You might consider blepharoplasty if droopy or sagging eyelids keep your eyes from opening completely or pull down your lower eyelids. Removing excess tissue from your upper eyelids can improve your vision. Upper and lower lid blepharoplasty can make your eyes appear younger and more alert.

Blepharoplasty may be an option if you have:

  • Baggy or droopy upper eyelids
  • Excess skin of the upper eyelids that interferes with your peripheral vision
  • Excess skin on the lower eyelids
  • Bags under your eyes

You may undergo blepharoplasty at the same time as another procedure, such as a brow lift, face-lift or skin resurfacing.

Insurance coverage may depend on whether the surgery repairs a condition that impairs vision. If you have the surgery only to improve your appearance, the cost probably won’t be covered by insurance. Lower lid blepharoplasty is almost always done just for cosmetic reasons.

Risks

Possible risks of eyelid surgery include:

  • Infection and bleeding
  • Dry, irritated eyes
  • Difficulty closing your eyes or other eyelid problems
  • Noticeable scarring
  • Injury to eye muscles
  • Skin discoloration
  • The need for a follow-up surgery
  • Temporarily blurred vision or, rarely, loss of eyesight
  • Risks associated with surgery in general, including reaction to anesthesia and blood clots

Talk to our doctor about how surgical risks apply to you. Understanding what’s involved in blepharoplasty and weighing the benefits and risks can help you decide if this procedure is a good option.

How you prepare

Before scheduling blepharoplasty, you will meet with a plastic surgeon and an eye specialist (ophthalmologist) or a plastic surgeon who specializes in eye surgeries (oculoplastic surgeon) to discuss:

  • Your medical history.our surgeon will ask questions about previous surgeries and past or current conditions, such as dry eyes, glaucoma, allergies, circulatory problems, thyroid problems and diabetes. Your doctor will also ask about your use of medications, vitamins, herbal supplements, alcohol, tobacco and drugs.
  • Your expectations.An honest discussion of your hopes and motivation for surgery will help set the stage for a satisfactory outcome. Our surgeon will discuss with you whether the procedure is likely to work well for you.

Before your eyelid surgery, you’ll undergo:

  • A physical examination.Our surgeon will conduct a physical examination, which may include testing your tear production and measuring parts of your eyelids.
  • A vision examination.Our eye doctor will examine your eyes and test your vision, including your peripheral vision. This is needed to support an insurance claim.
  • Eyelid photography.Your eyes will be photographed from different angles. These photos help with planning the surgery, assessing its immediate and long-term effects, and supporting an insurance claim.

And you’ll be asked to:

  • Stop taking warfarin (Coumadin, Jantoven), aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others), naproxen (Naprosyn), and any other medication or herbal supplement associated with increased bleeding. Ask your doctor how long before surgery you need to stop taking these medicines. Take only medications approved by your surgeon.
  • Quit smoking several weeks before your surgery. Smoking can reduce your ability to heal after surgery.
  • Arrange for someone to drive you to and from surgery if you’re having outpatient surgery. Plan to have someone stay with you for the first night after returning home from surgery.

What you can expect

Before the procedure

Blepharoplasty is usually done in an outpatient setting. Your surgeon injects numbing medication into your eyelids and administers intravenous medication to help you relax.

During the procedure

If you have surgery on your upper and lower eyelids, the surgeon generally works on your upper lids first. He or she cuts along the fold of the eyelid, removes some excess skin, muscle and possibly fat, and closes the cut.

On the lower lid, the surgeon makes a cut just below the lashes in your eye’s natural crease or inside the lower lid. He or she removes or redistributes excess fat, muscle and sagging skin, and closes the cut.

If your upper eyelid droops close to your pupil, your surgeon may do blepharoplasty with a procedure called ptosis (TOE-sis) that provides additional support to the eyebrow muscle.

After the procedure

After surgery you spend time in a recovery room, where you are monitored for complications. You can leave later that day to recuperate at home.

After surgery you may temporarily experience:

  • Blurred vision from the lubricating ointment applied to your eyes
  • Watering eyes
  • Light sensitivity
  • Double vision
  • Puffy, numb eyelids
  • Swelling and bruising similar to having black eyes
  • Pain or discomfort