Blepharoplasty, or cosmetic eyelid surgery, usually aims to surgically enhance the upper, lower, or both pairs of eyelids—sometimes the corners of the eyes and the region around the eyebrows. By doing so, this form of surgery reduces the puffiness and bags under the lower eyelids and raises the drooping upper eyelids, thereby granting the face a more youthful appearance. Individuals might undergo cosmetic eyelid surgery to enhance the aesthetic appearance of their eyes, primarily to make them look more attractive, tailored, youthful, and open. Equally, following the natural process of aging, many individuals suffer from excess eyelid skin which may spread over and above the eyelashes, droopy eyelids, bags under the lower lids, deep creases at the base of the lower eyelids, and laxity of tissues in the area close to the eyes. This excess skin can even impede their vision and limit their field of vision. Therefore, although common factors for this type of surgery are cosmetic, further evidence pinpoints the necessity to focus on the need to facilitate visual loss correction and upgrade sight.
Historically, the first evidence of plastic surgery procedures to the eyelid can be seen in ancient cultures. The techniques for blepharoplasty have changed based on medical knowledge through a variety of advances until these modern days. It is always of paramount importance to pick a registered institution and undertake this procedure by expert surgeons who can decrease the possibility of risks and boost the probability of the best clinical results, by the perfect art of consultation prior to the operations. Prospective patients who seek cosmetic eyelid surgery due to excess skin or fatty tissue should be evaluated promptly and prescribed surgery if it is indicated. Elective upper eyelid blepharoplasties must be aborted, however, in patients with thyroid disease, ocular disease, or both. Once the patient meets the regulatory criteria, the surgeon can continue the pre-operative planning starting with setting the patient’s expectations. It is advisable to have some eyelid surgery on a Friday to offer patients a full weekend recovery, with light activities for 3 to 5 days.
There are several benefits to eyelid surgery (blepharoplasty). Most importantly, it improves the appearance of the eyes by removing fatty pouches and extra skin, eliminating the tired or sad look patients frequently experience. In fact, eyelid surgery can make an individual look more alert, refreshed, and youthful.
Furthermore, the procedure can give visual field improvement, allow easier makeup application, and open up peripheral vision for more functionality that could have been previously obscured by those extra folds of skin and fat. The latter is helpful mostly in older patients, especially in improving reading ability. Patients who spent years “lifting up” their eyebrow skin to read their newspaper or book will now not have to do so. In addition to enhancing the primary appearance, there are psychological and physical benefits to blepharoplasty.
Patients with mild to moderate amounts of aging in the periorbital area often notice visual and physical improvement in vision. This is in addition to the potential psychological benefits of improved appearance, self-esteem, and confidence in social situations. Patients frequently experience satisfaction with their outcome because they appear more refreshed, especially when they are not tired. It is important to make sure the patient has clear goals for the procedure and that the surgeon has realistic expectations before proceeding, as some people perceive looking tired as purely medical as opposed to cosmetic. Of course, the functional benefits of eyelid surgery can deliver everyday improvement to the patient’s visual field and quality of life.
Swelling and bruising can occur around the eye area, alongside dryness of the eyes. In some cases, the eyes can become sticky or watery directly after blepharoplasty. In 1 percent of blepharoplasty surgeries, patients can develop high eye pressure. This risk is higher for individuals also undergoing local anesthetic during a procedure. In 0.5 to 0.7 percent of procedures, the wound can become infected, causing pain and swelling. If infection occurs, doctors may need to prescribe antibiotics. The color of the eyelids can change after blepharoplasty. The area might become darker if the skin around the eye goes white. One of the most severe complications is potential damage to the lacrimal glands and drainage apparatus. Problems include watery eyes, blocked tear ducts, or a wound leaking fluid. In rare cases, individuals may develop retinal detachment, pink eye, or suffer vision loss from a damaged optic nerve post-surgery.
Long-Term Risks and Complications Over the long term, flap lifting, or needle or injection use, can trigger skin and/or fat necrosis in 2.5 to 4.1 percent of cases. Approximately 3.9 to 6.3 percent of patients with blepharoplasty might develop hypertrophic or keloid scarring. These are bumpy scars that rise off the skin, appearing red or darker than the surrounding skin, and rarely fade. A person’s body will gradually break down and absorb fat cells directly after blepharoplasty. However, 3 to 4 percent of patients may develop a postoperative fat granule or cyst. Sometimes these lumps feel firm. More commonly, they are soft, fatty deposits under the skin. About 4.16 percent of individuals undergoing this procedure may develop an eyelid cyst called a chalazion, which causes redness and swelling. Blepharoplasty may also move the eyelid up or down slightly, or make its position asymmetrical. This can be the result of poor skin or muscle support, probably due to excessive skin removal or underlying fat. Patients may need repeat surgery to fix this condition. The psychological health of younger women and adolescents also raises similar cause for concern. Regret post-surgery affects approximately 40 to 100 percent of patients, while a mere 56 to 91 percent are satisfied with the cosmetic outcome of the procedure. Though an experienced surgeon can help achieve the optimal outcomes, the satisfying cosmetic result does not always equate to positive functional improvement following blepharoplasty. In fact, nearly 50 percent of blepharoplasty patients indicate no postoperative functional improvement.
Most patients feel tired and have soreness for the first few days after their surgery. Post-procedure discomfort can usually be reduced with over-the-counter pain-relief medications. Patients may experience a surprising auditory sensation compared to the feeling of coughing or sneezing. Swelling and bruising are often worse on the day after surgery and are likely to improve within a week or two. The gradual healing process of eyelids should not cause much itching and pain. Clear aftercare instructions will be provided, including emptying and avoiding sun exposure with the eyes, while also noting that the complete operation region should be rinsed and treated according to the surgeon’s instructions. Any medications prescribed, including eye drops, need to be taken according to the surgeon’s instructions. Opinions after surgery should be scheduled, along with meaningful instructions for changing activity and treatment. More visits will be required if further procedures are necessary or if there are any complications.
Patients should avoid direct sunlight, smoke, and other substances that can irritate and interfere with the healing process, and avoid excessive physical activity for some time. Elevated placement of the head allows the circulatory system to return quickly to normal levels. All possible risk factors should be clarified before treatment, but also symptoms of complications should be reviewed. Issues can be totally expected, but any signs or symptoms of concern should be shared with a surgeon before it is too late. Healing occurs in phases, along with recovery and effects. Maintaining a physical journal will help provide a detailed understanding of one’s personal recovery rate and quality, so as to have a means of sharing this with a surgeon.