What is Blepharoplasty?
The eyelid lift, technically known as Blepharoplasty, is a plastic surgery procedure designed to correct puffy, sagging or tired-looking eyes. The procedure restores a more youthful and refreshed appearance to the eye area by removing excess skin, fat and muscle. The eyelid lift may be performed on the upper or lower eyelids or on both eyelids, and it may be combined with laser skin resurfacing to enhance the results.
|What is the pain level after the surgery?||Mild|
|Anesthesia type (if applicable)||General anesthesia|
|Duration of Surgery||90 minutes|
|Where will scaring for this procedure be?||Incision is made in the creases of the upper eyelids or, for the lower eyelids just under the lash line or in the crow’s feet area|
|Timeframe to begin showing final results||2 to 3 weeks|
|When is the patient able to return to regular activities?||1 week|
|When is the patient able to resume exercise?||2 weeks|
|Cost of surgeon’s fee||Upper – $3,750 / Lower – $3,500 / Upper & Lower – $6,000|
Actual Patient Results
The blepharoplasty operation corrects the upper and lower eye region of the face. It requires an excision of skin or fat, with tightening and smoothing of the supporting muscle, and or tissues of the eyelids. Blepharoplasty is often times performed predominately to improve the appearance of “tired” appearing eyes, lower lid bags and drooping upper eyelids. In some instances upper blepharoplasty is performed as a medically necessary procedure in order to improve one’s peripheral vision. Blepharoplasty surgery is a popular cosmetic procedure among both male and female patients.
Dr. Jessica Kulak
Dr. Jessica Kulak is our Double Board certified Facial Plastic Surgeon. Dr. Kulak is a true specialist who only performs surgery on the face and neck. She performs the upper blepharoplasty procedure in office under local anesthesia, as well as in a hospital setting under general anesthesia. The lower blepharoplasty procedure is only done in a hospital setting under general anesthesia. When performed together upper and lower eyelid surgery takes about two hours to complete. Anesthetic options include MAC (monitored anesthesia care), general anesthesia, and local anesthesia. Dr. Kulak is extremely particular, making sure all of her measurements are precise to achieve symmetric eyelid creases. She is known for achieving natural results, without that “surprised”, or “hollowed” appearance. All of her scars are hidden in the natural eyelid creases, this also allows her to preserve the natural eyelid shape.
Who is a Candidate for Blepharoplasty?
Good candidates for the blepharoplasty include healthy patients who are looking to improve the appearance of eyelid bags and/or loose eyelid skin. The procedure is popular amongst male and females. Blepharoplasty can be performed on patient’s of all ages and ethnicities.
- Loose or sagging skin on the eyelid that weighs down
- Loss of the natural contour/shape of the upper eyelid
- Excess skin that impairs vision
- Fatty deposits
- Puffiness under eyes
- Bags under the eyes
- Any excess skin or fine wrinkles of the lower eyelid
- Dark circles
Actual Patient Results
The upper blepharoplasty surgery, also known as upper eyelid surgery, allows patients to look rejuvenated without having their face change drastically. Eyelid skin is normal, but as we age, the excess skin beings to sag and weigh down, making one appear older and tired. In the case of women, the loose excess skin makes applying eyeshadow difficult and easy to smudge. Difficulty with applying make-up is one of the top reasons why younger women in their 30s seek upper blepharoplasty surgery. When the upper eyelid gets heavy, patients often unconsciously elevate their brows to open up their eyes, leading to formation of horizontal forehead wrinkles. Furthermore until the excess skin of the upper eyelid is removed, our doctors cannot fully treat these forehead wrinkles with Botox. Relaxing the forehead muscles with Botox, in a patient that truly needs an upper blepharoplasty will prevent the ability to raise the brows and will make the upper eyelids feel even heavier and “droopy.” Prior to treating forehead lines, the main issue, loose upper eyelid skin, must be addressed first.
The upper blepharoplasty procedure removes droopy eyelid skin, eyelid fullness, or extra fat. Everyone has different shaped and sized eyes and the blepharoplasty procedure is custom tailored to each patient’s specific anatomy. It is extremely important to preserve the patients underlying muscles that surround the eyes and to not remove excessive amounts of tissue. If too much tissue is removed the patient may have trouble with closing the lids fully and experience dry eyes permanently. At The Naderi Center, our surgeon measures each eye multiple times to ensure that the proper amount of tissue is removed resulting in eyes that appear rested and rejuvenated.
One of the most common reasons for lower blepharoplasty is to diminish the appearance of “under eye bags”. Patients feel as if they constantly look tired, have under eye wrinkles, or sagging under eye skin. The under eye skin is the thinnest skin on the face, therefore the skin in this area is one of the first places to start to become crepey with aging. Often times patients have this area injected with hyluronic acid fillers or fat to allow for smoothening of the skin. This type of under eye filler injection is referred to as “tear trough” injections. In some instances filler injections are just not enough to get rid of the hollowness, dark circles and crepey skin. This is when the expertise of a board certified facial plastic surgeon is vital to determining whether a patient is a candidate for surgery.
Actual Patient Results
During the lower blepharoplasty procedure, our surgeon removes the fat pads, excess skin or creping skin from under the eyes. Our surgeon’s approach to a lower blepharoplasty is also known as a transconjunctival lower blepharoplasty. With transconjunctival lower blepharoplasty the incisions are placed inside the eyelid margin, creating nicely hidden scars. The transconjunctival lower blepharoplasty gives you natural results and preserves the structure and function of the muscles in the lower eyelid.
Types of Blepharoplasty
A functional blepharoplasty is when the sagging, excess eyelid skin impairs field of vision. Patient’s experience difficultly with peripheral vision.
Cosmetic blepharoplasty can be performed on the upper and lower eyelids. Cosmetic blepharoplasty is primerly performed to give patients a refreshed and more rejuvenated look.
Photos courtesy of Austin Oculoplastics and Utah Valley Eye
Why does the eyelid skin begin to sag?
During the natural aging process our body loses collagen in our face causing a loss in skin elasticity. Loss of skin elasticity combined with gravity causes the skin to drop down and sag. When it comes to eyelid tissue, the edges of the upper eyelid margin begin to fall first. The tendon of the eyelid muscle responsible for elevating the upper eyelid stretches, hence making it difficult for the upper eyelid muscle to lift the upper eyelid. Throughout aging elasticity and weakened muscles create a droopy upper eyelid appearance. Additionally, excessive manipulation of the upper eyelid (i.e. excessive eye rubbing, eyelid retraction, etc) can stretch the upper eyelid skin and lead to droopy upper eyelids. Cataract surgery (or other eye surgery) is also a common cause of droopy eyelids, because manipulation of the eyelid during the surgery can weaken the muscle holding the eye open. In some cases, droopy eyelids can be present since birth, this is called Congenital Ptosis.
Actual Patient Results
In addition to eyelid skin loosing elasticity, during the aging process the entire face begins to lose volume, making at times bony structures on the face more prominent. When the cheeks begin to fall, that’s when the under eyes appear more prominent and hollow.
The upper and lower blepharoplasty can be performed separately or at the same time. Our surgeon can perform the upper blepharoplasty procedure in-office under local anesthesia and oral sedation. If the upper and lower blepharoplasties are to be performed together they are done under general anesthesia.
Upper Blepharoplasty Surgical Technique
Our facial plastic surgeon begins the upper blepharoplasty procedure by making precise measurements to achieve symmetrical eyelid creases. Our surgeon then proceeds to remove the excess, sagging eyelid skin. The surgical incision is just beneath the lashes, this way the scar is unnoticeable after they have healed. Ones the skin is removed, the incision is closed with sutures. The sutures will be removed one week after the surgery. The natural eyelid shape is kept, so results will not look hollowed or “surprised”. Every patient is different, and our surgeon will determine how much fat, skin and tissue needs to be removed to achieve a natural result.
Lower Blepharoplasty Surgical Technique
Lower blepharoplasty is similar to the upper blepharoplasty. Our surgeon makes her incisions inside the eyelid, so that you have no visible scar. This also will prevent your eyelids from changing shape. The surgeon removes the excess, sagging skin, while removing any fat pads you may have.
The Asian blepharoplasty is slightly different because the “single eyelid is changed to a “double eyelid”. This means that eyelids without a crease, will now have a crease. The Asian blepharoplasty is not intended to alter the patient’s appearance, but it will create a subtle, lifted difference. The procedure is performed very similar to the upper blepharoplasty surgery. The only difference is, a small strip of the orbicularis muscle is sculpted to help form the new eyelid crease. The incisions are closed with sutures and the patient is left without a “heavy”, but natural looking eyelid.
Complications from Blepharoplasty
With any procedure, complications can occur. Our surgeon will always go over any potential complications you may have. Although, they are rare, they need to be discussed. These potential complications are also why patients should select a surgeon extremely well versed and experienced in blepharoplasty surgery.
- Vision loss from retrobulbar hemorrhage
- Double vision from problems with eye alignment
- Noticeable surgical scarring
- Malpositioned eyelids
- Overcorrection (removing too much skin)
- Numbness of the eyelids
Actual Patient Results
Recovery from Blepharoplasty
Immediately after the blepharoplasty procedure, a topical ointment will be applied to the eyes to keep the incision sites moist. Sometimes this topical ointment makes ones vision blurry and this is normal. The first day after surgery we advise applying cool compresses made of gauze that is dipped in ice water. Do not apply direct ice on the eyes. These cool compresses can be applied in intervals of ten minutes on and ten minutes off. The cool compresses help reduce swelling and keeps the bruising to a minimum. Our surgeon will prescribe pain medication to take if needed. You should expect mild discomfort immediately after the surgery, and a couple days following the procedure. Swelling, bruising and blood shot eyes are very normal. Swelling the first few days after surgery will be the worse, especially after you wake up from lying flat.
Some common side effects experienced after blepharoplasty surgery include:
- Swelling and Discoloration. It is completely normal for your eyes to appear swollen as well as have purple-bluish bruising around the eye and eyelid. The bruising will be greater on the second and third day after your surgery. This is temporary and over the course of the next six weeks this will improve. Cool compresses will minimize swelling and bruising.
- Mild Bleeding. Some mild bleeding is not unusual at the incision sites the first few days after surgery. If you try to do strenuous activity, increase your blood pressure by straining on the toilet, sneezing, heavy lifting or bending forward you will aggravate the bleeding and swelling.
- Numbness around the eyes. Parts of the eyelids may feel “numb” or lumpy after the eyelid operation. This is temporary and to be expected and may take months to feel normal again.
- Pain and Itching. It is normal to experience tightness, pressure, shooting pain, itchiness, soreness, and fatigue for several days to weeks following surgery as you recover.
- Blurry Vision. Patients often experience some blurring of vision for 2-3 days after surgery. This is g
Q & A
What are some common complimenting procedures that can be combined with to blepharoplasty?
DLaser resurfacing around the eyes or even the entire face is often times performed to enahce the surgical results. Laser resurfacing will help reduce fine lines and wrinkles, acne scars, lighten brown spots, tighten the skin’s elasticity, stimulate collagen, smoothen the skin texture, brighten your complexion and give the face an overall more rejuvenated appearance. Other popular procedures to combine with the blepharoplasty procedure include a facelift, browlift, rhinoplasty, chin implant or neck liposuction. As well as body procedures.
Actual Patient Results
Can patients with dry eyes proceed with a blepharoplasty procedure?
Patients with a history of dry eye syndrome can proceed with a blepharoplasty procedure however the surgeon must be extremely cautious to remove precisely the proper amount of eyelid tissue. If excessive eyelid tissue is removed the problem of dry eye will be aggravated as potentially more of the eye surface is exposed to air when the patient attempts to close the eyes.
When can I go back to work after blepharoplasty?
Every patient is different and heals differently. 1-2 weeks is recommended to take off of work.
Will the results of the blepharoplasty surgery be permanent?
The lower blepharoplasty rarely needs to be repeated. As time goes on, your eyes will continue to age after the procedure. The upper eyelid surgery can last with nice results for 10+ years. Once the fat is removed, it will always be removed. Patients rarely have another surgery.
Will the upper and lower blepharolplasty procedure get rid of deep wrinkles around my eyes?
The upper blepharoplasty will not remove deep wrinkles around the eyes. The Lower Blepharoplasty with a skin pinch technique can remove creping or deep wrinkles under eye.
Actual Patient Results
Can lasers that tighten the skin, give me the same results as an upper blepharoplasty?
Lasers can help tighten the skin, but the laser will not be able to remove the skin. The blepharoplasty is for skin removal and the laser is for fine line wrinkle removal.
What form of anesthesia will be used for the upper and lower blepharoplasty?
You have the option to get both, the upper and lower eyelids done under general anesthesia in a hospital setting or just the upper eyelids in office with local anesthesia.
Can I wear eyeglasses after my blepharoplasty surgery?
Eyeglasses may be worn after blepharoplasty surgery.
Can I wear contacts after blepharoplasty surgery?
We advise patients to wait one week post blepharoplasty surgery before applying their contact lenses.
Does insurance cover blepharoplasty?
If the severity of eyelid droopiness or ptosis, affects a patient’s peripheral vision most insurance providers will approve upper blepharoplasty as a functional procedure and medically necessary. An ophthalmology exam is usually needed in cases of functional blepharoplasty. Our surgeons only perform cosmetic blepharoplasty.
How much is the blepharoplasty surgery? (Not including hospital and anesthesia fees)
Upper & lower blepharoplasty- $6,000
lower blepharoplasty- $3,500
upper blepharoplasty (in office) $3,750.
When can I work out post blepharoplasty surgery?
Patient can resume exercise 1-3 weeks after belpharoplasty surgery.