Blepharoplasty

Blepharoplasty Overview

Eyelid surgery, or Blepharoplasty,  is a surgical procedure that can treat loose or sagging skin to the upper and lower eyes, bags to the under eyes, and excess skin and wrinkles around the eyes that develop as we age. It can be performed on the upper lids, lower lids, or both to rejuvenate the eye area and create a younger, beautiful, more refreshed appearance. A blepharoplasty is commonly combined with other procedures such as a brow lift, rhinoplasty, facial fat grafting,  or facelift to achieve an optimal rejuvenating effect. 

Upper blepharoplasty targets the tightening of the upper eyelid skin by removing excess tissue and reducing the amount of “hooding” resulting in a more alert and refreshed appearance. In some cases, the amount of redundant skin and hooding can obstruct one’s vision, in which case blepharoplasty can be a medical necessity. Other times, brow descent can exacerbate upper eyelid skin excess and hooding. If this is the case, Dr. Seth may recommend a brow lift in conjunction with upper blepharoplasty.

A lower blepharoplasty can address under eye bags, bulging fat pads, extra skin and lower eyelid hollowing. 

Candidates

You may be a good blepharoplasty candidate if you are

  • generally healthy
  • a nonsmoker
  • Without serious eye conditions
  • Without dry eyes

Procedure

Blepharoplasty procedure is performed as an outpatient procedure. For isolated upper blepharoplasty the procedure is done under local anesthesia.  For lower blepharoplasty or when doing both upper and lower lid surgery together it is performed  under general anesthesia or IV sedation. The procedure can take anywhere from 45 minutes to two hours depending on if both the upper and lower lid are done together or alone. 

Upper lid blepharoplasty is done  by making an incision in the natural eyelid crease, creating an incision that is imperceptible once healed. Excess skin above the incision is excised along with judicious removal of prolapsed fat. Careful attention is placed to ensure that the fat pads are not over-resected resulting in a sculpted or hollowed appearance. If necessary, the remaining tissue is tightened and the incision is sutured close.

During a lower blepharoplasty, an incision is typically made on the inner surface of your eyelid (transconjunctival approach) to gain access to the underlying fat pads. These fat pads can either be excised or repositioned to the cheek  to restore a smooth, youthful lower eyelid. If there is excess skin, a “skin pinch” excision can be performed just under the lash line to hide the resulting incision. Sometimes, additional procedures are necessary to optimize results. These can include fat transfer to the cheeks or laser resurfacing, which address volume loss/hollowing and wrinkles respectively.

Recovery

Following the procedure, most patients can return home the same day. We recommend someone be with the patient during the first 24 hours. Sutures are removed about 5-7 days after they are placed. 

You may experience swelling and bruising around the eyes after surgery; however, this should improve within two weeks. Applying ice can significantly reduce the swelling. Residual bruising can be camouflaged with makeup or glasses during this time. Some patients experience dry or irritated eyes after their blepharoplasty. This is usually transient and can be relieved with lubricating eye drops.

Most patients do not experience significant pain following the procedure. Pain medication is prescribed for pain relief but most patients are able to wean themselves off in 1-2 days, taking Tylenol only as needed. Severe pain or visual changes should be reported to the office immediately.

Patients can usually return to work within one week after the bruising has subsided, but should avoid exercise and strenuous activities for at least two weeks.

How To Get Started

If you’re interested in a Blepharoplasty or want to learn more about your options with Dr. Rahul Seth, please request a consultation online or by phone at (925) 357-9050.
During your consultation, you will have time to discuss your goals and treatment options. During this process, you will get to know Dr. Seth and the Golden State Plastics team that will be with you every step of your journey. Once your consultation is complete and your unique treatment plan is created you will work with the Golden State Plastics team to schedule surgery. Once your surgery is scheduled, you will receive a pre-operative appointment to review your procedure, post-operative instructions, and expectations on your road to recovery.

Frequently Asked Questions

People undergo upper blepharoplasty for various reasons, including:

  1. Excess Skin: With age, the skin on the upper eyelids can become loose and droopy, creating a hooded or heavy appearance. Upper blepharoplasty can remove the excess skin, resulting in a more open and refreshed look.
  2. Impaired Vision: In some cases, excessive skin on the upper eyelids can obstruct the field of vision, making it difficult to see properly. Upper blepharoplasty can remove the excess skin, improving vision and enhancing overall functionality.
  3. Aging: The natural aging process can cause the skin, muscles, and tissues of the upper eyelids to weaken and sag. Upper blepharoplasty can help restore a more youthful and rejuvenated appearance by tightening the skin and removing or repositioning fat deposits.
  4. Cosmetic Enhancement: Many people choose upper blepharoplasty to enhance their appearance. By eliminating sagging or puffy eyelids, the procedure can create a more alert, vibrant, and aesthetically pleasing look.
  5. Self-Confidence: Droopy or heavy eyelids can make individuals feel self-conscious or appear tired or older than they actually are. Upper blepharoplasty can boost self-confidence by creating a more youthful and well-rested appearance.

It’s important to note that the decision to undergo upper blepharoplasty is a personal one, and can be important to someone for a number of reasons and benefits.

People undergo lower blepharoplasty for several reasons, including:

  1. Under-Eye Bags: The accumulation of fat deposits or fluid retention in the lower eyelids can result in the appearance of under-eye bags. Lower blepharoplasty can address this concern by removing or repositioning excess fat, creating a smoother and more youthful contour.
  2. Excess Skin: Loose or sagging skin in the lower eyelids can contribute to a tired or aged appearance. Lower blepharoplasty can remove the excess skin, resulting in a tighter and more rejuvenated lower eyelid area.
  3. Wrinkles and Fine Lines: Fine lines, wrinkles, and crepey skin in the lower eyelid region can be addressed through lower blepharoplasty. The procedure can help smooth out the skin, reducing the appearance of these signs of aging.
  4. Dark Circles: Some individuals have dark discoloration or pigmentation in the lower eyelid area, commonly known as dark circles. While lower blepharoplasty cannot directly address pigmentation concerns, it can improve the overall appearance by addressing under-eye bags and excess skin, which may contribute to the shadowing effect.
  5. Cosmetic Enhancement: Lower blepharoplasty is often sought after for cosmetic reasons, as it can enhance the overall appearance of the lower eyelids, resulting in a more youthful and refreshed look.

It’s important to note that the decision to undergo lower blepharoplasty is a personal one, and can be important to someone for a number of reasons and benefits.

The lower eyelid ages due to a combination of factors, including natural physiological changes, genetic predisposition, lifestyle factors, and the effects of gravity over time. Here are some key factors contributing to the aging of the lower eyelid:

  1. Loss of Skin Elasticity: As we age, the skin loses its natural elasticity and becomes less firm. This can cause the lower eyelid skin to stretch and sag, leading to the appearance of wrinkles, fine lines, and excess skin.
  2. Fat Redistribution: The fat pads around the eyes that provide cushioning and support can shift and redistribute with age. In the lower eyelid area, these fat pads can protrude or herniate, resulting in the formation of under-eye bags or puffiness. Additionally, cheek fat descends to leave the junction between the lower eyelid and cheek more visible and defined. 
  3. Loss of Muscle Tone: The muscles supporting the lower eyelid may weaken over time, causing the lower eyelid to droop or become lax. This can contribute to a tired or aged appearance.
  4. Bone and Tissue Changes: Changes in the underlying bone structure and connective tissues can occur with age. The bone may recede or lose volume, and the tissues may lose their strength and resilience. These changes can impact the support and contour of the lower eyelid.
  5. Lifestyle Factors: Lifestyle choices, such as exposure to UV radiation from the sun, smoking, poor nutrition, and inadequate skincare practices, can accelerate the aging process and contribute to the appearance of aging in the lower eyelid area.
  6. Gravity: The effects of gravity can also contribute to lower eyelid aging. Over time, gravity can cause the tissues and structures of the lower eyelid and cheek to gradually descend or sag, leading to a tired or droopy appearance.

It’s important to note that everyone ages differently, and the rate and extent of lower eyelid aging can vary among individuals. Additionally, genetic factors play a role in how the lower eyelid ages. While certain factors are beyond our control, healthy lifestyle choices, proper skincare, and regular consultations with a qualified professional can help address and minimize the effects of lower eyelid aging.

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