Eyelid surgery (technically termed blepharoplasty) can enhance your appearance and your self-confidence, but it will not necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

Are you a candidate?

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.

A few medical conditions make blepharoplasty more risky. They include thyroid problems (such as hypothyroidism and Graves’ disease), dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma are also reasons for caution; check with your ophthalmologist before undergoing surgery.

What is the procedure?

Eyelid surgery is a procedure to remove fat-usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes-features that make you look older and more tired than you fee and may interfere with your vision.

Can you have blepharoplasty and other procedures simultaneously?

Blepharoplasty can be performed alone or in conjunction with other facial surgery procedures such as a Face Lift or Browlift.

What is the surgery like?

Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. In a typical procedure, your surgeon will make incisions following the natural creases of your upper lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, your surgeon will separate the skin from underlying fatty tissue and muscle, remove excess fat, and trim sagging skin and muscle if necessary. The incisions are then closed with very fine sutures.

If you have a pocket of fat beneath your lower eyelids, your surgeon will do a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin. When the skin shows increased elasticity, additional skin tightening procedures can be performed in conjunction with blepharoplasty. The transconjunctival blepharoplasty is a safer alternative to the traditional lower eyelid surgery in which the incisions were made in a crease just under the eyelashes.

What are the risks of blepharoplasty?

Complications are infrequent and usually minor. They may include infection or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon’s instructions before and after surgery.

Minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out; your surgeon can remove them easily with a very fine needle.

Are the effects permanent?

The positive results of your eyelid surgery-the more alert and youthful look-will last for years. For many people, these results are permanent.

How do you prepare for surgery?

During the initial and subsequent pre-surgery consultation you will undergo vision tests and your tear production will be assessed. You should provide any relevant information from your ophthalmologist and the record of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along. Discuss your goals and expectations with your surgeon to help determine whether to perform surgery on the upper or lower lids, or both. Your surgeon will determine whether skin and fat will be removed and whether any additional procedures are appropriate.

You will receive specific instructions on how to prepare for surgery, including guidelines on eating and drinking, taking or avoiding certain vitamins and medications, and not smoking. Carefully following these instructions will help your surgery go more smoothly. While you are making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Where is the procedure performed?

Eyelid surgery may be performed in our office-based facility, an outpatient surgery center, or a hospital. It is usually performed on an outpatient basis; rarely does it require an inpatient stay.

What will the recovery period be like?

After surgery, your eyes will be lubricated with ointment. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with prescribed pain medication.

Your surgeon will follow your progress closely for the first week or two. The stitches will be removed two days to a week after surgery. Once they are removed, the swelling and discoloration around your eyes will gradually subside and you will start to look and feel much better. You should be able to read or watch television after two or three days; however, you will not be able to wear contact lenses for about two weeks and they may continue to feel uncomfortable for a while.

Most people feel ready to go out in public (and back to work) in a week to ten days. By then, depending on your rate of healing and your surgeon’s instructions, you will probably be able to wear makeup to hide any remaining bruising. You may be sensitive to sunlight, wind, and other irritants for several weeks. Wear sunglasses and a special sunblock made for eyelids when exposed to sunlight.

It is especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports.

Healing is a gradual process. Your scars may remain slightly pink for six months or more after surgery. Eventually they will fade to thin, nearly invisible white lines.