Consultant Ophthalmologist,
Cataract & Refractive Surgeon

BMedSci BM BS MRCS MRCSEd MRCOpth FRCOphth MMedLaw PgD Cataract & Refractive Surgery

Blepharoplasty

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Droopy eyelids are a major reason why some people consider eyelid surgery (blepharoplasty) to remove and tighten excess eyelid skin for a more alert, youthful appearance.

Sometimes blepharoplasty also can improve your vision by providing a less obstructed field of view, once droopy eyelids are improved.

Blepharoplasty can remove excess skin, muscle and sometimes fat from the upper or lower eyelids. In some cases, you might need only skin removed but not muscle — or you might need the procedure done on both upper and lower eyelids.

An upper eyelid blepharoplasty (sometimes called an "eye lift") can sometimes can elevate an upper eyelid margin slightly if the heaviness of the excessive skin is "weighing down" the upper eyelid, causing it to droop. However this procedure is not designed to lift the eye lid itself. A proper droopy eyelid called a ptosis requires a completely different procedure to correct it.

What Is Cosmetic Blepharoplasty?

Cosmetic eyelid surgery is a surgical procedure that is not medically necessary and is performed solely to improve your appearance.

Unfortunately, your upper and sometimes lower eyelids may become droopy or baggy as part of the being less young.

The eyelid skin stretches, muscles weaken and fat pockets become more prominent as they bulge.

Cosmetically, such conditions may detract from the overall attractiveness of your eyes and face and cause a tired or older appearance.

Who Are the Best Candidates for Eyelid Surgery?

You might consider blepharoplasty if you have excessive drooping and sagging of skin around eyes, which often is due to normal aging. Sagging skin also can be exaggerated when you have other conditions such as puffy eyes caused by eye allergies or recurrent swelling.

If you are interested in blepharoplasty strictly for cosmetic reasons then we need to be realistic about what we can achieve.

The aging process will continue and, as with any cosmetic procedure, your improved appearance will sadly not last indefinitely. And at some point in the future, you might want to consider repeating the procedure.

Eyelid surgery tends to be more difficult to perform on people of Oriental descent because of the unique structure of this ethnic group's eyelids.

Possible Complications of Eyelid Surgery

A possible complication of eyelid surgery is a temporary inability to close your eyelids completely. This means that eyes may become abnormally dry.

Usually this condition resolves after a few weeks or months, during which time you would need remedies such as eye drops, humidifiers and even taping the eyes closed at night to protect the cornea.

If the condition persists beyond two or three months, an additional procedure might be required to restore enough skin to the eyelid to enable complete closure over the eye.

The risk of the eyes not closing properly (called lagophthalmos) is increased by how "heroic" we are with regards trying to take the excess skin away. If we are aiming to take away all the loose skin then the risk of over correcting (taking too much) increases. If we are happy to take most of the skin but leave a little fold then the risks reduce.

Other potential complications of blepharoplasty include:

Vision loss from retrobulbar haemorrhage – this is one of the most devastating complications of blepharoplasty surgery. It is thankfully extremely rare but it reminds us that this is a cosmetic procedure which was not strictly necessary and so we have to have to be sure about going ahead with it.

Infection, scarring, undercorrection (too much skin left behind) and an undesirable cosmetic appearance are always a possibility.

I hope that you will be happy with the appearance but it is impossible to please everyone.

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