Eyelid surgery (blepharoplasty) is the second most popular facial surgical procedure, both among men and women.
Eyelid lift consists of a surgery that removes excess skin and fat from the upper or lower eyelid. It is believed that almost every person, at some point of their life, will have excess skin formed on the upper eyelids, causing it to fall over the eyelashes and even block the upper portion of vision. In many countries of Europe, this surgery is performed for medical and not only aesthetic purposes.
In addition to all the facial rejuvenation modalities, blepharoplasty is among the most effective when it comes to the middle third of the face. Eyelid lift allows the eye to restore its size, shape and freshness that it had at younger age. Since the skin around the eyes is the thinnest and most delicate skin on the body, it is the first to show signs of aging. If a person looks tired even after a good night’s sleep, if the eyelids are swollen every day – it’s probably time to see a surgeon about eyelid surgery.
This surgery is designed individually for each patient, with preoperative markings and it is also important that the surgeon understands what the patient expects out of the procedure. There is a possibility of removing a small amount of skin and subcutaneous tissue, if the patient desires to keep the previous appearance but wants to get a refreshed look. When more skin and subcutaneous tissue are removed, more rejuvenated appearance is created.
Eyelid lift without surgery is possible and a smaller amount of excess skin can be treated with lasers or radio-frequency, but in this case only 20 to 30% of excess skin can be removed. When there is a bigger amount of excess skin, it is necessary to undergo a surgery.
Preparation for the surgery is not necessary. Patients should not take high doses of vitamin C, vitamin E or non-steroidal anti-rheumatic drugs for 7 days before surgery, in order to minimize bleeding. Bruising will develop to a lesser or greater extent, but certainly significantly less if bleeding-enhancing factors are avoided.
Eyelid surgery can be performed under local anaesthesia, when the local anesthetic is applied directly to the eyelid, or under general anaesthesia. In some cases, especially the surgery of the lower eyelids or under-eyes, sedation of the patient is necessary. The type of anaesthesia used will be assessed by the surgeon who is performing the procedure.
The incision on the upper eyelid are made such that after the procedure the scars get hidden in the natural creases of the upper eyelid.
The incision on the lower eyelids (under-eyes) can be made inside the lower eyelid in younger people where there is no excess skin, but only a genetically predisposed fatty pad. In middle-aged or elderly people, the incision is made immediately along the lower lash line. In that case, both the skin and the fatty deposits are removed.
Eyelid Surgery Recovery
The eyelid surgery takes about 40 minutes and the surgery of both upper and lower eyelids takes about 1 hour to 1 hour and 30 minutes. In local anesthesia, the patient feels no pain during surgery. After the operation, the patient can go home. The recovery period is painless. The eyelids can be swollen to a smaller or larger degree, especially if both upper and lower eyelid are treated the same day.
The bruises often develop in the region under the eyelids. Recovery may take one week in some people, and up to three weeks in other. The bruises should settle down in three weeks. Their disappearance can be accelerated significantly with Vbeam laser that we use in our practice. It is recommended to use cold compresses and you should sleep with your head elevated above your heart to minimize the swelling. The patients can return to their professional activities in 7 to 10 days. The stitches will be taken out after 7 days.
It takes 6 months to form scar tissue with minimal visibility of the incision. Sometimes it might be necessary to perform a laser treatment on the eyelids to further reduce scar tissue. Most patients will not have visible scars since the surgeons are careful to make the incisions along the eyelid’s natural crease so the scars are virtually imperceptible.
The result of the surgery lasts between 10 and 15 years. Therefore, it is important to assess at what age it is really indicated to have the eyelid surgery performed. If it is performed at a younger age (thirties or twenties), it is likely that it will be necessary to lift the eyelids again later in life. This rule applies to the upper eyelids. The removal of excess fatty pads from the lower eyelid region in younger people who are genetically predisposed is indicated regardless of age. Fatty deposits will not form again. However, a smaller or larger amount of excess will.
Complications can occur as a result of an infection or excessive removal of the skin of the eyelid. If more skin than necessary is removed, the eyelid may remain permanently open, causing the eye to dry out. Whether this complication will occur or nor depends solely on the surgeon, his experience and expertise. If ectropion is not too pronounced, it can be corrected using a laser or by adding hyaluronic acid.
For successful eyelid surgery, the experience and knowledge of the surgeon are crucial, as well as good cooperation with the patient, the patient’s expectations and the surgeon’s plan.