by ASPS

Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the eyelids.

Surgery can be performed on the upper lids, lower lids or both.

Whether you want to improve your appearance or are experiencing functional problems with your eyelids, eyelid surgery can rejuvenate the area surrounding your eyes.

What eyelid surgery can treat

  • Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
  • Fatty deposits that appear as puffiness in the eyelids
  • Bags under the eyes
  • Drooping lower eyelids that reveal white below the iris
  • Excess skin and fine wrinkles of the lower eyelid

Who is a good candidate for eyelid surgery?

Good candidates for eyelid surgery include:

  • Healthy individuals with no medical conditions that can impair healing
  • Nonsmokers
  • Individuals with a positive outlook and realistic goals
  • Individuals without serious eye conditions

Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to relaxation of the forehead skin and eyebrow. Sometimes stretching out of the upper eyelid muscle may cause a drooping eyelid. This is called eyelid ptosis and requires a different surgical treatment.

Your plastic surgeon will evaluate your facial anatomy thoroughly and will discuss what procedures might best remedy your concerns.

What should I expect during a consultation for eyelid surgery?

During your eyelid surgery consultation be prepared to discuss:

  • Your surgical goals
  • Medical conditions, drug allergies, previous medical treatments and specifically any problems you have had with your eyes
  • Current prescription medications, including vitamins, herbal supplements, alcohol, tobacco and drug use
  • Previous surgeries

Your plastic surgeon will also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Take photographs
  • Discuss your eyelid surgery options
  • Recommend a course of treatment
  • Discuss likely outcomes of eyelid surgery and any potential risks
  • Discuss the type of anesthesia that will be used

The consultation is the time to ask your plastic surgeon questions. To help, we have prepared a checklist of questions to ask your plastic surgeon that you can take with you to your eyelid surgery consultation.

It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

What questions should I ask my plastic surgeon about eyelid surgery?

Use this checklist of as a guide during your eyelid surgery consultation:

  • Are you certified by the American Board of Plastic Surgery?
  • Were you specifically trained in the field of plastic surgery?
  • How many years of plastic surgery training have you had?
  • Do you have hospital privileges to perform this procedure? If so, at which hospitals?
  • Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for this procedure?
  • What will be expected of me to get the best results?
  • Where and how will you perform my procedure?
  • What surgical technique is recommended for me?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • How can I expect my eyes to look over time?
  • What are my options if I am dissatisfied with the cosmetic outcome of my eyelid surgery?
  • Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?

What are the risks of eyelid surgery?

The decision to have plastic surgery is extremely personal and you will have to weigh the potential benefits in achieving your goals with the risks and potential complications of eyelid surgery. Only you can make that decision for yourself.

You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Possible eyelid surgery risks include:

  • Anesthesia risks
  • Swelling and bruising
  • Bleeding from the incision lines
  • Dryness to the eyes
  • Sensitivity to sun or other bright light
  • Difficulty closing your eyes
  • Ectropion, an outward rolling of the lower eyelid
  • Infection
  • Lid lag, a pulling down of the lower eyelid, may occur and is often temporary
  • Temporary or even permanent change in vision, and very rare chance of blindness
  • Changes in skin sensation or numbness of the eyelashes
  • Pain, which may persist
  • Possible need for revision surgery
  • Unfavorable scarring

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

How should I prepare for eyelid surgery?

In preparing for eyelid surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding and bruising

Eyelid surgery should be performed in an accredited office-based surgical facility, a licensed ambulatory surgical center, or a hospital. Be sure to arrange for a friend or family member to drive you to and from surgery, and to stay with you the first night following surgery.