Eyelid Surgery (Blepharoplasty)

What is eyelid surgery?

Eyelid surgery is an advanced procedure designed to enhance the appearance of the skin in the upper and/or lower eyelid areas. Very commonly, individuals seeking advice from a plastic surgeon about their aging appearances first focus their attention on their eyelids. Their concern is drawn to their droopy upper eyelids and baggy lower lids. Although corrective surgery for these problems will be discussed during their consultations, it is also important to address the adjacent facial zones because they directly affect the eyelid appearance. The eyes are like islands surrounded by the rest of the face. Their appearance is strongly influenced by what is going on around them. When the forehead sags, it spills more skin into the upper lid zone making them look considerably worse than they really are. On the opposite side of the eyes, gravity draws the cheeks down, leaving a depression in the lower lid zone. These anatomical relationships must be thoroughly considered first prior to focusing the consultation on the upper and lower lids.

What are the benefits of eyelid surgery?

Eyelid surgery, medically referred to as blepharoplasty, can be significantly advantageous for patients who would like to improve signs of age, exhaustion, and other concerns around the eyes. Depending on your unique needs, eyelid surgery can be performed in the upper eyelid areas, the lower eyelid areas, or both in combination. Some of the benefits of eyelid surgery include:

  • Reduction of excess fat or sagging skin in areas around the eyes
  • Correction of under-eye bags/bulges; these may go hand in hand with signs of dark circles or shadows under the eyes
  • Correction of excess skin/fat hanging over the eyes that may be causing a visual obstruction
  • Smoother skin and a more youthful, rested appearance around the eyes

Once Dr. Okamoto has examined you and talked with you about your goals, he will determine whether eyelid surgery is the most ideal procedure for your needs, or whether an alternative procedure would be more in keeping with your expectations. For many patients, procedures such as browlift or injectable dermal fillers can serve as a complement to eyelid surgery for a more comprehensive facial rejuvenation. If you are interested in additional procedures, Dr. Okamoto will be happy to answer your questions about those options at the initial consultation.

Who is an ideal candidate for eyelid surgery?

The best candidates for eyelid surgery are typically individuals who are experiencing fat deposits and/or excess skin around the eyes, puffiness or bagginess, hollowed tear troughs, a “hooding” effect in the upper eyes due to excess, overhanging skin, and general signs of age and exhaustion in the eye areas. Ideal candidates for this procedure are also those who have realistic expectations for results and who are in relatively good general health. During the initial consultation, Dr. Okamoto will evaluate your needs and determine whether eyelid surgery is the best option for your goals.

What are the different types of eyelid surgery?

Upper Blepharoplasty


BeforeAfter
View the Gallery

Upper blepharoplasties involve removal of excessive fat and skin. The incisions are placed in natural skin folds so that the resultant scars are rarely noticed once appropriate healing has occurred.

Lower Blepharoplasty

Lower lid blepharoplasties are more complex due to anatomical concerns and individual differences in presentation. Several factors must be weighed during this procedure. Attention must be given to the existing lower lid supporting structure if post-operative sagging is to be prevented. If laxity is noted in the lower lid pre-operatively, added support to the lid must be accomplished before removing the excess skin. Additionally, numerous options arise when dealing with the lower lid fat. At times, the excess fat is simply removed. At other times, it is transposed from one position to another to fill out hollowed areas that frequently exist. Sometimes no surgery is appropriate for the fat. Almost all the patients in our Facelift Gallery have had lower lid blepharoplasties.

Asian Blepharoplasty

Unlike their Caucasian counterpart, some Asian upper eyelids lack a curvilinear skin crease above the lash line, technically known as the supratarsal fold. When this fold is surgically produced, it substantially alters the presentation of the eyes in a way that many Asians desire. The eyes appear larger, an effect that many consider a cosmetic asset. Creation of the supratarsal fold is known as an Asian blepharoplasty, also referred to as “double eyelid surgery.”  

If you have questions regarding eyelid surgery or other procedures offered here at Fremont Plastic Surgery, or if you would like to schedule a consultation with Dr. Eric Okamoto, please contact us today.

How is the eyelid surgery procedure performed?

The surgical approach will ultimately depend on whether the procedure is performed for the upper eyelids, lower eyelids, or both. During the initial consultation, Dr. Okamoto will talk with you about what the treatment will entail and explain all risks and benefits involved. He will also discuss the types of anesthesia that will be necessary and what you can expect on the day of the procedure. The surgery is typically performed on an outpatient basis and takes between one to three hours to complete, depending on the extent of the procedure and whether both upper and lower eyelid areas are being treated simultaneously.

What is eyelid surgery recovery like?

Patients can expect some degree of temporary bruising and swelling after eyelid surgery; however, a cold compress can often be useful for reducing these effects. Any discomfort or tightness around the eyes after the procedure can be alleviated with pain medication. Keeping your head elevated when possible is recommended for several days following eyelid surgery. Contact lenses and eye makeup should be avoided for at least two to three weeks, and strenuous exercise should also be avoided for at least three weeks. While every individual heals at different rates, many patients are able to resume most normal daily routines within 10 days.

What eyelid surgery results can I expect?

The initial results should be noticeable very soon after surgery. The full effects of the procedure should become apparent after several weeks. It is important to strictly follow post-operative and recovery instructions to reduce the potential for complications or an extended healing process.

For many individuals, the effects of eyelid surgery can last at least 10 to 15 years with the proper care. This requires maintaining a good skin care regimen for areas around the eyes. Moisturizing your skin regularly, applying sunscreen on a daily basis, and giving up smoking can go a long way toward keeping your skin healthy and fresh for longer and longer periods.

How noticeable will eyelid surgery scars be?

One of the many advantages of eyelid surgery procedures is that the incisions are generally quite small and placed in inconspicuous areas. With the combination of Dr. Okamoto’s intricate surgical skills and advanced eyelid surgery techniques, residual scarring should become virtually unnoticeable.

What is the best age to have eyelid surgery?

Eyelid surgery can be beneficial for a number of aesthetic concerns, so patients in a variety of age ranges may be eligible for this procedure. While signs of age are often the impetus for one’s desire to undergo blepharoplasty, other factors may be sources of a patient’s concern as well. Typically, we see individuals around 40 years of age or older request this facial plastic surgery procedure, but it’s truly dependent on a person’s unique needs and goals. Our plastic surgeon will evaluate you during the initial consultation and help you determine if eyelid surgery is an ideal treatment for your concerns.

Is an eyelid lift without surgery possible?

When it comes to the significant, long-term results that are possible with eyelid surgery, there is no non-surgical procedure that can provide the same outcome. With that in mind, it is possible to achieve effective rejuvenation of the eyelid areas when the aesthetic concerns are milder in nature. These options can also be useful for patients who are not candidates for eyelid surgery or for those who simply wish to avoid a surgical procedure. Injectable treatments like BOTOX® Cosmetic/Dysport® can smooth out crow’s feet and furrows between the brows, while dermal fillers can be beneficial for patients who would like to address hollow tear troughs and other facial areas that are lacking volume. Also, Ultherapy® is often useful to improve eyelid appearances by raising the brows or by tightening the skin to the sides or below the eyes. Once Dr. Okamoto has examined you during the initial consultation, he can talk with you about any alternative options that may be able to achieve your goals and help you determine the best treatment for your needs.

What procedures can complement eyelid surgery?

Eyelid surgery can be a very effective procedure on its own; however, there are a number of other options that can be added to your treatment plan to create an even more comprehensive facial rejuvenation. With its ability to address common concerns affecting the upper face and forehead, browlift surgery is a popular complement to eyelid lift procedures. Facelift can also be of benefit for patients who would like to improve signs of age in the mid to lower face and neck. Cosmetic injectables such as BOTOX® Cosmetic, fat injections, and dermal fillers may also be appropriate for patients who would like to enhance volume to certain facial features or complement the effects of eyelid lift treatment without additional surgery. Our practice also offers an array of other non-surgical options, such as laser skin resurfacing.

Additional Frequently Asked Questions About Eyelid Surgery

Is blepharoplasty covered by insurance?

In some cases, blepharoplasty (eyelid surgery) may be at least partially covered by insurance if the sagging upper eyelid skin is obstructing vision, which may be considered a medical condition. For cosmetic enhancement, there is typically no insurance coverage available. If a vision impairment due to overhanging eyelid skin has been sufficiently documented and tests are performed and submitted to insurance companies for the proper authorization, eyelid surgery to correct the condition may be covered. After you have been examined by Dr. Okamoto, a member of our plastic surgery team can assist you with determining whether your insurance policy offers coverage for eyelid surgery.

Will eyelid surgery improve my vision?

If excess, drooping skin affecting the upper eyelids is obscuring your vision, upper eyelid surgery is typically able to correct this concern.

What’s the difference between blepharoplasty and ptosis repair?

Although sometimes the terms “blepharoplasty” and “ptosis repair” are used interchangeably, they are actually distinct techniques. Blepharoplasty (eyelid surgery) involves the removal or repositioning of excess skin and fat affecting the eyelid areas. Ptosis repair is an upper eyelid procedure that involves manipulation of an underlying muscle that may have weakened over time, exacerbating concerns in the area. In many cases, both blepharoplasty and ptosis repair can be performed in a single combination eyelid surgery procedure.

How can I reduce swelling after eyelid surgery?

Swelling is a perfectly normal side effect of eyelid surgery, and should dissipate relatively quickly during the recovery process. Swelling can often be minimized by maintaining an elevated head position for at least 24 hours after the eyelid surgery procedure. A light, cool compress over the eyes may also help the swelling go down; however, it is important to avoid placing pressure on the eyes or surrounding areas. Three days after surgery, warm (but not hot) compresses may be applied to help further reduce swelling. Please note that these general tips may not be for everyone; Dr. Okamoto will provide you with instructions specific to your needs once you have been evaluated.

When can I wear contacts again after eyelid surgery?

Contact lenses should be avoided for a minimum of two weeks following the eyelid surgery procedure. Some patients may need to avoid placing contacts in their eyes for an even longer period.  Dr. Okamoto will give you detailed post-operative instructions and guidelines so that you will know what to expect.

When can I wear eye makeup after blepharoplasty?

It is recommended that you wait at least two weeks following eyelid surgery before applying makeup to the treatment areas, as well as the regions that surround them.

Dr. Okamoto will be happy to address any further questions or concerns you may have about eyelid surgery. Please contact us today for more information, or to schedule a consultation.

*Individual results may vary