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Did you know blepharoplasty is the third most common cosmetic procedure in the United States?
If you’ve never heard of it before, blepharoplasty is a surgery performed on the eyelids to improve a person’s vision or appearance. Also known as an eye lift, the procedure can be done for cosmetic or functional reasons (Cosmetic Surgery National Data Bank Statistics, 2018).
As you age, your skin loses its natural elasticity. The skin around your eyes begins to sag and droop, leading to wrinkles, folds, and bulges that may make your eyes look older. In some cases, droopy eyelids can obstruct your peripheral vision.
Of the nearly 150,000 blepharoplasty procedures performed in the United States each year, around 70% are done for functional reasons like improving vision. The remaining 30% are done purely for cosmetic reasons to make the eyes appear more youthful (Kossler, 2018).
What is blepharoplasty?
During blepharoplasty, excess and droopy skin is removed from the upper eyelids, lower eyelids, or both.
The procedure can improve the appearance of sagging eyebrows, bags under the eyes, and puffy or drooping eyelids but won’t fix dark circles, crow’s feet, or other facial wrinkles.
On top of creating a more youthful appearance, blepharoplasty may be used to improve a person’s vision. Excess or sagging skin around the eyes can impair peripheral vision and make it harder to fully open or close your eyes.
Types of blepharoplasty
There are two main types of blepharoplasty, depending on which eyelids are being worked on:
- Upper blepharoplasty: This removes excess skin and fatty tissue from the upper lids. It is done to alleviate puffiness or improve peripheral vision.
- Lower blepharoplasty: Lower lid surgery aims to reduce droopiness and bags from your lower eyelids.
Benefits of eyelid surgery
The main benefits of an eyelift include an improved, more youthful appearance of the eyes and better peripheral vision. The results of eyelid surgery are typically long-lasting.
Blepharoplasty is generally successful, but it’s possible you may need additional surgery if you’re unhappy with the results or your eyelids don’t heal properly (Klapper, 2007; Patel, 2021).
How does eyelid surgery work?
There are three stages to eyelid surgery: preparation, the surgery itself, and recovery. Here’s what you can expect.
Prior to the procedure
First, you’ll meet with your surgeon to discuss your symptoms and your goals for the eyelift. They will perform a health assessment to understand your medical history, and previous surgeries and go over any medications you’re taking.
They’ll also conduct a physical and vision exam for insurance purposes, including taking photos of your eyes from various angles. Finally, you’ll discuss surgical options, what to expect from the procedure, and any risks involved before scheduling your surgery.
Your doctor may recommend that you avoid taking certain medications before the procedure. You’ll also want to ask a friend or family member to drive you home since driving isn’t an option until the sedation wears off.
Blepharoplasty can be done in a hospital or surgeon’s office and only takes an hour or two. It can also be performed in combination with other procedures like facelifts or laser resurfacing.
The surgeon will numb your eyelids with a local anesthetic, and you may be sedated with an injection so you feel more relaxed (Rebowe, 2021). If both upper and lower lids are being worked on, upper blepharoplasty will be done first. This involves making an incision along the crease in your eyelid and then removing excess skin, fat, or muscle.
In lower blepharoplasty, an incision is made just below the lashes or on the inside of your lower eyelid. Depending on your goals, the surgeon may either remove excess skin, fat, and muscle or move it around to prevent droopiness before closing the incision.
Recovery from eyelid surgery
Recovery from an eyelift takes a few weeks. Plan to schedule time off work and have someone stay with you overnight following surgery. Immediately after the procedure, you’ll be monitored in a recovery room before being sent home.
After surgery, you may experience the following side effects (Oestreicher, 2012; Patel, 2021):
- Blurry or double vision
- Watery eyes
- Bruising and swelling around your eyes
- Sensitivity to light
- Puffiness or numbness in the eyelids
These symptoms should go away on their own within a few days to a couple of weeks. To make your recovery as smooth as possible, follow any post-operative instructions given to you by the surgeon.
Instructions may include applying ice packs or cool compresses to your eyes throughout the day, cleaning eyelids with eye drops or ointments, and sleeping with your head elevated above your chest to reduce swelling (Oestreicher, 2012).
After 7–10 days, you’ll return to the surgeon’s office to have any stitches or sutures removed (Naik, 2009; Scawn, 2016). In the remaining weeks of recovery, your surgeon will likely tell you to avoid:
- Medications or supplements that increase bleeding (warfarin, aspirin, ibuprofen)
- Strenuous physical activity, such as exercise or lifting heavy boxes
- Rubbing your eyes
- Wearing contact lenses
You’ll also wear darkly tinted sunglasses to keep your eyes safe from sun, wind, rain, and snow (Klapper, 2007).
Risks of eyelid surgery
While eye lifts have a high rate of success, possible complications may include the following (Yang, 2017; Patel, 2021):
- Eye dryness or irritation
- Abnormal coloring in the eyelids
- Eyelid skin that folds in or rolls outward
- Being unable to close your eyes fully
- A pulled-down lash line on the lower eyelid
- Blurry vision
In addition to the above risks (which are specific to blepharoplasty), surgery and anesthesia carry their own risks. These include changes in blood pressure or nausea. Talk to your healthcare provider about your medical history and ask if you may be at higher risk for additional side effects.
Who is a candidate for eyelid surgery?
In general, good candidates for blepharoplasty include otherwise healthy people who don’t have a serious eye or medical condition that may affect their ability to heal following surgery.
However, eyelid surgery is not safe for everyone. Smokers and individuals with the following conditions are less likely to be candidates for an eyelift (Scawn, 2016; Rebowe, 2021):
- Dry eye
- Inflammatory disorders like eczema or psoriasis
- Thyroid disease
- Other serious eye or medical conditions that affect moisture in the eyes
How much does blepharoplasty cost?
The cost of this type of surgery varies, but generally, an eye lift costs a few thousand dollars. The total cost will include the surgeon’s fees, facility costs, anesthesia fees, testing fees, and prescription costs.
Financing plans are often available and depending on your reasons for having eyelid surgery, it may be covered by insurance. If you’re having the eye lift to improve your vision, it’s more likely to be covered by insurance. The photographs your surgeon’s office took and the vision exam they gave you can help with insurance claims.
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- Cosmetic Surgery National Data Bank Statistics. (2018). Aesthetic Surgery Journal, 38(3), 1–24. doi: 10.1093/asj/sjy132. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29846503/
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- Patel, B. C., Volner, K., & Malhotra, R. (2021). Transconjunctival Blepharoplasty. In StatPearls. StatPearls Publishing. Retrieved on Oct. 15, 2021 from https://pubmed.ncbi.nlm.nih.gov/30844179/
- Rebowe, R. E., & Runyan, C. (2021). Blepharoplasty. In StatPearls. StatPearls Publishing. Retrieved on Oct. 15, 2021 from https://pubmed.ncbi.nlm.nih.gov/29494003/
- Scawn, R., Gore, S., & Joshi, N. (2016). Blepharoplasty basics for the dermatologist. Journal of Cutaneous and Aesthetic Surgery, 9(2), 80–84. doi: 10.4103/0974-2077.184050. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27398007/
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Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.