Blepharoplasty is a delicate surgery to improve the appearance and/or functionality of the upper or lower eyelids. This may include redraping or sculpting of the eyelids to augment the way the skin folds. Blepharoplasty is the most commonly performed facial surgery in the world.
During eyelid surgery, skin or fat is removed or adjusted, and the skin tightened and smoothed.
A blepharoplasty may be cosmetic or medical, or both:
- Changing the way the eyelids look
- Improving vision by correcting overly droopy eyelids
There are two types of eyelid surgery: the upper and lower blepharoplasty. Upper blepharoplasty is often performed for both aesthetic and functional reasons, while lower lid blepharoplasty is almost always performed for aesthetic reasons.
Blepharon means eyelids
Plastikos means to mould
The human face is made up of small, functional units. The eye area is a main point of focus when we interact with each other. This makes it one of the two most important of our functional facial units. The other is the mouth area. (Think of emojis – they usually only include the eyes and mouth to create a huge array of subtle expressions that we immediately understand.)
Our eyes and surrounding skin and muscle provides a great deal of amount of information to others. How are we, what are we feeling, do we like you, do we like the food, are we surprised, happy, sad, disappointed, angry, tired, drunk…
Our ability to communicate through our eyes intentionally and unintentionally is profound. We express mood, emotion and character through our eyes, so when any one part of our eye’s functional unit changes, such as sagging lids or under-eye bags, it can lead to facial imbalance and disharmony. Giving the wrong impression, perhaps.
This upsets us , because it can make us look old, grumpy, tired or sad, which may not be an accurate representation of how we are feeling, or indeed what we want to convey to others.
This makes blepharoplasty a very popular surgery for both young and old: it can deeply impact our sense of what we present to the world, and in return, what the world presents to us.
Eyelid surgery on the upper eyelids
Eyelid skin is the thinnest on the human body, having no underlying fatty layer. The upper lids are unattached to our eyeball, and are attached only at the edges of our eyelids and brow. This means that eyelid skin ‘wears out’ faster than any other skin on our body due to our relentless blinking. Our eyelids are always active, even during parts of sleep.
The upper eyelid can completely cover the eyelashes, which may obscure vision. If this is the case, your eyelid surgery may be covered by Medicare.
The contour of the eye can be disturbed by sagging or large upper eyelids, which will not impair vision, but can be an aesthetic concern for some.
Eyelid surgery on the lower eyelids
The lower eyelids may droop, showing excess whiteness (the sclera). Fatty deposits may become more prominent underneath the lower eyelid, creating a puffy appearance. These fatty deposits can also create shadows at their edges and become ‘bags’ under the eyes.
Much like the top eyelid, the lower section under our eyes is not attached to anything directly, allowing room for fluid and fat to accumulate and appear prominent. As we age, the skin around the eye, both upper and lower, will wrinkle and sag.
The blepharoplasty surgery
The blepharoplasty surgery itself isn’t a long procedure, perhaps 60-90 minutes, and involves:
- Anaesthetic – your doctor will discuss the best type for you, but typically a local anaesthetic is used
- Depending on whether it’s the upper or lower lid, incisions will be made in areas that will naturally be hidden by creases or other natural lines
- Excess skin or fat will be removed or repositioned
- Loose muscle may be tightened with sutures
- Stitches, surgical tape or tissue glue are used to close the site
- You can expect some after-effects as your eyelids recover – some mild swelling, bruising and soreness
- You should follow the instructions given by your surgeon for after-care
What can I expect from blepharoplasty surgery?
The fat pads underneath our eyes can start to protrude, causing us to look like we’ve got allergies or are unwell. This can be caused by having naturally large fat pads under the eyes, or from droopy skin making the fat pads look more prominent.
If your surgery is for improvements to vision, you get all the above benefits, plus you’ll be able to see much more clearly. After eyelid surgery no matter the reason, you’ll look younger and seem more spritely (whether you feel it or not!).
You can expect the effects of a blepharoplasty to last from 5-10 years, and in some cases, your whole life.
Quick facts about blepharoplasty eyelid surgery
- Blepharoplasty can drastically improve the appearance of the eye area
- Blepharoplasty can vastly improve eyelid-driven impaired vision
- Blepharoplasty can reduce the appearance of tired, puffy eyes
- Your surgery may be covered by Medicare – ask
Blepharoplasty is not for everyone. There are other alternatives depending on your individual eyelids, such as skin tightening, lasers, anti-wrinkle injections and dermal fillers.
If you are concerned about sagging skin, the degree of sag will determine whether surgery is appropriate for you. If you have impaired vision because of your eyelids, surgery can be a positive, long-lasting solution.
Dermal fillers for the ageing eye area
There are several features around the eye that can create shadows, such as the fat pockets (causing bags) and our tear troughs. These can be quickly filled in with small amounts of dermal filler to remove the shadow, and thus the perception of tiredness, under-eye bags, or age. Great for younger people.
Anti-wrinkle injections for the ageing eye area
Muscle-relaxant anti-wrinkle injections can soften the muscles around the eyes and forehead to reduce worsening creases and wrinkles. These injections are carefully placed around the borders of tiny facial muscles to partially or fully disable the wrinkle-causing muscle.
Great for arresting wrinkles and creases in their tracks.
Laser or other energy-based treatments for the ageing eye area
Lasers may remove the top layer of skin, revealing fresh new skin underneath, while also stimulating collagen production. This has the effect of tightening the skin and creating a more youthful appearance around the eyes. We also have deeper-penetrating lasers that have excellent skin tightening activity with the ablative element.
Speak to your cosmetic doctor about your options. There are many!
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