For those of us who look chronically tired, one of the main contributing factors can be the amount of skin around your eyes, or how loose it is. If you struggle with drooping eyelids, drawn-down eyes, or simply want to look more awake, facial plastic surgeon Daniel J. Liebertz, MD Kirkland, WA has an answer: blepharoplasty.
What is Blepharoplasty?
This huge word simply means eyelid rejuvenation surgery, which can be performed on the upper eyelid, the lower eyelid, or both.
“An upper blepharoplasty addresses drooping or puffy upper eyelid skin, while lower blepharoplasty corrects excess skin, swelling, or sagging of the lower eyelids,” explains Dr. Liebertz. “Both procedures tend to improve the appearance of the eyes and make a person look less tired.”
The upper eyelid versus the lower eyelid
Unlike a lift, which involves some amount of skin tightening or even deeper layers of the face, a blepharoplasty usually involves removing excess skin and carefully concealing the scar. That said, the upper eyelid tends to be a quicker, easier surgery.”
“Upper blepharoplasty is a relatively simple procedure: using local anesthesia, excess skin is removed from the upper eyelid and sutures are used to close the incision,” says Dr. Liebertz. “Sometimes excess fat may also need to be removed. The procedure takes about 20 minutes and there is minimal pain involved. The stitches are removed within a week and any bruising and swelling usually subsides in 10 to 14 days.’
Lower eyelid rejuvenation, on the other hand, is more complicated. This is because it often deals with the deeper fat pads to accurately reshape the eye sockets, it is more difficult to hide the scar and in general, the anatomy of the lower eyelid is more difficult to work with.
“Lower blepharoplasty can be more complicated and may involve general anesthesia for patient comfort and safety,” says Dr. Liebertz. “Incisions are made either under the lower lashes or inside the eyelid and excess fat and skin is removed. Recovery from a lower blepharoplasty is similar to an upper – any bruising and swelling should subside within a week or two.
What you need to know before an eyelid surgery
This procedure is designed to treat tired eyes – this means that anyone with droopy, heavy eyelids may be a good candidate for blepharoplasty.
“Heavy, drooping upper lids or less ‘immovable’ eye shadow are common concerns that lead people to have an upper blepharoplasty,” explains Dr. Liebertz. “Patients interested in lower eyelid blepharoplasty usually complain of lower eyelid bags or shadows.”
Because these surgeries are so specific to the patient’s anatomy, a lot of testing is required before your surgeon makes any incisions. This will probably include a pinch test, where the laxity of your lower eyelid is checked by pinching the skin and looking at how long it takes to return to normal and where excess skin can be removed.
“Specific procedures and techniques depend on the patient’s unique anatomy, ophthalmologic history, and orbital function,” says Dr. Liebertz. “A full examination of the eyebrows, upper and lower eyelids, eyes and mid-face is done before any surgery is offered.”
You should also be prepared to avoid blood thinners and take it easy on your eyes for a few weeks. “Before undergoing any periorbital surgery, patients should stop all blood thinners such as aspirin or ibuprofen, as well as all vitamins, minerals, and supplements for at least two weeks,” explains Dr. Liebertz. “Postoperatively, patients should avoid vigorous activity, contact lens wear, or eye makeup for two full weeks.”
New Techniques and Approaches
Like all medicine, blepharoplasty is constantly being improved by technological advances. The biggest thing for the world of eyelid rejuvenation is probably the addition of lasers.
“Some surgeons choose to use a laser to incise the skin and eyelids,” says Dr. Liebertz.
When lasers are used, they seal the blood vessels as they make the incision, making it easier for surgeons to make precise changes. Laser incisions have also been found to cause less scarring overall.
In addition to the use of laser technology, blepharoplasty has advanced significantly thanks to the increase in fat transfer.
“Fat repositioning in lower eyelid surgery can help smooth the eyelid-cheek transition,” explains Dr. Liebertz. “This is especially true in patients with hollowing under the eyes.”
