Types of Eyelid Procedures
There are various methods used to enhance eyelid appearance. The following information is designed to give you a basic understanding of each. It is important to note that each of these procedures carries its own set of risks and benefits.
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Upper Eyelid Surgery
Upper eyelid surgery can improve two common problem areas: 1.) excess skin on the upper eyelid itself, often called “hooding of the upper lid, and 2.) puffiness in the inner corner and middle of the upper eyelid caused by herniation (pushing forward) of fat. The hooding of the upper eyelid can obstruct your vision, so its removal could actually improve the quality of your peripheral vision. Puffiness in the upper eyelid can cause patients to look old and tired; and upper eyelid surgery can create a more alert and younger appearance. Upper eyelid surgery can enhance the shape, position, and depth of the eyelid crease.
Note: A browlift can add to the enhancement of the upper eyelid’s appearance by lifting sagging eyebrows. In conjunction with upper eyelid surgery, a browlift removes skin hanging over the upper eyes. For more information on the Browlift procedure CLICK HERE.
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Lower Eyelid Surgery
Lower eyelid surgery is performed to remove the puffiness found in the lower eyelid. Some people refer to this as “bags” under your eyes. The accumulation of excess fat and skin, resulting from age and other factors, causes that puffy appearance in the lower eyelid, which makes people look older and tired. Removal of bulging fat in the lower eyelid can result in a younger, rested and alert appearance.
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Transconjunctival Blepharoplasty
For younger patients and those with thicker, more elastic skin, the surgeon may recommend transconjunctival blepharoplasty. During this procedure, a tiny incision is made inside the lower eyelid and fat is removed with tiny forceps. No skin is removed and the incision is closed with dissolving sutures.
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Asian Eyelid Surgery
Asian eyes have a different appearance than Western eyes. With Asian eyelids, the anatomical difference is that the orbital septum (the layer that holds back the fat) extends lower down towards the eyelid margin. This procedure is also known as double eyelid operation and Asian blepharoplasty. The surgeon performs the procedure similar, but not identical to, traditional eyelid surgery. Their goal is to enhance the patient’s eyelid appearance without taking away any ethnic features. Most surgeons do not advise patients to undergo eyelid surgery in order to “Westernize” their appearance.
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What are the Benefits to this Procedure?
There are many reasons why a person would want to undergo eyelid surgery. Even though reasons vary from person to person, the more common include:
- Improving peripheral vision
- Gaining a fresher, more alert appearance
- Restoring a youthful eyelid appearance
- Enhancing overall appearance
- Gaining a boost in self-confidence
Note: Eyelid surgery will not remove crow’s feet or other wrinkles around the eyes, nor will it eliminate dark circles under the yes, or lift sagging eyebrows. Consult with a cosmetic surgeon to inquire about procedures that take care of these conditions.
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Where Do I Begin?
Those considering eyelid surgery should first find a qualified cosmetic surgeon to perform the operation. CosmeticSurgery.com has created an easy and effective way for patients to
find a cosmetic surgeon online.
Patients should visit with their ophthalmologist before consulting the cosmetic surgeon. For the consultation, it is important that you bring the record of your most recent eye exam, as well as your contact lenses or glasses. You must also inform the doctor of any allergies you might have, or any vitamins or medications you are taking. One’s medical history will help the cosmetic surgeon determine if the patient is an ideal candidate for eyelid surgery.
Before deciding to undergo eyelid surgery, it is strongly recommended that patients meet with cosmetic surgeons for consultations. During the consultation, the surgeon and the patient discuss issues such as reasons for wanting surgery, desired outcome, various options available, the procedure itself, the risks, limitations, and benefits. The surgeon provides information about anesthesia options, the location and description of where the procedure will be done – in a hospital or office surgical suite – and associated costs. The patient’s medical history is taken, and examination of the area to be treated, which includes testing vision and assessing tear production, also takes place during the consultation.
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How is This Procedure Performed?
This procedure usually takes one to three hours to perform, depending on the extent of the operation (if it involves the upper, lower or all four eyelids). Some patients are given local anesthesia, meaning they will be awake during the operation but numb to pain. General anesthesia, which puts patients to sleep, is also a preference of surgeons.
How the surgeon performs the operation depends upon the type of eyelid being treated. In upper eyelid surgery, the doctor creates an incision that follows the natural lines of the eyelids. Working through the incisions, the doctor removes a crescent of excess skin and muscle, and any fat. The surgeon then closes the incisions with fine sutures, which will leave nearly invisible scars.
During lower eyelid surgery, the incisions are also made following the natural lines of the eyelids, just below the lashes in the lower lids. The fatty deposits are then typically repositioned (to prevent a hollow look) or removed from the inside of the lid. In some cases, when excess skin needs to be removed, a skin pinch is performed with an incision placed under the lashes to avoid making a conspicuous scar. As with the upper lids, fine stitches are used to close the incision. Lubrication with ointment is applied at the completion of both upper and lower eyelid surgery.
The recovery period for eyelid surgery is approximately two weeks. In that time, patients must follow their surgeon’s post-operative instructions. This will help promote better healing, reduce chances of complications, and to add more comfort during recovery. For example, eyedrops may be recommended because the eyelids might be dry, and eyes may burn or itch. Also, patients who wear contact lenses must avoid wearing them during the recovery period. Because the eyes will temporarily be sensitive to sunlight, wind, and other irritants, wearing sunglasses and sunblock is highly recommended. Patients will also be instructed on how to clean their eyes while recovering.
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What Are The Risks To Having Eyelid Surgery?
Many people have undergone eyelid surgery, with very few complications reported. However, eyelid surgery is still a very delicate procedure; one mistake could cost one’s vision. Hypothyroidism, Graves’ disease, dry eye, high blood pressure, cardiovascular disease and diabetes are just some of the medical conditions that can make eyelid surgery even more risky. A detached retina or glaucoma are also causes for concern. Speak with your ophthalmologist and cosmetic surgeon to gain a more thorough understanding of the risks.
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What Are the Results of Eyelid Surgery and How Long Do They Last?
Upper and lower eyelids are each performed differently and each displays a different result. Scars will still be visible six or more months after surgery in a slightly pink form, and then eventually fade to thin, nearly invisible lines. After undergoing eyelid surgery, your appearance is enhanced because the upper eyelids are no longer drooping and the skin under the eyes is smooth and firm. The results can last for many years, and in many cases, are permanent.
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What Are the Costs of Eyelid Surgery?
According to the American Society of Plastic Surgeons, the national average cost for eyelid surgery is $2,525. Surgeon fees within various regions may vary depending on whether the practice is in an urban, suburban or rural area. This fee only covers the surgeon and physician costs, and does not include other factors like anesthesia or other miscellaneous costs. Costs may also vary depending on if the procedure involves the upper eyelids, lower, or both. A comprehensive cost figure may be obtained while consulting with the surgeon. Make sure the total figure includes any and all associated costs.
In certain cases, eyelid surgery can be covered by medical insurance, if the procedure is needed for health reasons, including undergoing eyelid surgery to improve vision droopy eyelids or block your vision. Please check with your medical insurance provider, and a cosmetic surgeon for more information.
For those undergoing eyelid surgery for cosmetic reasons, most medical insurance providers do not cover the procedure. However, most surgeons do offer multiple financing options. CosmeticSurgery.com has created an easy and effective way for patients to finance their eyelid surgery online.
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Ten Questions Every Patient Should Ask Their Surgeon About Eyelid Surgery
To gain a more thorough understanding about eyelid surgery, and help form realistic expectations, it is recommended that the patient view before and after photographs of the surgeon’s previous patients and speak with them. It is also important for patients to ask questions about anything they do not understand about the procedure. Here are some recommended questions:
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Is what I described realistic?
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Where is the eyelid surgery performed and how long will it take?
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In my case, what technique is most appropriate in helping me achieve my cosmetic goal?
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What kind of anesthesia will be used during the surgery?
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How much does eyelid surgery cost and what elements factor into that cost like hospital fees, anesthesia, and so on?
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What is the surgeon’s level of experience in performing eyelid surgery?
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What percentage of patients experience complications with eyelid surgery?
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What is the surgeon’s policy about correcting or repeating the procedure if the first eyelid surgery operation does not meet agreed upon results?
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What should I expect, post-operatively, in terms of soreness, scaring, activity level, and so on?
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Have you ever had your malpractice insurance coverage denied, revoked or suspended?
Patients should also inform their surgeons about any allergies, serious medical conditions, and medications they may be taking. In the case of eyelid surgery, provide your most recent eye exam, and bring your glasses or contact lenses to the consultation.
CosmeticSurgery.com provides information about plastic / cosmetic surgery and is designed to help users make decisions regarding their own treatment options. However, the medical information provided is not the same as medical advice – the application of medical treatment to an individual’s specific circumstances. Although we go to great lengths to make sure our information is accurate and useful, we recommend that you consult a qualified medical practitioner if you want the professional assurance that our information, and your interpretation of it, is appropriate to your particular situation.
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Sheldon J. Sevinor, MD
Scott J. Zevon, MD,FACS
Haven J. Barlow, MD
Jonathan Pontell, MD, F.A.C.S.
