Facial plastic surgery

Blepharoplasty (eyelid surgery)

Blepharoplasty, also known as eyelid surgery, improves the appearance of the upper eyelids, lower eyelids, or both, and gives a rejuvenated appearance to the surrounding area of your eyes, making you look more rested and alert.

Before blepharoplasty		After blepharoplasty

Blepharoplasty before (lower eyelid)		blepharoplasty after (lower eyelid)
Before blepharoplasty		After blepharoplasty

Before blepharoplasty		After blepharoplasty

Blepharoplasty can be both a functional and cosmetic surgical procedure intended to reshape the upper eyelid or lower eyelid by the removal or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons.

Functional blepharoplasy
When an advanced amount of upper eyelid skin is present, the skin may hang over the eyelashes and cause a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision.

Blepharoplasty before		blepharoplasty after
Blepharoplasty before		Blepharoplasty after

Cosmetic blepharoplasty
Patients with a less severe amount of excess skin may have a similar procedure performed for cosmetic reasons. Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid "bags" and reduce the wrinklingof skin.

A blepharoplastry cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. Though blepharoplasty is often performed as a single procedure, we may also recommend a browlift, facelift, or skin resurfacing to achieve the best results.

Blepharoplasty before		Blepharoplasty after
Before blepharoplasty		After blepharoplasty

Blepharoplasty Procedure

Blepharoplasty is performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid.

Excision of excess fat and skin is made along the natural creases of the eyelids.

Initial swelling and bruising take one to two weeks to resolve but at least several months are needed until the final result becomes stable. Depending upon the scope of the procedure, the operation takes about one hour per pair of eyelids to complete. Permanent stitches will be removed about five days after surgery.

Blepharoplasty Complications

The anatomy of the eyelids, patients' skin quality, patients' ages, and the adjacent bony and soft tissue all affect the cosmetic and functional outcomes after blepharoplasty. Factors which are known to cause complications after surgery include failure to recognize factors such as

• Preexisting dry eyes: this may become exacerbated by disrupting the natural tear film.
  
  
• Laxity (looseness) of the lower lid margin (edge): this predisposes to lower lid malposition.
  
  
• Prominence of the eye in relation to the malar (cheek) complex: this predisposes to lower lid malposition.

Specific types of blepharoplasty

Asian blepharoplasty

An upper blepharoplasty in someone who is east Asian is termed Asian blepharoplasty or double eyelid surgery. It is the most popular form of cosmetic surgery among those of east and southeast Asian background. Due to anatomic differences between the Asian and occidental eyelid, about half of this population are born without a supratarsal eyelid crease and are called single-lidded. Surgery can be used to artificially create a crease above the eye.

Transconjunctival blepharoplasty

Transconjunctival blepharoplasty involves removing lower eyelid fat through an incision on the back of the eyelid, eliminating the need for an external incision. Because there is no external incision, excess skin can not be removed during the surgery, but skin resurfacing with a chemical peel or carbon dioxide laser may be performed simultaneously. This allows for a faster recovery process.