Blepharoplasty (Eye Lid Surgery)

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Pioneering work conducted at UT Southwestern Medical Center provides our ear, nose, and throat surgeons with an advanced understanding of facial aging and effective cosmetic procedures.

Our innovative surgical techniques include blepharoplasty (eyelid surgery), brow lifts, and other minimally invasive treatments to eliminate droopy eyelids, sagging skin, and bags beneath the eyes. We combine approaches to achieve a natural, refreshed look and give patients the results they want.

What Is Blepharoplasty (Eyelid Surgery)?

Blepharoplasty, also known as eyelid surgery, is a procedure to improve the appearance or function of the eyelids. This procedure involves the removal of excess skin, muscle, and sometimes fat from the upper or lower eyelids. It rejuvenates the area around the eyes by addressing issues such as drooping upper lids, puffiness, and bags under the eyes.

The two main types of blepharoplasty are:

Upper eyelid blepharoplasty: This procedure is commonly performed to remove excess skin and fatty tissue that cause drooping or sagging, which can affect appearance and sometimes obstruct vision. In some cases, it also involves repairing the muscles responsible for lifting the eyelids.
Lower eyelid blepharoplasty: This surgery targets issues such as under-eye bags, wrinkles, and sagging skin. It often involves repositioning or removing fat pads, tightening muscles and tendons, and eliminating excess skin to create a smoother, more youthful shape beneath the eyes.

Why Choose UT Southwestern for Blepharoplasty?

UT Southwestern’s approach to eyelid surgery offers significant advantages over some conventional methods, which can sometimes result in a pulled, “windswept” look.

Recent advances include a five-step lower-eyelid rejuvenation process we pioneered to improve results and reduce the complexities of eye rejuvenation. This type of procedure might be considered challenging at other surgical centers, but UT Southwestern simplified the surgical process to achieve a natural, more youthful look for patients.

UT Southwestern’s research has shown separations between the fat compartments in the face become more apparent as people age and lose volume in their faces. With eyelid surgery, we address the skin and underlying muscles while restoring loss of volume.

Who Is a Good Candidate for Blepharoplasty?

Blepharoplasty is often chosen by people who have sagging or droopy upper eyelids as they get older. Some people are also born with or develop conditions that cause eyelid drooping. The procedure can help fix issues such as:

Sagging or droopy upper eyelids
Excess skin on the upper eyelids that interferes with peripheral (side) vision
Excess skin on the lower eyelids
Bags under the eyes

Ideal candidates for blepharoplasty are:

In good overall health
Typically at least 30 years old
Without significant eye conditions

Patients with health issues such as eye diseases (for example, glaucoma, dry eye, or detached retina), thyroid disorders, heart disease, hypertension, or diabetes should consult with their eye doctor and surgeon to assess if the procedure is right for them.

Also, it's important for patients to have realistic expectations for the procedure. While blepharoplasty can enhance appearance and boost confidence, it will not dramatically alter facial structure.

"Aging often begins around the eyes. This area can be impacted by loose skin and muscle, fatty bags, sagging eyelids, and low brows. We will tailor an eye-lift procedure – including an upper or lower eyelid lift when appropriate – that matches your needs and helps turn back time."

Jeffrey Kenkel, M.D.
Professor and Chair of the Department of Plastic Surgery; Dr. Kenkel practices in Dallas and Frisco

How Should Patients Prepare for a Blepharoplasty?

Before the procedure, it’s important to prepare at home with items such as:

Ice packs
Gauze pads
Prescribed eye drops or artificial tears
Clean washcloths
Over-the-counter pain relievers

Patients should arrange for transportation home after the procedure and have someone stay with them on the first night. We also recommend that people plan to take time off work and limit activities for several days to allow proper healing.

What Can Patients Expect with Blepharoplasty?

Before Eyelid Surgery

Before surgery, patients will undergo a comprehensive medical evaluation, including a review of medical history and any existing eye conditions.

Our cosmetic and plastic surgeons can perform eye lifts alone or at the same time as other facial procedures, such as a face lift or forehead lift. Patients should consult with their doctor to explore how combining procedures can enhance their overall results.

It's important that patients discuss all medications and supplements with their doctor, as some may need to be adjusted to reduce bleeding risks.

During Eyelid Surgery

Blepharoplasty is an outpatient procedure. Patients can go home the same day.

Options for anesthesia include:

General anesthesia
Sedation
Local anesthetic (for upper eyelid procedures, this can sometimes be performed in the office)

UT Southwestern’s five-step approach to blepharoplasty for lower eyelid rejuvenation combines nonsurgical and surgical options:

Our surgeons use small incisions, following the natural lines of the upper eyelid creases and the lash lines of the lower lids, to surgically repair the eyelid.
We preserve the eyelid muscle to maintain the natural eye shape and contour – to both provide safety and keep the eye from becoming dry as the patient ages.
The malar fat compartment is also restored to smooth the transition zone between the eye and cheek.
A filler substance, which can be the patient’s own stem cell-laden fat, can be used to augment the deep malar fat compartment in the cheek.
If needed, the outer part of the eye is also restored to create a more natural look.

After Eyelid Surgery

Patients may experience:

Temporary swelling, bruising, and some pain
Blurred vision and increased light sensitivity, which usually resolve within a few days

Patients can expect to receive medication to relieve pain for a few days after the procedure. Swelling, bruising, irritation, and dry eyes can be relieved with medication, cold compresses, and lubricating ointment.

Adhering to the surgeon's postoperative care instructions is crucial for a smooth recovery.

How Long Does Blepharoplasty Recovery Take?

Most patients can return to activities, including work, in about a week. Patients should allow two to three weeks before starting strenuous activity, and four weeks for most of the swelling to go away. It might be 10 to 14 days before patients can wear contact lenses again.

Patients should see a noticeable difference in the shape of their eyelids soon after surgery.

How Long Do Results Last?

The results of eyelid surgery are long term, lasting about 10 years. While the natural aging process continues, patients can expect a more youthful and rested appearance around the eyes for many years following the procedure.

Lower eyelid surgery generally does not require repetition, while upper eyelid surgery may need to be repeated in some cases due to the natural aging process. If sagging recurs in the upper eyelid, it may be more appropriate to address it with a forehead lift rather than repeating the blepharoplasty.

In addition to blepharoplasty, our surgeons offer a new technique for repositioning the upper eyelid, called ptosis repair, to give a more rejuvenated look or improved visual field.

Our plastic surgeons can also perform a forehead lift, also known as a brow lift, to address low or sagging eyebrows, usually a result of aging. A brow lift is often combined with cosmetic eyelid surgery or nonsurgical alternatives.

During this procedure, we use advanced, minimally invasive endoscopic incisions hidden in the scalp or within the hairline. By using state-of-the-art endoscopic procedures, which allow for very small incisions, we’re able to minimize postoperative discomfort and recovery times.