For many people, the first place aging becomes apparent is around the eyes. The eyelid skin is quite thin and tends to stretch as we age. Many people are born with “hooded” upper lids. For others, this hooding begins in middle age. The extra skin may make it difficult to wear mascara and shadow, as the makeup tends to smear. Sometimes the lid skin can overhang the eyelashes and impair vision!
An eyelid lift, also known as blepharoplasty, removes this extra skin to “clean up” the eyes. The removal of this skin can result in a more open, rested and alert look. It may make it easier to wear makeup. Many people say they feel less tired at the end of the day, because the excess skin is no longer weighing down on their eyelids.
Fat beneath the eyelid skin is an additional factor. This fat acts as insulation around the eyeball, so that when you jump or take a fall, your eyeball is cushioned by the fat and isn’t injured. However, its location near the sinuses means that it is affected by symptoms such as hay fever and sinusitis, which can make the fat swell. This swelling has nowhere to go but to “pooch out” the eyelid! The swelling can come and go, but after a while it tends to stay “pooched”, giving you permanent bags under the eyes. Blepharoplasty can remove the excess fat, or even reposition the fat to fill in abnormal depressions and restore a smooth and well-rested appearance.
View More Blepharoplasty Before and After Photos
Eyelid surgery is done under local anesthesia with sedation. The surgery takes one to two hours to perform. We have you use iced compresses on the eyes to reduce the swelling and bruising. However, most patients look a little beady-eyed and bruised for a few days. Usually there is not much discomfort involved, but the eyes do feel tight and tender. Most patients describe the post-operative feeling as “annoying” rather than painful. Sutures are removed around day 5 after surgery. You are usually presentable to the public within 10 to 14 days. However, it may be two to three months before the final results become visible. It takes a period of time before the tightness dissipates, the mild dryness of the eyes disappears, and the sensitivity to bright lights (keep your sunglasses nearby!) goes away.
While I try to get the eyelids as smooth as possible, I must also not pull things so tight that you can’t close your eyes completely, or the white below your pupil may show. If pulled too tight, your eyes can suffer from too much dryness and be very irritated. You will sometimes see celebrities with poor results after eyelid surgery, which makes them look a bit “pop-eyed”. My goal is to get you back into your normal activities as quickly as possible, and to have no one say, “Oh, my goodness, you had your eyelids done!” I want you to return to your friends looking alert and rested, so that they say, “You look great! You must have had a wonderful vacation!”
Frequently Asked Questions about Blepharoplasty
Who is an ideal candidate for blepharoplasty?
Ideal candidates for blepharoplasty are individuals with loose, excess skin that obscures the natural contours of the eyelids. On the upper eyelids, this skin may hang so low that it interferes with sight. On the lower eyelids, the skin can create unsightly wrinkles. Ideal candidates may also have large fat deposits on the lower eyelids that create puffy bags under the eyes. Candidates should be in good overall health and have realistic expectations of surgery. Candidacy is determined on a one-on-one basis and during a personal consultation.
How do I select a surgeon for blepharoplasty?
First and foremost, you must select a surgeon who is certified by the American Board of Plastic Surgery, the only board recognized by the American Board of Medical Specialties to govern plastic surgeons whose training includes cosmetic surgery. Being board certified also means the surgeon operates in an accredited medical facility. You can find out whether a plastic surgeon is board-certified here.
Other factors to consider when selecting a plastic surgeon include experience and skill. You can find out how many years your surgeon has been practicing plastic surgery (including how many eyelid lift procedures they have performed) during your initial consultation. Viewing before-and-after photos of past patients can give you an idea of the results you can expect.
What are the risks and complications that come with blepharoplasty?
As with all surgical procedures, blepharoplasty comes with inherent risks and complications. Possible complications include infection, excessive bleeding, poor scarring, and an unsatisfactory cosmetic result. The risk of complications is greatly reduced when working with an experienced, board certified surgeon. Nonetheless, all possible complications should be explained in detail by your surgeon prior to surgery.
Will I have scars after blepharoplasty?
Scarring is to be expected after blepharoplasty. However, the incisions are carefully planned to minimize the visibility of scars. The incision on the upper eyelids is made in the natural crease. The incision for the lower eyelids is made just below the lower lash line, often extending into the crow’s feet area.
What is the cost of blepharoplasty?
The cost of blepharoplasty depends on a variety of factors including whether the upper eyelids, lower eyelids or both are being operated on, and the degree of correction needed. Upper blepharoplasty may be covered by medical insurance if you have loose skin that hangs over your eyelashes and obstructs your vision.
How long will my blepharoplasty results last?
The results of blepharoplasty can last for many years, but it is important to remember that the procedure can slow down the hands of time, not completely stop them. You will look younger and refreshed but the natural aging process will resume immediately after surgery. Proper skin care (e.g. sun protection, moisturizing) is a must in order to prolong your results. Tips on how to prolong your results can be discussed during your consultation.
Are the results of blepharoplasty permanent?
Once fat is removed during eyelid surgery, it will never come back. Blepharoplasty does not freeze time, however; you will experience a normal loosening of skin over the next 10 or 20 years. Eyelid surgery has reset the clock, so that natural “aging” process starts with much younger-looking skin.
Because the result is long-lasting, it is important that a surgeon refrain from removing too much skin. Experienced Sacramento plastic surgeon Dr. Debra Johnson favors a conservative approach, removing an amount that is sufficient to give you a relaxed, optimistic look. When too much skin is excised, the resulting side effects may include dry eyes and difficulty completely closing the eyelids.
What are some of the alternatives to blepharoplasty?
One alternative to eye lift is to try a dermal filler. New types of these temporary injectables are put on the market each year, and trusted Sacramento plastic surgeon Dr. Debra Johnson keeps up to date on each new innovation.
Small injections of products such as Bellafill, Restylane, Juvederm or Perlane can improve the appearance of the skin around the eyes by smoothing out the skin. Some patients may also benefit from an advanced technique in which fat from other areas of the body is used to add volume to facial features. Fillers are an effective way to treat dark circles under the eyes, too. Loss of volume and thinning skin exposes blood vessels under the skin, giving the area a darker appearance. Injecting a dermal filler provides a cushion that compensates for the thinner skin and loss of fat.
Blood vessels and pigment can be directly targeted with laser treatment. Laser is also very effective in treating so-called “crepey” skin under the eyes. In some cases, Botox or Dysport can be an effective way to relax muscles that are causing wrinkles and volume displacement near the eyes.
Will there be scarring?
Scars resulting from eyelid surgery are typically minor. Often they are only visible when you close your eyes. When a surgeon makes the upper eyelid incision, it may sometimes also includes a small portion of the “crow’s feet” area. Even here, the resulting mark will be faint. The thin skin of the eyelid is actually less likely to form scars than thicker skin elsewhere on the body.
When fat is removed from the lower eyelid as part of the surgery, incisions are made in the inside of the lower eyelid, where a scar cannot be seen. Sometimes an incision is also made beneath the eyelash; this thin scar is rarely noticeable.
All scars will gradually fade over a period of about one year. In addition, your degree of scarring will depend on both your genetic profile and the skill of your surgeon. Dr. Johnson is experienced in the precise placement of incisions, and will provide post-surgical care that promotes optimal healing to minimize scarring.