As we age, the delicate skin around the eyes can appear
puffy or saggy. Eyelid skin stretches, muscles weaken, and the normal deposits
of protective fat around the eye bulge. The surgical procedure to remove excess
eyelid tissues (skin, muscle, or fat) is called blepharoplasty.
Blepharoplasty can be performed on the upper eyelid, lower
eyelid, or both. The surgery is performed for either cosmetic or functional
reasons. Sometimes excess upper eyelid tissue obstructs the upper visual field
or can weigh down the eyelid and produce tired-feeling eyes. Most often, people
choose blepharoplasty to improve their appearance by making the area around
their eyes firmer. When blepharoplasty is performed to improve vision, rather
than for cosmetic reasons only, it may be covered by insurance.
Blepharoplasty for the lower lid removes the large bags
under the eyes. It is unusual for third party payers to cover lower lid
The surgery is usually performed on an outpatient basis
and can take one to three hours. Upper lid incisions are made in the natural
crease of the lid, and lower lid incisions are made just below the lash line. A
procedure for lower lid blepharoplasty, called transconjunctival
blepharoplasty, removes excess fat through an incision inside the lower lid.
Incisions are closed with fine sutures.
Swelling, bruising and blurry vision are common after
blepharoplasty. Stitches are removed three to five days after surgery, except
in the case of transconjunctival blepharoplasty where the self-dissolving
sutures require no removal.
Possible complications associated with blepharoplasty
include bleeding and swelling, delayed healing, infection, drooping of upper or
lower eyelid, asymmetry, double vision, and dry eye. It is important to note
that the puffiness of the fat pockets may not return, but normal wrinkling and
aging of the eye area will continue.