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Blepharoplasty (Eyelids): Symptoms, Classification, Diagnosis & Recovery

A beautiful pair of eyes coupled with shapely eyelids can say a lot. But drooping eyelids can make one look older than their age. This is the reason why blepharoplasty or eyelid surgery is considered by many to reduce those extra bags of fatigue around the eyes. Not only for cosmetic reasons but blepharoplasty may also be considered for improvement of eyesight and widening of vision.

Due to hereditary reasons, fat percentage pockets may develop that may bulge out around weakened muscles and loose eyelids skin around the eyes. It may also take place because of natural aging. There can be functional problems in the upper and lower lids that can prevent one from having a wider view and cause difficulty in wearing contact lenses or spectacles. All these problems can be rectified with the help of an eye plastic surgery or blepharoplasty.

For the same reason, blepharoplasty is also known as lower blepharoplasty, eye bag removal surgery, and sagging eyelids surgery. Blepharoplasty is usually done for cosmetic reasons. But sometimes this procedure can also be performed for functional reasons. Usually, a team of ophthalmologists and cosmetic surgeons perform such surgeries. An eye lift may be performed but basically, excess fat from both upper and lower lids are removed to make the eyelids look youthful. The skin is stretched in a required way to make it look agile and appealing.

Blepharoplasty can be conducted on a single eyelid or both the upper and the lower eyelids (bilateral), depending on the extent of bags and puffiness around the eyes.

Make sure to inform your surgeon about your medical history well before sagging eyelids surgery. Depending on your overall health, the surgeon may ask you to do the following before eye bag removal surgery:

Refrain from taking medicines such as aspirin and ibuprofen that may cause thinning of the blood and cause unwanted bleeding during the procedure. These medicines should be stopped at least two weeks prior to the upper and/or lower blepharoplasty.

  • Avoid drinking or eating anything after midnight on the day of the surgery.
  • Stop taking any herbal supplements.
  • Stop smoking.
  • Eat something light in the evening prior to the surgery, for example, have a soup.
  • Take medications as advised by the doctor before surgery.
  • Do not wear any kind of makeup on the day of the surgery and do not travel alone for the surgery.

  • Local anaesthesia is administered in the regions around the eyes with the help of a series of systemic sedatives.
  • The patient will remain awake but the region around the eyes would feel numb for the total period of surgery. It can be administered orally or intravenously using a needle.
  • In case of blepharoplasty bilateral, general anaesthesia is administered.
  • The surgeon first makes incisions on the eyelids along the natural crease of the upper eyelid and beneath the eyelashes or behind the lower lid in case of the lower eyelids. These positions ensure that the cuts are not visible after the surgery.
  • The surgeon makes specific and well-defined markings to understand from which regions of the eye loose skin and baggy fat must be removed. In many cases, he would also mark the underlying muscles.
  • The amount of fat, skin, or underlying muscles that must be removed is decided during the preoperative visits where the facial structure, bone alignment in the face, muscle configuration, and eyebrow alignment and symmetry are studied.
  • The instruments or devices employed to remove extra skin, fats or muscles are a scalpel, radio frequency cutting device, surgical scissors and cutting lasers.
  • To reconfigure the areas of eyebrows and eyelids and make them smooth, tissue adhesive glue and sutures are used.
  • To resurface the skin and remove any remaining wrinkles around the eyes and the eyelids, the surgeon may take the aid of carbon dioxide laser. This makes the surface smooth.
  • Incisions in the scalp can also be made to lift the eyebrows simultaneously in case of drooping eyebrows.

  • After the surgery, a topical antibiotic ointment must be applied.
  • Cold packs must be applied to the eyes every hour for 10 to 15 minutes as you are awake.
  • Next day, the frequency can be reduced to a few hours. This will keep the bruises and swelling to its minimum.
  • For faster healing, warm compresses must be applied after 48 hours.
  • Take medications to relieve pain or as advised by the doctor.
  • The sutures in the eyes will dissolve in a week. If not, then visit the surgeon who would have it removed.
  • As soon as the redness in the eyes subsides, one can resume a normal life. Till then rest is advised.


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Frequently Asked Questions

Q: How long will the effect of blepharoplasty last?

A: The effects of blepharoplasty may last for 10 to 15 years if conducted properly.

Q: What are the other alternatives for blepharoplasty?

A: Laser skin resurfacing can be considered as a non-surgical method for alternative treatment for blepharoplasty. In this method, collagen production is stimulated. Loss of collagen is the reason for drooping eyes. It can also reverse the effects of sun damage and discoloration. Radio frequency waves can be passed over the region to smooth out the skin and make it taut (thermage treatment). Cosmetic botox involves injecting botulinum toxin to paralyze the muscles that cause wrinkles from its contraction and relaxation. Dermal fillers can add volumes to baggy or sagging.

Q: At what age blepharoplasty can be performed?

A: There are no age criteria as such but it is most commonly performed among older people. A few young patients could be genetically prone to develop fat and loose skin around the eyes. They may undergo the surgery.

Q: Can blepharoplasty help with wrinkles around the eyes?

A: No, this procedure is not suitable for removal of crow’s feet or wrinkles around the eyes.

Q: When are the stitches removed?

A: Depending on the type of stitches used, they may dissolve on their own or can be removed by the surgeon after three to five days of the surgery.

Q: What are the risks of blepharoplasty?

A: Temporary blurry or double vision, asymmetry, slow healing rate are some of the possible risks of the surgery.