Blepharoplasty, Eyelid Surgery

Eyes are a prominent facial feature. It is the surrounding skin, rather than the eyes themselves, that conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Age, sun exposure and hereditary factors all contribute to wrinkles, deep lines and puffiness around the eyes.

The aging process can cause unwanted changes in expression, causing us to look permanently fatigued and older than we really are. These changes in appearance can cause emotional distress and sometimes even visual impairment. An eyelid lift, or blepharoplasty, is designed to restore a more youthful appearance to your eyes. It may involve the upper lids, the lower lids, or both.

The drooping of the brow area also frequently has an impact on the appearance of your eyes. As the brow region descends with age, it weighs down on the upper eyelids and creates additional “heaviness” in the eyelids.  In these cases it is important to consider the benefit of a brow lift in conjunction with an eyelid lift in order to achieve your best result in refreshing the upper half of your face.

Dark circles may be accentuated by skin discoloration due to seasonal allergies or other conditions that a blepharoplasty may not elliminate. You may have a medical reason for this surgery if your field of vision is obstructed, and as such, your surgery may be covered by medical insurance. Set up a consultation with Dr. Sofola and allow him to use his expertise to address your concerns.


Do you need a Blepharoplasty?

You might consider blepharoplasty if you want to rearrange what appears to be excess tissue around your eyes that gives you the tired look. Repositioning the displaced tissue around  your eye can improve vision and make your eyes appear younger and more alert. Specifically, blepharoplasty repairs:

•Baggy or puffy upper eyelids
•Excess skin on lower eyelids
•Dark circles or bags under eyes 


New and Traditional Techniques

Traditional Blepharoplasty: An incision is made in the crease of the upper lid toward the temples. Once healed, it is not noticeable when the eye is open. On the lower lid, the incision is made along the lash line toward the temples, and is hidden by lashes when healed.

The Transconjunctival Approach: This is a newer technique for lid blepharoplasty, involving an incision inside the lower lid. Fat can be removed through this incision, but excess skin cannot be eliminated.

Fat Transposition and Fat Injection:

Traditional blepharoplasty techniques focuses on removal of excess skin and fat. This can often result in a hollow and skeletonized. To avoid such results, current techniques in blepharoplasty emphasize fat preservation with fat repositioning rather than excision. This method results in a more natural look with restoration of the natural convexity that charaterizes the youthful eyelid and cheeks. This technique involves transferring fat from areas in the eyelid that are eccess, to areas that are deficient in fat, creating a smooth and youthful appearance between the lower eyelids and the cheek.

Laser resurfacing or chemical peeling of the eyelids is a non-surgical alternative that may delay the need for a surgical blepharoplasty. It results in significant tightening of the skin around the eyes, but will not effect the fat around the eyes and may even accentuate it.

Your individual needs will be assessed at your consultation with Dr. Sofola. together, you will decide what is best for you.

Please ask your doctor if you have any questions about which procedure is right for you.

What to expect during a Blepharoplasty consultation:

•Your medical history. We obtain a general medical history to access your health status and ability to safely tolerate a blepharoplasty procedure. We also enquire about conditions that may affect your results including allergies that affect your eyes, dry eyes, glaucoma, use of contact lenses or other problems with your eyes.
•Evaluation. A thorough facial examination and analysis will check for skin changes, brow position, eye muscle function, eyelid support, vision and tear production.
•Photographs and Computer morphing. With your permission, we take photographs of your eyes are taken from different angles. We may then generate a comuperized digital image that you can easily see and discuss the changes you desire. These photos are also useful for before-and-after assessments and long-term reviews.
•Discussion of your expectations. We discuss your motivations and expectations, explain the options available and what blepharoplasty can and can’t do for you and what your results might be.

Before blepharoplasty, it is important to :

•Avoid medications containing aspirin or ibuprofen for two weeks before and after the surgery. These medications may increase bleeding. Take only those medications approved or prescribed by your surgeon. The desicion to stop any of your medications should be agreed upon by all your doctors.
•Avoid exposing your skin to sunlight for one week before surgery and two to three months after surgery. Too much sun may cause permanent irregular coloration of the skin.

The Surgery

Local anesthesia is given around the eyes. An intravenous line is started so that sedation may also be given. During the procedure you will be awake but comfortable and relaxed. General anesthesia is rarely used.

This procedure is performed on an outpatient basis at our surgical center. It is important to arrange for care after the surgery. Someone must drive you home and be available to care for you for the first 24 hours.


Recovery: What to Expect

The area surrounding the eyes will remain swollen in the days following the surgery. It should begin to subside after the first day. Some vision blurring is normal.

The stitches will be removed in 4-5 days. Swelling and bruising will persist for about 10 days, but you can begin wearing makeup to help conceal these concerns. You may expect to resume normal activity within a week to 10 days, and start enjoying your new look within approximately 10-14 days. It may take about 6 months for the scars to lose their redness.

Wrinkling will recur later in life, however it is unlikely that the “bags” will recur if the fat has been removed. Deeper wrinkles around the outer eye extended onto the temple are not greatly affected by the eyelid lift. These areas may be treated with laser resurfacing.