The eyes are often the first thing people notice about one's face and are an important aspect of facial attractiveness. Unfortunately, over time an upper eyelid and /or lower eyelid may become "droopy" or "baggy" because the eyelid skin stretches, muscles weaken, and fat pockets bulge and become more prominent around the eyes. The eyebrows also may sag or droop as part of this same process. This most commonly occurs because of the aging process but may also be due to a hereditary condition that runs in your family.
Aesthetically, such conditions may detract from the overall attractiveness of the eyes and cause one to appear "tired", older, and even "unhappy". When severe, these conditions also may cause functional problems, such as impaired field of vision (secondary to eyelid hooding due to very droopy eyebrows and/or baggy upper eyelids) or difficulty wearing glasses (secondary to baggy lower eyelids).
Eyelid surgery aimed to improve the appearance of the eyelids is termed "blepharoplasty". Blepharoplasty is usually an outpatient procedure performed under local anesthesia, with sedation if desired. General anesthesia may be used as well to add to patient's comfort.
The goal of the eyelid surgery is to improve the "baggy" or sagging tissues, which may include skin, muscle, and/or fat pockets. During upper blepharoplasty, typically redundant eyelid skin and fat are reduced. During lower blepharoplasty, either only the fat pockets need to be reduced or the excess skin also may need to be removed and the eye muscle may need to be tightened.
During eyelid surgery, incisions are made in the natural folds of the eyelid so that they are virtually unnoticeable after the tissues have healed. Upon the completion of the procedure, the incisions are closed with fine sutures.
If only fatty tissue needs to be removed from the lower eyelid, and not any skin, the surgery can be performed behind the eyelid. This surgery is known as "transconjunctival blepharoplasty" and leaves no visible scar.
In cases where the eyebrows are also droopy, a procedure to elevate the eyebrows may be appropriate. This procedure, known as a brow or forehead lift, may be done directly above the eyebrows, within the forehead creases, or by approaching the brows from the hairline or just behind the hairline as in "coronal brow lift" or "endoscopic brow lift."
Following eyelid surgery, cold compresses are applied to the eyelids to reduce swelling and bruising. These are later followed by warm compresses to improve blood flow to the area and to aid in the healing. The eyes do not need to be patched shut. During the first week, antibiotic ointment is applied to the eyelids, and strenuous activity should be minimized.
Discomfort is usually minimal after eyelid surgery. One may temporarily experience a minor pain, tightness of an eyelid, swelling, bruising, and dryness of the eyes. These will usually resolve as the wounds heal. Excessive pain, bleeding, infection, or vision changes are very rare. In the unlikely event that such a problem occur, you should notify your physician promptly. Remote complications that may occur include slight asymmetry in eyelid appearance or eyelid position. These problems occur infrequently and may require additional surgery to correct.