Jeffrey Kenkel, M.D. Answers Questions On: Eyelid Surgery

Patients who are in good health and weight stable are generally good candidates for eyelid surgery (blepharoplasty). Many candidates are over 35 years old, but if droopy, baggy eyelids run in your family, you may decide to have the surgery at a younger age.

Some medical conditions make this surgery more difficult, including:

• Hypothyroidism
• Graves’ disease
• High blood pressure or other circulatory disorders
• Cardiovascular disease
• Diabetes
• Dry eyes

A detached retina or glaucoma are also reasons for caution.

In a typical procedure, the incisions are well-concealed in either the natural crease of the upper eyelid or just beneath the lash line of the lower eyelid. I often make a small incision on the inside of the lower eyelid to help facilitate the removal of fat there.

Working through these incisions, I’ll separate the skin from the underlying fatty tissue and muscle, remove excess fat, and trim the sagging skin and muscle when indicated.

In the case of the lower eyelids, I’ll also perform the appropriate suspension technique to improve its shape. The incisions are then closed with very fine sutures.

Upper eyelid surgery can be performed under local anesthesia with or without mild sedation. In some cases, upper eyelid surgery can be performed in the office. I prefer to perform lower eyelid surgery under general anesthesia in the operating room.

About one to two-and-a-half hours, depending on the extent of the procedure. It’s performed in the outpatient surgery center; an overnight stay is not necessary for most patients.

Potential side effects include:

• Swelling
• Bruising
• Temporary blurred vision
• Recurrent skin laxity

Like any surgery, an eyelid procedure involves certain risks, such as:

• Poor healing
• Eyelid retraction
• Scarring

Swelling and some bruising are common around the eyes following surgery. This can last for several days to several weeks, depending on which type of procedure you undergo.

You should be able to return to work in approximately seven to 10 days, depending on your occupation and the extent of your surgery.

While patient experiences vary and recovery for lower blepharoplasty is typically longer, here is a general timeline for recovery milestones:

• Hospital stay: Not needed for most patients
• Apply cold pack: First two days as directed
• Keep upper body elevated: Two days
• Sutures removed: Seven to 10 days
• Blurry vision: Several days to a few weeks
• Wear contact lenses: One to two weeks
• Resume nonstrenuous exercise: Two weeks
• Swelling and bruising fades: 10 to 14 days
• Ready to go out in public: 10 days for upper lids; two to three weeks for lower lids
• Resume strenuous activities: Four weeks

About 10 to 20 years.