Aesthetic blepharoplasty is the plastic surgery procedure by which excess of the skin and fat is removed (making up the “bags” and wrinkles of the eyelids), eliminating the cause of the old and tired eyes and raising of the fallen eyebrows. Reconstructive blepharoplasty is the surgery performed for the correction of eyelid defects that affect the vision.

Preoperative considerations

For blepharoplasty surgery, the first step is to consult a plastic surgeon. The patient has to openly discuss their expectations about how they will look and feel after the surgery, but they must take into account that the desired result is an improvement, and it is not perfection. Emotional stability is one of the most important factors to be established before any aesthetic surgery. Blepharoplasty can improve your appearance, renew your self-confidence, but you will remain the same person for the rest. After your examination, the surgeon will expose and explain all the other factors that influence your decision in relation to surgery such as: age, condition of the skin, and other medical considerations. In younger people, for example, blepharoplasty is used to remove adipose tissues, and in older people, loss of skin tone requires excision of excess tegument. It is very important that ophthalmic problems that prevent vision or the process of forming tears to be detected before surgery. Under these conditions, problems can be solved by an ophthalmologist, prior to surgery, or in some cases during the blepharoplasty surgery. Also during the consultation, the surgeon will show you all the details specific to your case, including the surgical procedure to be performed, the type of anesthesia. During this time, you will discuss other details to be considered before choosing blepharoplasty, such as risks and cost. Every year thousands of blepharoplasties are performed, but this does not mean that the potential risks and specific complications associated with blepharoplasty do not exist. Postoperative complications such as infection and hematoma are rare. Rarely, poor scarring may require a second intervention, but following the surgeon’s instructions, you can avoid the risk of complications.

Surgical procedure

Blepharoplasty is usually used to remove excess skin, eye bags, lift the external corner of the eye, or in some instances perform the procedure for lifting the fallen eyebrows at the same time. During the same surgery one or more of these operations may be performed but the magnitude of the surgery depends on what you want and the surgeon’s considerations. The exact location of the incisions will be chosen based on considerations chosen by the surgeon. Upon their recommendation, you can be operated in ambulatory but surgery takes place in the operating room. This surgery can be performed both under local anesthesia and general anesthesia. Prior to local anesthesia, you will be given medication to remove nerve tension, sedatives and anesthetics making you feel comfortable and relaxed throughout your surgery. If general anesthesia is used, you will sleep throughout the surgery. Blepharoplasty surgery is usually performed starting with the upper eyelid and ending with the lower eyelid. In both areas the underlying fat compartments will be removed, the incisions on both eyelids being made following the natural lines and folds of the skin. Generally, they may extend into natural creases or “crow’s feet” in the outer margin of the eye. Through these incisions the surgeon removes the skin from the underlying tissues, the exposed fat tissue being excised, as well as the excess skin. The type of suture is chosen according to the decision of the surgeon. Once the suture is healed (thin as the hair), it will be hard to see, especially after 6 to 8 weeks. Immediately after surgery, wet compresses will be applied to the eyes. Depending on the amplitude of the surgery, it may take 1-2 hours or more.

Postoperative recovery

After surgery, you will feel a slight sensation of nausea and discomfort. If there is a slight pain, it can be easily controlled with medication. You will also be advised to keep your head up and applying cold compresses will reduce any bruising and swelling (hives and swelling). You will need to use drops (eye instillations) for a few days and you will be told how to rinse your eyes. The eyelids tend to regain their original color and 5-7 days after surgery, when the stitches are removed, the swelling and black-and-white coloration will diminish, and the bruise traces can be covered with makeup easily. Other postoperative short-term effects may be excessive laxity and sensitivity to intense light. Removing the bags, excess skin and loose tissue around your eyes makes you look younger and more “rested” but can not remove the fine creases from the outer edge of the eye. The day after surgery, you can go home and the surgeon will give you the necessary instructions on how to resume your activity. To allow proper healing, avoid excessive effort and bending for 2-3 weeks. To protect your eyes from sunshine, wear sunglasses. Integration into your normal activity depends on how quickly the healing process evolves, and also on how you feel.