Changes around the eyes are one of the first signs of aging. In many people, under-eye sagging can develop as soon as the early 30s. Other people have eye issues since birth, with hereditary bags under the eyes causing a perpetual tired or sad look. Sagging and wrinkling can also be caused or exacerbated by chronic allergies, sun exposure, or excessive squinting and rubbing. Blepharoplasty, or eyelid surgery, is a broad name for a group of procedures performed to improve both the appearance and the function of the eyes.
It can be performed on both the upper and lower eyelids, and can reposition fat, tighten muscle, support tendons, and remove excess skin. This can help to repair sagging eyelids, bags under the eyes, and even certain lines and wrinkles.
Am I a Candidate for Eyelid Surgery?
Good candidates for eyelid surgery include anyone who has excess skin causing the upper eyelids to droop and possibly impairing vision, bags and dark circles under the eyes, or excess skin or wrinkles under the eyes. Ideally, patients will also maintain realistic expectations from the surgery and understand that blepharoplasty, like any procedure, will bring improvement rather than perfection.
A consultation at Dr. Clevens’ Melbourne office is the first step toward having eyelid surgery. During this meeting, you’ll explain your concerns, and Dr. Clevens will evaluate your eye area and discuss potential solutions. You’ll also discuss any additional procedures that you may like to have at the same time. Many patients opt to add a brow lift to correct forehead wrinkles, dermal fillers or fat transfer to add a bit of volume, or laser treatments to help with fine lines.
After deciding on what you’d like to have done, you’ll also go over the aftercare and recovery process for your eyelid surgery as well as any precautions that you should take before the procedure.
About the Blepharoplasty Procedure
Blepharoplasty is generally performed under a local anesthetic with intravenous sedation to keep you comfortable. The procedure will begin by marking the eyelids to indicate exactly where the excess tissue will be removed. The process for the upper eyelid involves an incision on the crease to allow removal of skin, fat, and excess muscle. For the lower eyelid, the standard approach is to make an incision directly below the lash-line to allow removal of fat and skin, but it’s also possible to use an incision just inside the eyelid to remove fat, although this trans conjunctival approach does not allow for the removal of excess skin.
Once any extra skin has been removed, Dr. Clevens will redistribute the fat to reduce bulging or puffiness in the area. After this reshaping, the incisions will be closed with glue or self-dissolving sutures and you will be moved to the recovery room.
At first there will be quite a bit of swelling and bruising, but this will fade in a week or so. There may also be numbness, excessive tear production, light sensitivity, or double vision in the first few days after surgery. Your discomfort should be minimal and can be treated with over-the-counter medications like acetaminophen, although you should avoid aspirin and other drugs that can increase bleeding. Cold compresses can be used to help control swelling.
You should be ready to get back to life as normal in about two weeks. During those two weeks, you may need to use eye drops to keep your eyes properly lubricated, and you may need to avoid activities like reading that will tire your eyes. You should keep your head elevated as much as possible, including reclining during sleep rather than lying flat. Vigorous exercise should be avoided since the increased blood pressure will cause more swelling. Sunglasses should be worn as much as possible to protect your eyes from wind and sun.
Possible Risks and Complications
Blepharoplasty is a very safe surgery, but it does carry the standard risks of surgery. These include bleeding, infection, and hematoma. Many patients also experience changes in sensation such as tingling or numbness which may continue for several months. Dry eyes are another concern that results from friction from the swollen lids and typically resolves within a few days. Rarely, dryness can persist for longer, causing irritation to the cornea and requiring medical attention. In a few cases, eyelid surgery can result in malpositions such as eyelid retraction. This is quite uncommon, but it can be resolved with a revision blepharoplasty.
Eyelid Surgery FAQs
Q- Is eyelid surgery ever medically necessary?
A. Blepharoplasty is generally considered medically necessary when the eyelids cause functional problems. Usually this occurs when the upper eyelid droops so far that it obstructs the field of vision. To qualify for insurance coverage, most companies require documentation of at least a 25% obstruction.
Q- I’ve heard of a “skin pinch” option for eyelid surgery. What exactly does that do?
A. A skin pinch blepharoplasty is a somewhat less-invasive version of full lower-eyelid surgery. It removes a small amount of skin but does not touch the muscle. It’s useful for patients with less extra skin and for those who may be more prone to dry eyes. Dr. Clevens can determine its viability in your specific case after a professional evaluation.
Q- Will I be able to wear makeup again after my eyelid surgery?
A. Yes, absolutely. In order to allow the incisions to heal properly, though, you should wait for 2-3 weeks. Not only is the makeup itself irritating to fresh incisions, but the bacteria present on the brushes and the cleanser used to remove it can be very damaging as well. To minimize risks of infection, hold off on the makeup until everything is healed.
Q- Is eyelid taping a good alternative to eyelid surgery?
A. Eyelid tape can create a natural-looking crease on mono-lidded eyes, but it only lasts for as long as you have the tape on. It’s a good temporary option to make sure that you like how you look with the added crease, but for permanent results, surgery is necessary.
Q- How visible will the scarring be?
A. In most cases, the scars will be invisible or nearly so. Scars on the eyelids usually heal very well and become narrow, flat, and close to your natural skin color. Since the locations are well-protected in the crease or near the lash-line, they will not be very apparent. However, they may be quite red and raised for the first month or two, so it’s important to be patient while they heal.
Q- What is blepharoplasty?
Blepharoplasty, often referred to as eyelid surgery, or simply having your eyes done, is a popular procedure that can dramatically improve sagging upper eyelids and bulging bags in the under eye region. The delicate eye area is one of the first to be visibly effected by the aging process, causing a tired or fatigued appearance. As early as your thirties, these signs may become visible and those around you might comment that you look tired or sad. Dr. Clevens performs blepharoplasty in order to restore a refreshed and youthful look to your eyes. The lower eyelids achieve a smoother appearance. The droopiness in the upper eyelids is corrected. In addition to its cosmetic effects, those who are experiencing a decrease in their field of vision because of sagging upper eyelids may benefit from this procedure.
Q- Does Dr. Clevens perform cosmetic eyelid surgery often?
Over 250 men and women each place their trust in Dr. Clevens and elect to have blepharoplasty performed, making it one of the most popular facial plastic surgery procedures. Patients who choose to have a blepharoplasty procedure performed by Dr. Clevens can expect to achieve more rested, vibrant eyes. Dr. Clevens has performed thousands of cosmetic eyelid procedures and offers extensive experience in many techniques of blepharoplasty, including a method that does not use external scars (Transconjunctival blepharoplasty) laser blepharoplasty, fat preservation, and revision blepharoplasty.
Q- How do I know if I am a good candidate for an eyelid lift?
The best candidate for blepharoplasty is a physically healthy person who is realistic in their expectations regarding improvement of droopy upper eyelids and bulging lower eyelid bags. Blepharoplasty will not correct sagging of the brows, forehead furrows, or deep lines and wrinkles. These patients may benefit from other procedures, such as brow lift or skin resurfacing. Dr. Clevens will help you decide which procedures are right for you during your initial consultation.
Q- Where is the blepharoplasty procedure performed?
To ensure your safety and comfort, Dr. Clevens performs eyelid surgery in a state-licensed, fully accredited ambulatory surgical facility or Outpatient Surgicenter.
Q- What type of anesthesia is used during the blepharoplasty procedure?
Blepharoplasty may be performed under local anesthesia with sedation or general anesthesia. Regardless, a board certified physician MD anesthesiologist will be responsible for administering your anesthesia or sedation. Dr. Clevens and your anesthesiologist will help determine what best suits your particular needs.
Q- How does Dr. Clevens perform an eyelid lift?
During upper eyelid blepharoplasty, the excess skin, muscle and fatty tissue that have created a sad or tired appearance are simply removed through a tiny incision hidden in the crease of the upper eyelid. Dr. Clevens performs ‘invisible’ lower eyelid surgery where the incision is hidden inside the lower eyelid so there is not visible external incision.
Q- How long does the actual blepharoplasty procedure take to perform?
Blepharoplasty typically takes Dr. Clevens about one hour to perform, depending on the case.
Q- What other procedures may be combined with cosmetic eyelid surgery?
A number of other cosmetic procedures may be safely performed at the same time as blepharoplasty. These include skin resurfacing, facelift, neck lift, brow or forehead lift, neck and cheek liposuction.
Q- Where are the incisions made for blepharoplasty? Are there scars after blepharoplasty?
When performing blepharoplasty of the upper eyelid, Dr. Clevens makes an imperceptible incision in the upper eyelid crease. These incisions are made in such a way that they will heal into tiny, virtually hidden scar. During blepharoplasty of the lower eyelids, Dr. Clevens makes a small incision on the inside of the eyelid, which results in no external scar whatsoever – the incision is ‘invisible’.
Q- What is the recovery like after blepharoplasty? When are the stitches removed?
Patients may expect to have some swelling and bruising for as little as one to two weeks. Patients sometimes experience dryness, itching or burning of the eyes, excessive production of tears, a sensitivity to bright light, or blurred or double vision. Dr. Clevens uses dissolving stitches that vanish a few days after your procedure. Dr. Clevens and his staff are devoted to delivering the best aftercare and aid you in the speediest and most comfortable recovery possible.
Q- How much time will I need to take off from work after my blepharoplasty procedure?
Patients are advised to take off five to seven to ten days of work after their blepharoplasty procedure. Dr. Clevens has an experienced team of medical aesthesticians on his staff available to instruct you how to conceal any bruising and swelling that may remain when you are ready to return to your normal routine. After surgery care with our aestheticians is offered as a complimentary service to our patients.
Q- When can I exercise after my blepharoplasty procedure?
Even though you may feel ready to resume your normal physical activities and grow restless within a few days, to achieve the best results of your blepharoplasty, it is very important that you give your body its very best chance to recuperate and take it easy. The healing process is a delicate time, and you should cease your exercise regimen and avoid other sTRenuous activities for several weeks after your procedure. It is also wise to stop consuming alcohol prior to and during your recovery period.
Q- When are the stitches removed after the blepharoplasty procedure?
Dr. Clevens uses dissolving stitches that vanish a few days after your procedure.
Q- What are the risks or complications associated with blepharoplasty?
Patients should be informed that every surgical procedure carries certain risks and the potential for complications. Potential complications associated with blepharoplasty may include the following: bleeding, difficulty in completely closing the eyes, dry eyes, infection, pulling down of the lower lids, slight asymmetry in healing or scarring, swelling at the corners of the eyelids, temporary blurred or double vision, and whiteheads. To help ensure a good outcome, it is important to select an experienced facial plastic surgeon such as Dr. Clevens. Dr. Clevens performs over 250 sets of eyelid procedures each year.
Q- Does insurance cover the cost of blepharoplasty?
If your blepharoplasty is performed solely to achieve a cosmetic benefit, insurance will not provide coverage. In such instances where your vision is being affected by drooping of the upper eyelids, insurance may cover part of all of the cost of the procedure. Dr. Clevens has insurance specialists on staff who can help guide you through this process.
Please contact our offices in Melbourne and Merritt Island, Florida at 321.727.3223 or 888.438.3223 today to arrange your consultation.