Upper Blepharoplasty

Who makes a good candidate for an upper eyelid blepharoplasty?

Upper eyelid bleph procedures are popular among individuals who want to refresh their appearance and reduce the signs of aging around the eyes, as they target drooping skin, wrinkles, and fine lines. The surgery is also popular among people with a genetic predisposition to skin redundancies, eye wrinkles, and eyelid creases.

However, an eyelid lift isn’t exclusively cosmetic. For those whose eyesight is threatened by heavy upper lids and sagging skin, undergoing the procedure often has practical motivations more than anything else.

That said, an upper eyelid blepharoplasty isn’t suitable for everyone. Individuals who make good candidates for eyelid surgery share a few important characteristics:

• Age: The best candidates for an upper eyelid bleph are at least 30 years old, as saggy eyelid skin and wrinkles typically result from the natural aging process, except when these conditions are caused by genetics. Although young people can have these conditions, they usually develop after age 30.
• Generally healthy condition: It’s important to have a clean bill of health from your doctor before undergoing an eyelid lift. Ideal candidates are those without serious medical conditions that may jeopardize the healing process, such as cardiovascular disease, high blood pressure, and diabetes.
• Good eye health: Several eye conditions beyond those addressed by upper eyelid surgery can disqualify you from undergoing the procedure. Individuals with excessively dry eyes, Graves’ disease, thyroid issues like hyperthyroidism or hypothyroidism, and other eye diseases are generally discouraged from having eyelid lift surgery.
• Healthy lifestyle: Non-smokers are better candidates for eyelid surgery than smokers. Smoking can hinder the healing process, increase the risk of infection, and worsen inflammation, which can make recovery longer and more uncomfortable.

In addition to a healthy lifestyle and a sound medical history, having specific goals and realistic expectations for the outcome makes individuals ideal candidates for an upper eyelid blepharoplasty. An eyelid lift won’t correct every issue, so knowing exactly how you would like to improve the appearance of your eyes and understanding what the procedure is likely to accomplish is essential.

Consult with a plastic surgeon to discuss your desired enhancements, which will help you understand whether a blepharoplasty can address them.

What is a blepharoplasty consultation like?

Besides having an excellent bill of health and realistic expectations, a consultation with a qualified plastic surgeon is crucial before scheduling an eyelid surgery. Only a qualified medical professional can help you accurately evaluate whether blepharoplasty is appropriate for your condition and provide you with a comprehensive understanding of the potential risks and benefits.

During the consultation, your surgeon will review your medical history, listen to your concerns, and assess your desired outcomes. They will then carefully examine your upper eyelids to determine if you’re a suitable candidate. The eye examination may include:

• Checking your visual acuity
• Examining the pupil
• Evaluating your blink rate
• Assessing your eyes’ mucus layer
• Measuring your eyelid laxity

The surgeon will also check for specific eye-related medical conditions during the exam, such as:

• Bell’s phenomenon
• Infraorbital hollowing
• Globe prominence (proptosis)
• Canthal tendon dehiscence
• Malar fat atrophy

They may also want to rule out certain skin conditions like lesions, dyschromia, and dermatitis. If an eyelid lift seems like a safe and beneficial option for you, the surgeon will then go over the details of the operation, the associated risks, and the benefits of upper-lid blepharoplasty.

What are the benefits of upper eyelid blepharoplasty?

An upper eyelid blepharoplasty offers both cosmetic enhancements for appearance and functional improvements for eyesight.

Cosmetic benefits

An upper eyelid blepharoplasty targets excess skin and wrinkles on the upper eyelid. Addressing these issues can make you look younger and fresher, subsequently boosting your confidence and enhancing your overall self-esteem. The procedure can also improve droopy eyes, helping you look less tired and more engaged.

Functional benefits

Having excess skin around your upper eyelids can affect your eyesight. This often occurs when the upper eyelids have so much extra skin that they become droopy and hang over the eyes, interfering with vision.

In some cases, the eyelid skin droops so much that it affects daily activities such as reading, using a computer, and driving. This condition is known as ptosis or blepharoptosis and can affect one or both eyelids, significantly impairing central and peripheral vision. An individual may be born with ptosis or develop the condition as the result of eye injury, nerve damage, or prior eye surgeries. For some people, ptosis is age-related, while for others, it’s linked to an underlying medical condition like diabetes, infection, or a vitamin deficiency.

Ptosis surgery can correct the condition in adults by strengthening the levator muscle in the upper eyelid. Depending on the severity, the surgery is performed by either shortening the muscle or tightening it with permanent sutures. In many cases, ptosis surgeries are combined with blepharoplasty to remove excess skin, lift the eyelids, and strengthen the eyelid muscle by moving it further up the eyelid tissue.

How long do the improvements last?

The enhancements from an upper eyelid blepharoplasty are typically long-lasting and may vary slightly depending on individual factors. For some individuals, the results can even last a lifetime. Several factors can influence the longevity of the results, including:

• Skin quality
• The body’s natural aging process
• Lifestyle

Upper eyelid blepharoplasty does not halt the aging process, and over time, the skin and tissues around your eyes will age naturally, just like the rest of your body. Genetic predispositions and adherence to post-surgery care instructions may also influence the longevity of the results. Under optimal circumstances, the outcomes of an upper eyelid blepharoplasty can last 7 to 10 years or longer.

What do the pre-op and operating procedures entail?

When you arrive at the clinic for your upper eyelid blepharoplasty, you’ll be given either local anesthesia with sedation or general anesthesia. The doctor will begin the procedure by making incisions in the eyelid skin along your natural eyelid creases to minimize the appearance of potential scars.

Your eyelid lift surgery will also involve carefully removing excess skin. Depending on the condition of your eyelids and the corrections you hope to achieve, the doctor may also reposition some of the fatty tissue in your eyelids to give them a fuller look. Subsequently, the doctor will close the incisions with sutures. These sutures will typically remain in place for at least nine days but no more than 12. After this period, you’ll need to return to the doctor’s office to have them removed.

What are the post-op care needs and recovery period like?

After your upper eyelid blepharoplasty, you may experience swelling, bruising, and mild discomfort around your upper eyelids. There may also be swelling and bruising around the eyes. In most cases, these side effects go away after a week or two. However, there are rare circumstances where they can persist for three weeks to a month. Your doctor will typically prescribe pain medications, eye drops, and ointments to fight off infection. They may also suggest using cold compresses during your recovery period if you need additional help managing the pain and swelling.

Self-care instructions after the procedure can vary from patient to patient. In general, it’s recommended to get plenty of rest, maintain a healthy diet, and keep your head elevated to facilitate the healing process. Your doctor will also provide guidance on certain movements to avoid during your recovery period, such as bending, leaning over, and lifting, as well as activities such as swimming and athletics.

Household chores like dusting and gardening may also be off-limits until your eyes are fully healed. Most patients can resume normal activities in about two weeks, depending on their surgeon’s recommendations. However, for some individuals, it may take up to six weeks before they can return to their regular routine.

Keep in mind that after an upper eyelid blepharoplasty, your surgeon will schedule follow-up appointments to monitor your healing and address any complications that arise.

What are the risks of an upper eyelid blepharoplasty?

An upper eyelid blepharoplasty is a complex and intricate procedure that carries the risk of complications and short-term side effects.

Bruising is the most common side effect experienced by all blepharoplasty patients. This is accompanied by varying amounts of pain and discomfort. To manage these side effects, your doctor will prescribe pain medication during your recovery.

Infection is also one of the many risks of the procedure. The sutures on your incisions can become infected if not cared for properly. After the procedure, your doctor will prescribe eye drops and ointments to help keep the surgical site clean and ward off infection. It’s imperative to use the prescribed eye drops and ointments as your doctor recommends.

Some patients may experience various other conditions following an eyelid lift. These can include dry and irritated eyes, overcorrection of the upper eyelid, and abnormal scarring. Additionally, patients may also find it difficult or impossible to fully close their eyes after the procedure. Discoloration of the skin around the eyes and blurred or impaired vision are also possible outcomes. The good news is that these complications may only be short-term.

However, other complications can be longer lasting, which may include:

• Retrobulbar hemorrhage: This condition refers to the accumulation of blood behind the eyes. While rare, it can be quite serious as it may compress the optic nerve, leading to a condition known as proptosis or bulging eyes.
• Pyogenic granuloma: Some patients may develop granuloma lesions on the conjunctival membrane covering the eye, the interior of the eyelids, and the cornea. These small cell clusters are typically non-cancerous and are often treated with steroids, although surgical removal may be necessary in some cases.
• Chemosis: Chemosis, or swelling around the eye, can happen after an upper eyelid blepharoplasty. When this occurs, patients may have difficulty closing the affected eyelid completely. This condition is also known as lagophthalmos.
• Diplopia: In rare instances, an upper eyelid blepharoplasty can cause injury to the muscles in the eyes, which may persist after surgery. This can result in a disconnection of the movement between the inferior oblique muscle and its associated yoke muscle, leading to double vision or diplopia.
• Suture cysts: These occur when the body’s immune system attempts to separate eyelid tissue from sutures by surrounding them with clusters of cells.
• Hypertrophic scars: These are thick, red, raised scars that resemble keloids. They result from an immune system response to an overabundance of collagen and connective tissue.
• Eyelid retraction: When too much skin tissue is removed during the surgery or if the wound doesn’t heal properly, the lower eyelid may sag, leaving a larger area of the eye exposed.
• Ectropion: Although generally not serious, this condition causes the lower eyelid to droop away from the eye.

Is an upper eyelid blepharoplasty worth it?

Whether an upper eyelid blepharoplasty is “worth it” depends on your specific aesthetic goals, medical history, and life circumstances. Having realistic expectations regarding the procedure’s outcomes, along with the doctor’s approval, can make it a valuable investment towards achieving more youthful eyes and a rejuvenated appearance. Additionally, the potential for enhanced self-confidence and improved vision can also make the procedure more appealing.

You can assess the value of an upper eyelid blepharoplasty more effectively by considering the following factors:

• Cost: Although it can have functional health benefits, an upper eyelid blepharoplasty is an elective cosmetic procedure, which means it may not be covered by your health insurance. The cost can vary depending on the surgeon, location, and complexity of the surgery. In general, the cost of the procedure ranges from $1,500 to $9,000.
• Recovery time: The recovery period for an upper eyelid blepharoplasty is relatively short, but you will experience some swelling and bruising initially. Most people can return to work and normal activities within a week or two, although you may need to avoid certain activities for up to a month following the procedure. Following your doctor’s post-surgery instructions is crucial to ensuring that your wounds heal properly and that you maximize the benefits of the surgery.
• Risks: Like any surgical procedure, blepharoplasty carries risks of infection, bleeding, and scarring. It’s essential to discuss these risks with your surgeon beforehand.

In other words, besides consulting with an oculoplastic surgeon to make sure you’re a good candidate for an upper eyelid blepharoplasty, it’s important to evaluate whether you can fulfill the post-operative requirements. Depending on your situation, you may need to take time off from work or other obligations, such as doing household chores or taking care of the family. Additionally, make sure you have a full picture of the cost of the procedure.

FAQ

• How much does an upper eyelid blepharoplasty cost? On average, an upper blepharoplasty costs between $1,500 and $9,000. The complexity of the procedure, the cost of anesthesia, and facility fees all impact the total price. Other factors that contribute to the cost include your location and the expertise and experience of the surgeon.
• Is an upper eyelid blepharoplasty painful? Patients undergoing an upper eyelid blepharoplasty should expect bruising, swelling, pain, and discomfort immediately following the operation. These side effects typically peak on the day of the procedure but generally subside after a week or two in most cases.
• How long does an upper eyelid blepharoplasty procedure take? An upper eyelid blepharoplasty generally takes around one to two hours. Apart from the procedure, you’ll need to spend some time in the recovery room, which adds to the overall time commitment.
• How long do the results of an upper eyelid blepharoplasty last? The longevity of the results from an upper blepharoplasty varies from patient to patient but can typically last anywhere from 7 to 15 years. For some patients, the results can last a lifetime.
• What is the best age range for an upper eyelid blepharoplasty? Since the issues addressed by this procedure are often age-related, it is typically recommended for patients aged 30 or older.
• What makes a good candidate for an upper blepharoplasty? The best candidates for an upper blepharoplasty are individuals in good physical health, non-smokers, and those who don’t have preexisting conditions such as glaucoma, thyroid issues, or severe dry eyes. The procedure is not recommended for people with heart disease, high blood pressure, or diabetes.