As people age, some of the earliest changes are in the eyelids. The skin of the upper and lower eyelids stretches out. Blepharoplasty can make a person appear more rested and youthful.
Fatty tissue that surrounds and supports the eye also may begin to bulge, creating a puffy, tired or angry appearance. Surgical repair of this condition is called blepharoplasty. This surgery can improve the puffy appearance. While it also can make improvements in the fine wrinkles on the lower lids and “crow’s feet” on the side of the eye, it cannot eradicate them completely. Sometimes, sagging skin can become so excessive that it hangs down onto the lashes and obstructs vision. Repairing this condition is considered a medical necessity and may be covered by insurance, unlike the repair of a lesser deformity.
During blepharoplasty, the excess skin and muscle and any protruding fat are removed. The resulting scar on the upper eyelid usually is hidden in the crease formed when the eyelid opens. The extension of the scar to the side usually is hidden in any “crow’s feet.”
Two approaches can be used on the lower lid. One approach involves making the incision just under the lower lashes and the scar usually is inconspicuous. Another common approach is called a transconjunctival blepharoplasty. The incisions are made from the inside of the lower lid avoiding an external incision, minimizing problems with lid position and eye shape.
Postoperatively, there will be bruising and swelling of the eyelids. If both upper and lower lids are operated on at the same time, it may be difficult to see for two or three days until some of the swelling dissipates. Permanent alterations in visual acuity are extremely rare. Some patients may have difficulty closing their eyes completely or may notice changes in their lower lid position, but these problems are most often temporary. Sutures will be removed within three to five days after surgery, and you may shower then. You may resume light exercise one week after surgery and more strenuous exercise two weeks after the operation. Most bruising will disappear within 10 to 14 days postoperatively.
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