Eyelid surgery (blepharoplasty) can be performed on your upper eyelids, lower eyelids, or both. Based on a preoperative evaluation of factors such as your underlying facial muscle structure, bone structure, and the symmetry of your eyebrows, your surgeon will decide how much skin, muscle, and/or fat to remove.

  • Your surgeon will make precise markings to indicate where excess tissues will be removed in your upper eyelids and in your lower eyelids.
  • In your upper eyelid, your surgeon will make an incision hidden within the natural fold of the upper eyelid.
  • In the lower eyelid, the incision will be hidden just below the lower lashes. Alternatively, when excess fat is being removed, the incision can be placed inside the lower eyelid (transconjunctival incision). A laser may sometimes be used in conjunction with this method to tighten lower eyelid skin.
  • Your surgeon will remove tissue through these incisions using surgical instruments, including scalpels, surgical scissors, radiofrequency cutting devices, and, sometimes, cutting lasers.
  • Sometimes fat may be redistributed in the lower lids to eliminate puffiness or bulges. Your surgeon may make other adjustments to correct special problems such as muscle laxity.
  • He or she will then apply sutures or tissue adhesives (glue) to smooth and reconfigure areas around the eyebrows and eyelids. Sutures are invisible to the eye and are commonly self-dissolving. In most cases, there is virtually no detectable scar.
  • Less tissue is removed in patients with dry eyes to avoid exposing more of the eye to the air, which can cause symptoms to worsen.
  • Your surgeon also may use a laser to enhance the procedure by resurfacing skin and smoothing wrinkles in the eyelid and eyebrow area.

When to Consider Eyelid Surgery

  • If you have excess, hanging skin covering the natural fold of the upper eyelids
  • If you have loose skin hanging down from the upper eyelids over the eyelashes
  • If your upper and lower eyelids appear puffy, making your eyes look tired and aged
  • If you have deep grooves under your eye 

Are you a good candidate for eyelid surgery?

The following are some common reasons why you may want to consider eyelid surgery:

  • You have excess skin obscuring the natural fold of the upper eyelids
  • You have loose upper eyelid skin that impairs your vision
  • You have a puffy appearance to the upper eyelids, making your eyes look tired and sad
  • You have excess skin and fine, ‘crepe paper’ type lower eyelid wrinkles
  • You have bags and dark circles under the eyes
  • Your upper eye surface is too small or not smooth enough to apply makeup

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

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