Blepharoplasty the Repair of Droopy Eyelids

As you age, your eyelids stretch, muscles weaken and excess fat gathers above and below your eyelids. This can cause sagging eyebrows, drooping upper lids and bags under your eyes. Baggy skin can even impair vision and make you look and feel older.

Eyelid surgery, or blepharoplasty (BLEF-uh-ro-plas-te), repairs droopy eyelids by removing excess skin, muscle and fat. To help decide if this surgery is right for you, find out what you can realistically expect and the benefits and risks involved.

You might consider blepharoplasty if you want to remove the excess tissue that keeps your eyes from opening completely. Removing this tissue can improve vision and make your eyes appear younger and more alert. Specifically, blepharoplasty repairs:

• Baggy or puffy upper eyelids
• Excess skin on lower eyelids
• Dark circles or bags under eyes

You may have a medical reason for this surgery if your ability to see is affected. If you have the surgery only to improve your appearance, it might not be covered by insurance.

Before scheduling blepharoplasty, you need to meet with your doctor to discuss the important factors that determine whether the procedure is likely to work well for you. This meeting generally includes:

Your medical history; Your doctor asks questions about conditions you have or have had, as well as any current medications. Your doctor may ask if you have allergies that affect your eyes, dry eyes, glaucoma or other problems with your eyes.

• A physical examination; Your doctor conducts a complete physical examination, which includes testing your vision and tear production.
• Photographs; Photographs of your eyes are taken from different angles. Your doctor uses these photos for before-and-after assessments and long-term reviews.
• A discussion of your expectations; You and your doctor talk about your motivations and expectations. He or she explains what blepharoplasty can and can't do for you and what your results might be.

Before blepharoplasty, you may also need to:

• Avoid medications containing aspirin or ibuprofen for two weeks before and after the surgery. These medications may increase bleeding. Take only those medications approved or prescribed by your surgeon.
• Avoid exposing your skin to sunlight for one week before surgery and two to three months after surgery. Too much sun may cause permanent irregular coloration of the skin.

you have surgery on your upper and lower eyelids, the surgeon works on your upper lids first. The surgeon makes an incision along the natural fold of the upper eyelid. Then excess skin and some muscle and fat beneath the skin are removed. The incision is closed with tiny stitches that leave a nearly invisible scar.

The incision on the lower lid is made just below the lashes in your eye's natural crease or inside the lower lid itself. The surgeon removes excess fat, sagging skin and muscle. Depending on where the initial incisions are made, stitches may follow the lower lid's natural crease or be placed inside the lower eyelid.

Blepharoplasty is usually done in an outpatient setting under local anesthesia. Your doctor injects the pain-numbing medication and sedates you with medication injected through an intravenous (IV) line. This makes you groggy but not fully asleep.This surgery usually takes one to three hours, depending on the extent of the procedure. Afterward you wake up in a recovery room, where the doctor's staff monitors you for any complications. You can leave later that day to recuperate at home.

Blurred vision is common after blepharoplasty because of the ointment used to lubricate and protect the eyes. You may also experience excessive tearing, light sensitivity and double vision just after the surgery. In addition, your eyelids may be puffy and feel numb for several days. Expect swelling and discoloration to last a week or more.

Take the following precautions for a week after the surgery, unless advised otherwise by your doctor:

• Don't lift anything weighing more than 20 pounds.
• Don't bend from your waist unless you flex or bend your knees.
• Don't swim.
• Avoid strenuous activities, such as aerobics and jogging.
• Avoid extreme neck movements, such as moving your head forward or back or turning your head right and left.
• Sleep with your head raised higher than your chest.

Scars from the incisions may take three to six months to fade. For many people, the result of blepharoplasty is permanent.

As with any surgery, blepharoplasty carries some risks, such as infection or reaction to the anesthetics. Other possible risks specific to this surgery include:

• Temporary numbness of the eyelid skin
• Dry, irritated eyes
• Impaired eyelid function
• Scarring
• A very small risk of blindness due to bleeding behind the eye

Talk to your doctor about how these risks apply to you. Understanding what's involved in blepharoplasty and weighing the benefits and risks can help you decide if this procedure is a good option.