The eyelid and surrounding tissues can say a lot about a person. Unfortunately, many of the things that the eyelids say are unflattering. Dark circles under the eyes say that the person is tired or run down. These circles can rob a young person from their fresh face. Bags under the eyes can make a face (and a person) appear to weigh more than they do.
Sadly the fat that accumulates under and above the eyes is not always linked to the weight of the body; a person can properly diet and effectively exercise but not shed the fat from around the eyes.
In another patient group, just over half of all Asians are born with eyelids that do not have a crease or fold (called a pretarsal crease). This can make applying makeup difficult, if not impossible. For these reasons, many people turn to blepharoplasty or eyelid surgery.
Is Eyelid Surgery Right for You?
Candidates for cosmetic eyelid surgery typically include healthy adults who are concerned about droopy eyelids, puffy bags under the eyes, or impaired vision due to sagging skin.
While upper eyelid surgery is often performed to lift sagging lids, lower eyelid surgery is commonly used to eliminate under-eye bags and smooth out wrinkles.
People considering blepharoplasty should have realistic expectations and be free of serious eye conditions. A qualified board-certified plastic surgeon will assess your facial structure and skin elasticity to determine the most effective approach to rejuvenating your eye area.
Lower Eyelid Surgery: Removing Eye Bags
When the fat pads under the eyes (“eye bags”) are to be removed, a small incision is made just inside and parallel to the lower lash line. The skin is separated and most of the fat is gently removed.
Since new fat cells are not created, only increase in size, eye bag removal surgery is a very long-lasting surgical procedure.
Upper Eyelid Surgery and Asian Eyelid Crease Creation
When the upper eyelids are going to be revised, a line is cut along the pretarsal crease, the large fold in the center of the eyelid. In Asian patients that do not have a pretarsal crease, a strip of eyelid skin is removed to create this fold.
If fat is to be removed from the upper eyelid, it is done while the eyelid is surgically open. The eyelid is then closed with usually a small amount of skin removed. This creates a crease in patients that do not have one and corrects ptosis (droopy eye lid) in those that do have a pretarsal crease.
Eyelid surgery may correct the dark circles under the eyes, but it may not. Ask your surgeon about dark circles, if they are a concern for you.
Eyelid surgery is a very delicate procedure with a great deal of art involved. If too much skin is removed the eyelids may not close properly. Also, the fat pads need to be removed gently as to avoid trauma to this sensitive area.
Local Anesthesia and Awake Surgery Benefits
Blepharoplasty is a same-day surgery and local anesthesia is used with an intravenous sedative. Since you are awake during eyelid surgery you must realize that surgical instruments will be used very near your eyes. Some patients have a difficult time tolerating that. The sedation generally relaxes the patient to the point where it is tolerable.
The benefit of an “awake” approach is that it is far easier for the plastic surgeon to determine the amount of skin of the eyelid to removed. The patient can open their eyes naturally and a good estimate can be made. In an unconscious, anesthetized patient, the eyelid droop is actually improved and is underestimated by the surgeon.
Eyelid surgery can last between one to three hours depending on the extent of the procedure and the delicateness of the skin, among other factors. The average cost of blepharoplasty is about $3,000 though this may vary depending on the region of the country and the specific fees charged by your surgeon.
What to Expect During Recovery After Eyelid Surgery
Recovery after blepharoplasty varies from patient to patient but generally follows a predictable timeline. Swelling and bruising are most prominent during the first week following eyelid surgery and gradually subside.
Applying cold compresses and keeping your head elevated can help reduce inflammation. Most patients return to normal activities and work within 10 to 14 days, although full results from upper or lower eyelid surgery may take several weeks to appear.
Your plastic surgeon will likely recommend avoiding strenuous activities, makeup, and direct sun exposure during this critical healing period.
Cost of Blepharoplasty and Insurance Considerations
Facility fees, medications, and aftercare items may increase the price as well. Unless the eyelid surgery is being done for a specific abnormality (e.g. eyelids that interfere with vision or do not close tightly), blepharoplasty is paid for out of pocket.
Most people can return to work within two weeks and, since the surgery is very long-lasting, it usually only requires one treatment.
Combining Eyelid Surgery With Other Facial Procedures
For those seeking a more comprehensive facial rejuvenation, blepharoplasty can be combined with other cosmetic procedures such as a brow lift or facelift.
A brow lift can enhance the results of upper eyelid surgery by elevating the brow and smoothing forehead wrinkles, while a facelift can address sagging skin on the cheeks and jawline.
Combining procedures may also reduce overall recovery time and deliver a more harmonious aesthetic outcome. Be sure to consult with your surgeon about whether multiple treatments can be safely and effectively performed at the same time.