Blepharoplasty is a very common aesthetic surgical procedure for men as well as women. As we age, excess skin can form around our eyes, causing us to look older, tired, wrinkled or puffy. This is natural because, as we grow older, our skin loses elasticity and previously tight tissues can begin to droop. With eyelid surgery (blepharoplasty), we work toward restoring a youthful and refreshed appearance to your eyes without noticeable scarring.
When we look at the tissues around the eyes, we need to consider the upper and lower areas separately.The need to address either the upper lid, the lower lid, or both varies widely from patient to patient.
UPPER EYELIDS + BROW
The upper eyelid is connected to, and very influenced by, the brow. It is surgically corrected through an incision along a natural crease in the eyelid. Through the incision, we can adjust or remove fat deposits, tighten muscle structures around the eye, and remove any excess skin.
The effects of aging in the upper eyelid are so common that eyelid surgery is regularly performed for medical as well as cosmetic reasons. Sometimes the upper eyelid has become so heavy and low that it interferes with the patient’s ability to see. This is considered a medical problem, and we work to improve the structure of the eyelid to improve vision.
It’s important to understand that it’s not just the skin of the eyelid that has drooped. As tissues become lax with age, the entire brow can move down, creating the drooping effect in the eyelids. A brow lift may be able to move some of the tissue in the upper eyelid and improve the problem greatly, but some patients have more tissue that will need to be removed from the eyelid itself.
LOWER EYELIDS + MIDFACE
The tissues below the eyes are connected to the cheek. So when we address the eyelids, we have to consider and often work with the condition of these surrounding areas to achieve the correct effect. We address the lower eyelid through an incision concealed just under the lash line. As we age, our cheeks become more lax. Rather than having smooth tissue under the eyelid, the lower eyelid may become elongated and somewhat sunken. The nasolabial folds, a furrow going from the nose down to the corner of the mouth, can also become more pronounced with age. By lifting and restoring volume in the cheek, we soften the crease of the nasolabial folds and bring tissue up under the eye; this shortens and better supports the eyelids.
If a person has extra fat in their lower eyelids (puffiness), we remove it. However, we want to be very conservative removing fat from around the eye, to avoid a “gaunt” look. We conduct the procedure from inside the lower lid; this allows us to avoid cutting through all three layers of the lower eyelid. If we need to remove a little bit of skin, we do that right below the lash line; that way we don’t have to cut through the muscle of the lower eyelid. These incisions usually heal extremely well. The tissue around the eyelid is very privileged when it comes to healing, so there is rarely an objectionable scar.
PROCEDURE
Blepharoplasty is performed under local anesthetic and intravenous sedation, or general anesthesia if the procedure is more extensive. Patients can return home the same day. The stitches are left in place from three to five days. There may be bruising and swelling which slowly dissipates over one to two weeks.
This is one of the more popular facial procedures since improvements can often be obtained with minimal time for recovery. Scarring is usually quite minimal due to the fact that eyelids heal with very fine and light scars.
COSTS + RECOVERY
Patients cannot drive themselves home and should be out of work for a few days. They are given oral pain medication to ease any discomfort.
The cost varies depending on what procedure or combination of procedures are desired. Costs vary widely from patient to patient; it largely depends on how much work is done—a small incision in the eyelid costs a lot less than if there is a brow or mid-face lift and some additional work on the eyelid. Blepharoplasty procedures including doctor’s fee, operating room and anesthesia typically range from $3,800–7,500.
Like so many aspects of plastic surgery, a careful balance has to be maintained. A successful blepharoplasty, brow lift, or mid-face lift procedure must create significant change to be worthwhile, but it should still look natural. This is where years of hands-on, surgical experience can really make the difference.
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