As we age, the delicate skin around the eyes can appear puffy or saggy. Eyelid skin stretches, muscles weaken, and the normal deposits of protective fat around the eye bulge. The surgical procedure to remove excess eyelid tissues (skin, muscle, or fat) is called blepharoplasty.
Blepharoplasty can be performed on the upper eyelid, lower eyelid or both. The surgery is performed for either cosmetic or functional reasons. Sometimes, excess upper eyelid tissue obstructs the upper visual field or can weigh down the eyelid and produce tired eyes. Most often, people choose blepharoplasty to improve their appearance by making the area around their eyes firmer. When blepharoplasty is performed to improve vision, rather than for cosmetic reasons only, it may done in our Trust under the NHS service.
The surgery is usually performed on day care basis and can take 1-3 hours, depending on whether all four lids or just two (upper lids / lower lids) are done. Upper lid incisions are made in the natural crease of the lid and lower lid incisions are made just below the lash line.
A procedure for lower lid blepharoplasty, called transconjunctival blepharoplasty, removes excess fat through an incision inside the lower lid. Fat may also be moved or transposed, rather than removed, particularly if there are pre-existing hollow areas. Incisions are closed with fine sutures.
For lower eyelid surgery, it is common to perform other procedures to tighten the lower lid, giving it support and reducing the risk of lower lid retraction and ectropion.
Swelling, bruising and blurry vision are common after blepharoplasty. Stitches are removed 5-7 days after surgery, except in cases where self-dissolving sutures are used.
Possible complications associated with blepharoplasty include:
- bleeding and swelling;
- delayed healing;
- scarring;
- infection;
- drooping of upper eyelid or retraction of the lower eyelid;
- asymmetry;
- double vision; and
- dry eye.
Rarely, a bleed tracking to behind the eyeball (retrobulbar bleed) can occur, which can threaten your sight. It is important to note that although the puffiness of the fat pockets may not return, normal wrinkling and ageing of the eye area will continue.
Smokers are known to have healing problems. Please let your surgeon know if you are a smoker or ex-smoker.
Further resources
Patient information leaflets section on the Leeds Teaching Hospitals NHS Trust website