplasty results may last a lifetime. For others, upper eyelid surgery is good for nearly 5-7 years. Lower eyelid surgery usually doesn’t need to be repeated. But remember that your eyes will still age after the surgery!
WHAT KIND OF PATIENTS USUALLY ASK FOR EYELID SURGERY?
Blepharoplasty is one of the least invasive facial cosmetic surgeries with better results. It rejuvenates the face in a very natural way and with no visible scars.
The surgery is designed for each individual, according to the particular needs of the patient.
It is routinely performed on patients over 35 years old. However, if genetics are not on your side and baggy/ droopy eyelids run in your family, you may decide on having the surgery before long.
Also, you could choose surgery for medical or cosmetic reasons, or maybe both. Upper eyelid surgery, also known as upper blepharoplasty, is not performed just for vanity.
For some patients, saggy upper eyelid skin can obstruct the visual field. So, surgery is performed to improve peripheral vision, especially the upper and outer parts of your field of vision.
Before The Surgery
Before choosing to have an eyelid surgery, you have to meet with the plastic surgeon and an eye specialist (ophthalmologist). Or, in any case, a plastic surgeon who specializes in eye surgeries (oculoplastic surgeon) to discuss your case.
They will take a look at your medical history. Also, a physical examination is mandatory. Your surgeon will verify your tear production and measure parts of your eyelids.
Additionally, some insurance carriers require the submission of a visual examination.
Your eye doctor will examine your vision, including your peripheral vision. This could be required to support an insurance claim and to approve blepharoplasty as a medically indicated procedure.
Your cosmetic surgeon most likely will take before and after photographs from different angles. These photos help planning out the surgery. Also, they are used to have an honest preview of the possible outcomes considering your goals and expectations.
Your surgeon will discuss with you both the risks and benefits. He is responsible for answering every question you may have before making this important decision. After all, blepharoplasty is not for everyone!
This consultation is also important to give preoperative recommendations. For example, it is best to avoid smoking, take alcohol, aspirin, blood thinners, or ibuprofen-like medications several days prior to the surgery.
These medications could increase the risk of bleeding and slow down the wound healing process. In the case of patients who cannot quit smoking completely, at least they should cut down on tobacco use.
WHAT DOES UPPER EYELID SURGERY INVOLVE?
Upper eyelid excess skin and fat can create heavily hooded eyes that could give you an unflattering tired appearance. And they can even block the upper field of vision too.
Hence, you must have upper eyelid blepharoplasty to improve the area between the eyebrow and the eyelashes. To correct the upper lids, the surplus part of the skin is removed, and the excess fat is extracted or repositioned.
The doctor will make an incision along the natural eyelid crease. Rest assured because the scar will not be visible; it will remain hidden within the natural fold of your eye.
The eyelid surgery practiced by Doctor Benito is the most conservative. He doesn’t remove too much from the eyelids, just the right amount. The main goal is to get natural results and for your eyes to look well-rested and alert.
Normally, upper eyelid surgery is done under local anaesthetic in the same doctor’s office. Hospitalization is not necessary. If you have surgery on both your upper and lower eyelids, the surgeon generally works on your upper lids first.
Upper blepharoplasty recovery is almost painless. However, during the recovery period, patients may refer discomfort during the first days after surgery.
The inflammation could stop the eyelid from closing completely. Also, there could be bruising and swelling.
The stitches are removed seven days after the surgery. From that moment on, the bruising can be covered with make-up, preferably yellow tone concealers.
Intense sport and the swimming pool are discouraged during the first month.
It is normal for the patient not to see immediate results. Fortunately, the eyelid heals very quickly, and the inflammation disappears completely in about four months. The scar is practically invisible in a year.
WHAT DOES LOWER EYELID SURGERY INVOLVE?
A lower eyelid surgery (lower blepharoplasty) is a more complicated procedure. Lower eyelid blepharoplasty improves the area between the eyelashes and the cheeks.
There are various techniques available: classic, transconjunctival, Loeb, and canthopexy. Any approach can be combined with laser resurfacing of the eyelid skin to reduce lines and wrinkles, which gives you an added bonus.
Your doctor could choose one technique over the other depending on your particular case. First, he must evaluate your eyelids, overall face and consider your expectations.
In general terms, lower eyelid surgery can involve skin incisions directly below the lash line or on the inside of the eyelid, known as the transconjunctival approach.
Usually, for younger patients, the transconjunctival approach allows for access to the eyelid without visible incisions. This is a scarless technique perfect for patients who need fat bulges or bags under the eyes removed.
Indeed, eye bag surgery is a very popular procedure. The skin closure can be made using either removable sutures or glue. In the last case, no suture removal may be required.
In case of stitches, four or five days after the surgery, they are removed. Drainage massages are advised to reduce swelling and to give elasticity to the skin.
Due to the tissue manipulation, there could be an accumulation of fluid or swelling in the bags under the eyes. But this is a transient effect.
HOW DO I REDUCE THE INFLAMMATION AND BRUISING AFTER A BLEPHAROPLASTY?
The eyelids swell easily. The most effective way to reduce inflammation is to apply cold to the zone using ice packs for 10 minutes every hour the night after surgery. In the next few days, use ice packs on your eyes four to five times daily.
We recommend making some camomile tea, keeping it in the fridge, and afterward soaking gauzes in it and putting them on the eyes. You could also use cold gel masks or a frozen peas bag wrapped in a towel.
It is very important not to lie down completely flat. Sleep in a sitting-up position with the head slightly raised on pillows.
Any bruises and swelling have an evolution time from 10 to 15 days. Although, expect 2-4 weeks’ worth of swelling after upper and lower eyelid blepharoplasty. You could use a venous congestion reliever. Arnica tablets and creams can also be a good preventive treatment.
After a blepharoplasty surgery, the eyes are more sensitive, and if we read or watch television, they can get more swollen. The recommendation is to forego reading and television during the first four days of rest.
Also, as the eyelid doesn’t close adequately, it is crucial to protect the cornea to avoid dry eyes, especially at night.
Immediately after surgery, you could have blurry vision and be sensitive to light. Also, your eyes could feel watery or dry.
For this reason, your doctor will prescribe anti-inflammatory drops, artificial tears, and a thick protective eye ointment for night time. This ointment should be used for the first 2-3 weeks until we are sure that the eyelid shuts completely.
Some people may complain of dry eyes after surgery, but usually, that doesn’t last more than two weeks. If you persist with dry eyes lasting more time, contact your doctor.
WHAT PERIOD OF THE YEAR IS RECOMMENDED FOR HAVING A BLEPHAROPLASTY?
The best time to have a blepharoplasty surgery is the eight months from September to April. It is necessary to protect the scars and bruises from the damage that can be caused by the sun.
Many facial surgeries, including facelifts, nose jobs, or blepharoplasty, leave bruises during the first 15-20 days.
If the intervention is done in summer, we need to be very strict with regard to using protection from the sun. You should wear a total sunblock, sunglasses, and wide-brimmed sun hats.
During the summer, you shouldn’t go to the beach or to the mountain where there is the risk that the scars and bruises could become pigmented. This hyperpigmentation is visible and very difficult to treat afterward.
HOW MUCH EYELID SURGERY COSTS?
Eyelid surgery cost depends on many factors. Without meeting the patient we don’t offer approximate prices as each patient is a different case.
But we know that the economic factor is important when it comes to making a decision. Therefore, we offer the possibility for the patient to come to our facilities for a first free no-obligation visit.
You can consult with the surgeon regarding all your doubts and worries. According to your characteristics, we will offer the best solution and the best price for your eyelid surgery.
HOW WILL I LOOK AFTER A BLEPHAROPLASTY?
When a person decides to go in for a blepharoplasty there is a feeling of uncertainty. And here is where computer simulations come into play, since they let you see a before & after result. Recent progress in photographic software allows the patient to get an idea of what the final result will be. What surgeons aim to achieve after the surgery.
Computer simulation is done with the purpose of getting surgeon and patient to agree on the result they want to obtain. But the computer simulation should in no way be considered as what the final result will be.
Undoubtedly the surgeons and the patients are the most interested in getting the desired result. But we should not forget that the plastic surgery involves working with living tissue. Changing the appearance of something specific on the computer is a matter of seconds. However, the computer doesn’t take into account the quality and thickness of the eyelid skin, how aged the skin is, and the wound healing of the tissues during the procedure nor the possible complications.
WHY CHOOSE DOCTOR BENITO FOR YOUR BLEPHAROPLASTY IN SPAIN?
The eyelid correction technique used by Doctor Jesús Benito is minimally invasive and offers excellent results. The goal is to get a young and very natural look.
Scars are not visible. Blepharoplasty doesn’t require hospitalization and the postoperative period is almost painless.
With more than 20 years of experience, Antiaging Group Barcelona is a leading clinic in Spain in eyelid surgery.
Doctor Benito is a recognised authority in Spain in plastic, reconstructive and cosmetic surgery.
Doctor Jesús Benito
Specialist in plastic and cosmetic surgery.
- Secretary of the ISAPS (International Society of Aesthetic Plastic Surgery).
- Former president of the Spanish Association of Aesthetic Plastic Surgery (AECEP).
- 2013 Gold Medal (Forum Europa)
Bibliography & Publications:
Rejuvenecimiento periorbitario (blefaro y actuación en pómulo mediante injertos de tejido adiposo o lifting de tercio medio). Dr. Jesús Benito Ruiz. III Simposium Internacional de Cirugía Plástica, reconstructiva y Estética. Guayaquil, 9-10 de octubre de 2013.
Refinements in Upper Blepharoplasty: The Five-Step Technique. Rohrich RJ, Villanueva NL, Afrooz PN.Plast Reconstr Surg. 2018
Blepharoplasty: Anatomy, Planning, Techniques, and Safety. Alghoul M.Aesthet Surg J. 2019
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