Eyelid Surgery (Blepharoplasty)

Eyelid surgery encompasses various procedures to correct problems with the eyelids that affect vision or appearance. This includes surgery for drooping upper eyelids (ptosis), excess eyelid skin, and eyelid malposition.

Types of Eyelid Surgery

Ptosis Surgery

Corrects drooping upper eyelid:

• See Ptosis Surgery for detailed information
• Tightens or repositions the muscle that lifts the eyelid
• Several techniques available

Upper Blepharoplasty

Removes excess upper eyelid skin:

• Addresses dermatochalasis (extra skin)
• Improves superior visual field
• May be combined with ptosis repair

Lower Blepharoplasty

Addresses lower eyelid concerns:

• Removes excess skin and fat
• Corrects "bags" under eyes
• May tighten lax lower lid

Eyelid Malposition Surgery

Entropion repair

• Eyelid turns inward
• Lashes rub on cornea
• Causes discomfort and damage

Ectropion repair

• Eyelid turns outward
• Eye exposed and dry
• Tearing problems

Eyelid Retraction Surgery

For thyroid eye disease:

• Lowers upper eyelid if too high
• Raises lower eyelid if too low
• Improves exposure and appearance

When Surgery Is Recommended

Medical Reasons (May Be Covered by Insurance)

• Superior visual field blocked by eyelid
• Ptosis affecting vision
• Chronic irritation from malposition
• Corneal damage from exposure
• Related to thyroid eye disease

Documentation Often Required

• Visual field testing showing obstruction
• Photos showing eyelid position
• Documentation of symptoms

Cosmetic Reasons

• Appearance concerns without functional problems
• Usually not covered by insurance

Before Surgery

Evaluation

• Complete eye examination
• Eyelid measurements
• Visual field testing if medically indicated
• Photos for documentation
• Review of medications (stop blood thinners if approved)

Medical Clearance

• May need clearance from primary doctor
• Review of health conditions
• Discussion of anesthesia options

The Procedure

Anesthesia

• Usually local anesthesia with sedation
• General anesthesia sometimes used
• Outpatient procedure typically

Duration

• 30 minutes to 2 hours depending on procedure
• Bilateral surgery takes longer

What Happens

• Incisions made in natural eyelid creases
• Excess skin, muscle, or fat removed
• Muscles tightened or repositioned as needed
• Sutures placed (may be dissolvable)

Recovery

First Few Days

• Swelling and bruising expected
• Ice compresses helpful
• Head elevation while sleeping
• Antibiotic ointment as directed
• Avoid straining, bending over

First Week

• Sutures may be removed (5-7 days)
• Swelling begins to improve
• May have blurred vision from ointment
• Avoid makeup around eyes

First Month

• Most swelling resolved
• Can usually resume normal activities by 2 weeks
• Avoid strenuous exercise for 2-3 weeks
• Final results develop over weeks to months

Risks and Complications

Common

• Bruising and swelling
• Temporary dryness
• Minor asymmetry
• Scarring (usually well-hidden)

Less Common

• Infection
• Bleeding
• Over or under-correction
• Difficulty closing eye
• Need for revision surgery

Rare

• Vision loss (very rare)
• Significant asymmetry
• Chronic dry eye

Results

Expected Outcomes

• Improved visual field
• Better eyelid position
• More refreshed appearance
• Results typically long-lasting

When to Expect Final Results

• Swelling resolves: 2-4 weeks
• Final settling: 2-3 months
• Scars mature: 6-12 months

Cost Considerations

Insurance Coverage

May be covered if:

• Visual field obstruction documented
• Medical necessity demonstrated
• Prior authorization obtained

Out-of-Pocket

• Varies by procedure and location
• Cosmetic surgery not covered
• Ask about all fees upfront

Frequently Asked Questions

How long do results last?

Results are typically long-lasting (10+ years), though aging continues and some patients eventually need revision.

Will I have visible scars?

Incisions are placed in natural creases and typically heal very well. Most scars are not noticeable after healing.

Can both upper and lower lids be done together?

Yes, often upper and lower blepharoplasty are performed at the same time.

When can I wear makeup again?

Usually 1-2 weeks after surgery, once incisions have healed.