Eyelid surgery (blepharoplasty) is a popular cosmetic plastic surgery to remove excess skin, fat, or muscle from the upper and lower eyelids. Blepharoplasty cosmetic surgery improves baggy skin under the eyes, sinking upper eyelids, or drooping eye lashes that impair vision. The surgery may also be performed to treat a medical condition called ptosis (drooping eyelid), which is caused by poor muscle tone or nerve damage. Ptosis causes the eyelids to hang very low and block vision.

Blepharoplasty treats drooping eyelids, but not drooping eyebrows or wrinkles. Blepharoplasty is often performed with another cosmetic surgery such as a brow-lift or facelift to improve droopy eyebrows, crow's feet, and facial sagging.

As we age, excess skin forms in the eye area and the skin loses elasticity. Fatty tissue can accumulate under the skin. Your eyes will "look older" because these aging processes leave the eyes appearing tired, wrinkled, or puffy. Even with a good skincare and eye care regimen, wrinkles, puffiness, and drooping eyelids will catch up to you. Genetic factors and body chemistry can cause these aging effects in younger people. Plastic surgery may restore a youthful and refreshed appearance to your eyes.

The best candidates for blepharoplasty are physically healthy, emotionally stable, and well-informed about the procedure. Ideal candidates are typically at least 35 (although genetic factors may indicate treatment for younger patients). Candidates may be excluded if they suffer from any of the following conditions: dry eyes, high blood pressure, hypothyroidism, cardiovascular disease, diabetes, glaucoma, or Graves' disease. Personal anatomy issues, including bone and supporting structure, may also affect your candidacy.

Incisions are made along the line creases of the upper eyelid and possibly along the outer lower rim of the eye's skin. When removing fatty tissue, but not skin, the surgeon may perform a transconjunctival blepharoplasty with an incision inside the lower rim of the eye's skin. These incisions often reach the outer corners of the eyes. The surgeon then divides the fatty tissue and muscle from the skin so that excess skin, fat, or muscle can be removed.

The blepharoplasty procedure is often performed under local anaesthesia — while you are sedated, numbed, and awake — in an outpatient surgery centre, surgeon's office, or hospital. General anaesthesia (while you are asleep) may be used. Be sure to discuss the appropriate type of anaesthesia with your doctor and the anaesthesia provider.

Depending upon the number of eyelids and extent of the procedure, time in surgery may be up to three hours. Patients return home typically within hours of the surgery.

The eyes will often be lubricated and covered with bandages after surgery. Pain and discomfort can be managed with oral medications. Unmanageable pain should be reported to your doctor immediately. The doctor will also prescribe an antibiotic to prevent infection. You will receive a list of instructions to follow for a number of days, including

• the proper way to clean your eyes
• use of cold compresses
• use of lubricating eye drops
• head elevation
• no makeup
• no alcohol
• no television
• no contact lenses

Stitches are removed about a week after surgery. Bruising and swelling will continue to decrease after stitches are removed. Sunglasses and a protective sun block are required for several weeks. Normal activities can be resumed after about ten days. Strenuous activities such as lifting, bending, or exercise can be resumed after about three weeks.

Following surgery, patients may experience tearing, itchy, burning eyes, dry eyes, light sensitivity, and blurred or double vision, which can persist for several days. These complications can be relieved with lubricating eye drops. There will also be some swelling around the eyes. Scarring is another possible complication. Sometimes patients will have difficulty closing their eyes when asleep: although very uncommon, this complication can be permanent. The lower lids may appear to be pulled down: this rare condition, called ectropion, may require additional surgery. There also may be some asymmetry to the eyes.

As with any surgery, there is risk of complications related to infection or reaction to anaesthesia. You can avoid most complications by selecting the right plastic surgeon and following pre- and post-operative instructions. With proper precautions by the surgical team, complications are typically minimized or prevented. During consultation with our qualified plastic surgeon and ophthalmologist, your medical history and vision will be evaluated to assess candidacy and risks.