What is upper blepharoplasty?

Upper eyelid blepharoplasty is one of the most commonly performed functional as well as cosmetic facial plastic surgical procedures. It deals with the contours of the upper eyelid space, mainly the region between the eyebrow and the eyelashes. The operation can be performed for aesthetic or functional purposes (impairment of vision).

Upper eyelid blepharoplasty can be performed for any of the following reasons,

  • Hereditary factors and involutional changes can cause a drooping of skin and the tissues under the skin with protrusion of fat causing the ¨heavy eyelid¨
  • The appearance of the eyelids may be asymmetrical and blepharoplasty may be performed to improve symmetry
  • Saggy eyelid skin can obstruct the visual field (you may not be able to see the full extent of your lateral vision) so blepharoplasty is performed to relieve this obstruction

Could I benefit from upper blepharoplasty ?

You may be an appropriate candidate for an upper eyelid blepharoplasty if;

  • You are bothered by the dropping of your upper eyelids which may give you an old and tired looking
  • There is asymmetry between your eyelids
  • Some young patients need this procedure because of congenital characteristics that displease them
  • You notice obstruction of your visual field from drooping of the upper eyelid skin. The consequent obstruction of your visual field can stimulate eyebrow elevation to relieve visual field, which may cause headaches as well.

How is upper blepharoplasty surgery done?

Blepharoplasty surgery is most often performed under local anesthesia. Sedation or general anesthesia may be utilized in appropriately selected patients. First, the blepharoplasty incision is measured and marked. Subsequently variable amounts of skin, soft tissue and fat are removed to achieve a pleasing and youthful appearance of the eyelid and to improve the visual field. After the desired amount of excision is accomplished skin incisions are closed with sutures.

What can I expect after surgery?

You can typically get up and walk around the evening of the surgery or the following morning. You should be prepared for moderate swelling and bruising of the skin. The degree of swelling and bruising differs markedly from patient to patient. Either way the swelling and the bruising both subside within few weeks, after which time it is typically hardly notable that you just underwent surgery.

Will I have a bandage or dressing after surgery?

A bandage is not used after the surgery. A steril strip may be used which is changed or removed after one to three days, and ointment is applied over the suture daily for approximately 1 week.  Artificial tear drops can be prescribed to prevent the dryness at early postoperative period. Ice packs are applied over the operated area for 24 to 48 hours.

Do you need to remove the sutures?

Non-absorbable skin sutures are removed 5 to 7 days, Absorbable sutures dissolve within 1-3 weeks.

Will I be in pain after the surgery?

The upper eyelid blepharoplasty is a minimally invasive procedure. Pain after surgery is typically very mild and well controlled with pain medications. A mild analgesic (non-aspirin containing) is used to control the postoperative discomfort for one to five days.

What are possible risks and complications of upper eyelid blepharoplasty ?

Failure to meet the patient’s expectations, residual excess skin, asymmetry or scarring may necessitate additional treatment or a secondary operation.

Overcorrection may cause upper eyelid retraction which may result in the inability to close the eye. Topical lubricants and massage may be helpful for managing mild situations. Injectable steroids can be used. Severe cases may require a secondary operation. Eversion of the eyelids inwards or outwards is a rare complication and may also require a secondary procedure for correction.Very rarely double vision may occur due to injury of eye muscles.

Is it possible that I will need revision surgery?

Although the result of an upper eyelid blepharoplasty may be expected to last for years, aging will continue and drooping of the eye lids may recur. This should not be regarded as a complication of the procedure, but as a result of the continued aging process. A second procedure may be desired.

How long will I be off from work?

Generally speaking the recovery period after upper eyelid blepharoplasty is usually short and you may start doing your daily routines as soon as the following day. The swelling and ecchymosis vary among patients, but rarely last longer than few weeks and almost never limits patient mobility.

Will I be able to use make-up after the surgery?

Your surgeon may ask you to refrain from applying make-up for 7-8 days after the surgery.

How long can I expect the outcome of surgery to last?

It depends on the age of the patient and the type of the patient’s skin. The aging process continues after surgery and relaxation of the skin and underlying structures is inevitable. This will lead to drooping of the eyelids. But it is generally accepted that this takes place after 10 years of surgery.