Saggy or drooping eyelids can be an age-defining feature for many people. It is a major reason people consider eyelid surgery (blepharoplasty) to remove the excess sagging skin, to create a more alert and youthful eyelid appearance. The blepharoplasty procedure is safe, and it can be performed under local anesthesia while you are awake. The numbing procedure is similar to getting a skin biopsy. The excess tissue is removed, and the scar is hidden in the crease of the eye. The incisions are virtually unnoticeable after they have healed.
Pain medications and relaxing medication are given orally 1 hour prior to the eye lift procedure, so a driver is necessary. After the area is numbed, the blepharoplasty procedure itself is essentially pain-free, and the recovery is associated with minimal discomfort. Most people do not need narcotic medication afterwards, but you will have a prescription to take if needed. You will need a driver because you will be unable to drive home due to the pre-medications given. You will be able to see well immediately after the procedure. The whole procedure, including numbing, takes about 2 hours, and you driver will be called prior to finishing the procedure.
In some patients, blepharoplasty can improve vision by increasing the peripheral vision and providing a less obstructed field of view. Often, you must have severely droopy eyes hanging over the eyeball in order to qualify for insurance reimbursement. The cosmetic eyelid lift is not covered by insurance, as an artfully designed lift is created to maximize the cosmetic benefit, rather than taking the minimal amount to allow you to see better.
The risks associated with the procedure are similar to having a biopsy. There is a risk for pain, bleeding or bruising/hematoma, infection, and decreased sensation in the upper eyelid which improves with time. You will take an oral antibiotic to prevent infection. Nearly every patient has baseline asymmetry where one eyelid is worse than the other. It is possible to reduce the asymmetry with surgery, but perfection may not be possible.
Prior to eye lift surgery, you need an eye exam with an optometrist or ophthalmologist stating that your eyes are healthy, noting if you have any history of dry eyes or reasons that you cannot have an upper eyelid lift. If you do have dry eyes, you can still have surgery though a smaller amount must be taken.
The eye lift blepharoplasty procedure including all the visits before and after the surgery is $3000. You will have a pre-operative visit 1 week prior to the blepharoplasty procedure where photographs will be taken, consents will be signed, and questions answered. 6 weeks after the blepharoplasty procedure, you will receive a free trial of Latisse, which has been FDA approved to improve the thickness and length of eyelashes. The aging process will continue, and you may want to repeat the procedure at some point in the future. However, depending on your health and other factors, an upper eyelid blepharoplasty can last on the order of 10 years.
Smokers, diabetics, and patients on blood thinners are at increased risk of surgical complications because they heal more slowly. You should stop any blood thinners (aspirin, fish oil, Vitamin E, ibuprofen – see list) 2 weeks prior and limit alcohol intake. Arnica pellets will be provided to you, which will improve bruising. You should start taking 5 pellets, 3 times a day, beginning a week prior to surgery. You will eat as normal prior to surgery, and take your pre-operative antibiotics. Do not wear any makeup on the day of surgery.
Prior to the blepharoplasty procedure, a purple surgical pen will be used to create precise markings to designate where the excess skin and fat pads need to be removed. These markings may stay on your skin for 1-2 days after surgery but will fade easily. During the procedure, the decision for how much tissue to remove will be made based on an evaluation of factors such as your underlying facial muscle structure, bone structure and the symmetry of your eyebrows.
After surgery, you should apply cold packs (or frozen peas) every hour for 5 minutes over each eye. The ice can reduce the swelling and keep bruising to a minimum. Sleep on two pillows and avoid bending over where your head is below the level of your heart. Expect minimal, mild discomfort during the immediate recovery period. If the pain is severe or any abnormal symptoms develop, call the office immediately.
While you recover, your eye area will be bruised and possibly swollen almost shut, particularly during the first few days. It may take a few weeks for healing to be complete, during which time you should not wear eye makeup. You can resume wearing contact lenses when the eyelid swelling subsides enough to allow the lenses to be comfortable. If you wear eyeglasses, you can put them on carefully at any time after surgery.
Sutures are removed in 6-7 days, although you may have a black eye or experience bruising which may last 7-10 days. Some patients have delayed swelling, though most experience a full recovery by 2-6 weeks. Collagen continues to remodel over 6-12 months. During this time, sunscreen and sunglasses are critical to improve wound healing and scar appearance. You can use silicone gel and massage to improve the recovery process.
The upper eyelid blepharoplasty is a procedure associated with a very high satisfaction rate and improved self image. It can easily result in a more natural and youthful appearance and erase 5-10 years, while not changing the shape or overall character of your face.
Dr. Joanna Chan is a fellowship-trained cosmetic surgeon who has had experience with hundreds of cases. She attended Harvard University, Stanford Medical School, University of Texas Southwestern dermatology residency, and a prestigious Mohs Micrographic surgery fellowship at the California Skin Institute.
If you’d like to learn more about our Blepharoplasty treatments, please fill out the form on this page or call (562) 997-1144.