Eyelid Surgery (Blepharoplasty)

Every year, more than 100,000 men and women choose eyelid surgery to improve the way they look. Technically known as Blepharoplasty, this procedure corrects droopy eyelids and puffy bags below your eyes – features that can make you look older and also impair your vision. Eyelid surgery cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Instead, eyelid surgery can remove puffiness and bags under the eyes that make you look worn and tired. Though blepharoplasty is often performed as a single procedure, your surgeon may also suggest a brow lift, facelift, or skin resurfacing procedure to achieve the best results.

Before you elect to have surgery, know your expectations and share them with your surgeon. The best candidates are healthy men and women who are psychologically stable and realistic about their results.

During the pre-surgical consultation, your surgeon will explain what you can expect from blepharoplasty and take a complete medical history. It is important to inform your doctor of any allergies you may have, vitamins and medication you are taking, and if you smoke or have a history of dry eyes. You can expect an open and honest exchange with Dr. Cohen, which will establish the basis for a successful outcome. It is also necessary to provide applicable information from your ophthalmologist or a copy of a recent eye exam. If you wear glasses or contact lenses, please make sure to bring them with you.

You and Dr. Cohen should discuss your goals and expectations of surgery. You’ll both need to clarify whether the surgery will be performed on all four eyelids or just the upper or lower portions, whether skin as well as fat will be removed, and whether any additional surgery is recommended for the results you are looking to obtain. After you and your surgeon make a mutual decision, the technique indicated for your individual surgery will be discussed. The type of anesthesia, the surgical facility, any supportive surgery, and the risks and costs inherent in the procedure will be explained. Don’t hesitate to ask your doctor any questions you may have related to your surgery.

Dr. Cohen will give you specific instructions on pre-surgery preparation, which includes instructions on eating, drinking, smoking, and consumption of certain vitamins and medications. Following these guidelines will make your surgery a more pleasant experience. It is also recommended to arrange for someone to drive you home after the surgery, and to help take care of you as needed. Your eyelid surgery will be performed in Dr. Cohen’s surgery center and is done on an outpatient basis; rarely does it require an extended stay. The surgical procedure is a relatively short one and takes about two hours, depending on whether the upper and/or lower lids are being done.

In a typical upper eyelid procedure, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.

In lower eyelid surgery, Dr. Cohen will decide which approach is appropriate. He may recommend that an incision be made, in an inconspicuous site, along the lash line and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is either removed or repositioned to achieve normal contour of the lower lid. No visible sutures are required.

After the surgery has been completed, your surgeon may lubricate your eyes with ointment to prevent dryness. Your eyelids might also feel tight and somewhat uncomfortable as the anesthesia wears off so medication will be prescribed. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort.

For a week and a half following blepharoplasty, you must clean the eye area (the eyes may feel sticky, dry, and itchy). Eye drops may be recommended. Dr. Cohen, or his nurse, will also list activities and environments to avoid in the weeks immediately following surgery. Permanent stitches will be removed in three to five days after surgery. Once they’re removed, the swelling and discoloration around the eyes will eventually go away, and you’ll begin to look and feel better.

You should be able to continue normal reading and television activities within a few days. However, you won’t be able to wear contact lenses for a while longer, and even then they may take a little time to feel comfortable again.

Most people are ready to go out in public within a week or so. By then, you should be able to wear makeup to hide any bruising. It’s possible that you may be especially sensitive to light and wind among other irritants for a few weeks, so you should consider wearing sunglasses and a special sun block for your eyelids when you go out.

Finally, your surgeon will also make recommendations for keeping your activity levels to a minimum immediately following surgery since it’s especially important to avoid activities that elevate your blood pressure including bending, lifting, and rigorous sports. You may also be advised to avoid alcohol since it is directly related to fluid retention.

Your eyelid surgery can offer a refreshed appearance, with a younger, firmer eye area and a happier you.