What is Eyelid Surgery (Blepharoplasty)?
An eyelid lift removes excess fat and skin from the upper and lower eyelids, correcting drooping upper lids and reducing puffy bags below your eyes. At West End Plastic Surgery in Washington, D.C., eyelid surgery is one of the most popular procedures performed by Dr. Paul G. Ruff IV and Dr. Justin Cohen. However, it’s important to know that it won’t correct crow’s feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. And while the surgery can add an upper eyelid crease to Asian eyes, it won’t eliminate ethnic or racial characteristics.
If you are considering eyelid surgery (blepharoplasty) in the Washington, D.C. area, request a consultation online to meet our surgeons, or call our office at (202) 785-4187 to schedule an appointment.
Am I a Good Candidate for an Eyelid Lift?
An ideal candidate for an eyelid lift is someone in general good health, who has realistic expectations about the procedure, and who has one or more of the following characteristics. Most candidates are 35 years of age or older, but if your droopy eyelids are an inherited condition you may decide to have the surgery at a younger age.
- Puffy areas or “bags” under the eyes
- Excessive skin or sagging of your upper eyelids
- Excessive skin on your lower eyelids
- Loss of your natural upper eyelid crease
A non-surgical approach may be an appropriate alternative in your case. West End Plastic Surgery offers ThermiSmooth™, an FDA-cleared, non-invasive treatment that tightens saggy skin and minimizes fine lines in the eye area, including on the eyelids.
Your Consultation With Your Plastic Surgeon
Prior to scheduling your eyelid lift, you will have an extensive consultation with Dr. Ruff or Dr. Cohen. The goals of the consultation are to evaluate your facial structure to determine whether an eyelid lift will give you the facial enhancement you desire and to assess your specific risks for the procedure. Your plastic surgeon will thoroughly explain the procedure and its expected results and answer any questions you have. Dr. Ruff or Dr. Lessner may also recommend combining your eyelid lift with another procedure, such as a brow lift, to meet your cosmetic goals. The type of anesthesia to be used and cost and payment information will also be discussed. You will be asked to provide a medical history and to explain the results you hope to achieve with an eyelid lift.
Your plastic surgeon along with the team at West End Plastic Surgery will:
- Test your vision and assess your tear production
- Review the various eyelid lift options with you
- Clearly discuss the potential risks of the procedure
- Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
- Provide detailed cost and payment information
- Answer all your questions
You will be asked to provide:
- Details about your medical history
- A list of all medications you currently take, including over-the-counter medications such as aspirin, vitamins, and herbal supplements
- Information regarding your tobacco and alcohol use
Your eyelid lift procedure will be performed in our state-of-the-art surgical suite. The procedure generally takes 1 to 3 hours to complete depending on how extensive it is. The surgery is usually performed using local anesthesia with sedation. You may feel a bit of tugging around your eyelid area but will experience no discomfort. General anesthesia can be used if you would rather be completely asleep during the procedure.
Your doctor makes small incisions following the natural lines of your eyelids. These incisions are made in the creases of your upper lids and just below the lashes of your lower lids or inside the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of the eyes. Working through these incisions, your doctor separates the skin from underlying tissue and muscle, removes excess fat, and trims any sagging skin and muscle. If you are having all 4 eyelids done, your doctor will work on the upper lids first, then the lower ones. The incisions are then closed with very small stitches. Ointment is placed in your eyes and bandages are placed over your eyes for the first 24 hours after surgery.
The type of anesthesia used and the anticipated length of your procedure will be discussed with you at your initial consultation. In most cases, the surgery is performed on an outpatient basis and you go home shortly after the procedure. If your eyelid lift is extensive (or combined with other procedures), a stay of 1 to 2 nights in the hospital may be required.
What to Expect During Eyelid Surgery Recovery
|Watch TV or Read||2 to 3 Days After Surgery|
|Wear Makeup Around the Eyes||7 to 10 Days After Surgery|
|Stitches Removed||2 to 7 Days After Surgery|
|Back to Work or School||7 to 10 Days After Surgery|
|Driving||As Soon as You Feel Comfortable|
|Wear Contact Lenses||2 to 3 Weeks After Surgery|
|Strenuous Activity||3 Weeks After Surgery|
|Fading of Scars||Several Months to 1 Year|
Immediately After Your Surgery
In most cases, eyelid lift surgery is performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy from the anesthesia and your eyelids will feel tight and sore as the anesthesia wears off. Pain medication will help you control this discomfort. It is important to have someone drive you home after surgery and to stay with you for the first few days after surgery. Your eyes also will appear bruised. Bruising varies among patients and usually reaches its peak during the first week after surgery. The discoloration disappears 2 to 4 weeks after your eyelid lift.
The First 24 to 48 Hours After Your Surgery
In the first few days after surgery, your eyes will most likely feel sticky and itchy, and you may experience a burning sensation. Your eyelids also may feel dry and tight. You may also have some numbness along your lash line. Your discomfort level will improve rapidly after the first 2 days, but it is still important to keep regular activities to a minimum for the first 3 to 5 days after your procedure.
There may be some bruising and swelling around your eyes. You can use cold compresses (a medium-size bag of frozen peas works well) to help reduce these conditions. You may have slight bleeding from your incisions. This is nothing to worry about and can usually be controlled by firmly holding a pad or sponge on the area for 10 to 20 minutes. You can clean off any dried or clotted blood with soap and water or diluted peroxide. If the bleeding does not stop, call West End Plastic Surgery for further instructions.
The First 2 Weeks After Surgery
You will notice a marked improvement in your discomfort level during the first few weeks after your surgery. Although you will be up and around in the first few days, you should take it easy for the first 3 to 5 days after surgery. Your stitches will be removed 2 to 7 days after your surgery depending on how extensive the procedure was. The bruising and swelling will begin to fade within about 5 to 7 days of your surgery.
You may read or watch TV a few days after your surgery and most patients return to work within a week to 10 days. You can wear makeup around the eye area within 7 to 10 days of your surgery and begin to wear your contact lenses within 3 to 4 weeks. Strenuous activity should be avoided for at least 3 weeks after your surgery.
Resuming Your Normal Routine
Everyone heals at different rates, and you are the best judge of when you are ready for certain activities, but the following are general guidelines:
- You may read or watch TV within 3 days of your surgery.
- You can most likely return to work or school within 7 to 10 days after your surgery.
- You may resume driving as soon as you feel comfortable doing so.
- You can most likely return to your physical exercise program within 3 weeks of your eyelid lift. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
- Your scars may look slightly pink for 6 months, sometimes longer. Eventually, the scars will fade to a nearly invisible white line. Tiny whiteheads may appear after your stitches are taken out and they can be easily removed and cause no scarring.
- The scars caused by the incision should be protected from sunlight for at least a year after surgery.
- Your eyes will be sensitive to sunlight, wind, or other airborne irritants for several weeks after your surgery. Wear sunglasses, along with a special eyelid sun block whenever you are outside.
Things to Be Aware of After Your Surgery
- It is normal to experience blurry or double vision for a few days after your eyelid procedure.
- After surgery, some people have minor trouble closing their eyes to sleep.
- The nerves of the lower eyelid may be temporarily affected by the surgery, causing sagging of the margin of the eyelid. This condition usually corrects itself within a few days or weeks. Upward massage and support of the eyelid itself with tape can help the healing process.
Eyelid lift surgery can enhance the youthful appearance of your eyes. These results generally last between 5 to 10 years and longer in many cases. It is important to keep in mind that the effects of aging, gravity, and environmental factors will eventually cause sagging and drooping of the eyelid area.
Eyelid Lift Risks
All surgical procedures have some degree of risk; however, major complications from eyelid lift surgery are unusual. During your initial consultation with Dr. Ruff and the staff of West End Plastic Surgery, your individual risks will be assessed and discussed. As with any surgery, you can help reduce the risks by closely following the pre- and post-surgery instructions provided to you. Your doctor and the staff of the practice will be with you every step of the way to ensure a safe and pleasing outcome. Most likely risks include the following:
- Dry eyes
- Inability to close eyes
- Loss of asymmetry of the eyes
- Sagging of the lower eyelid (ectropion)
- Hematoma (blood collection)
Eyelid Surgery FAQs:
Are there other procedures that could be done along with eyelid lift surgery to give me a more youthful appearance?
An eyelid lift is often performed in conjunction with a brow lift or a mid-facelift to provide a smoother, more youthful look to the face. Many patients have blepharoplasty in conjunction with body contouring.
Will my insurance coverage pay for my eyelid lift?
In most cases, eyelid lift surgery is considered cosmetic surgery and, therefore, is not covered by insurance. You are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation. In rare instances, insurance will cover the cost of an eyelid lift if it is considered medically necessary to improve vision that is impaired due to overhanging eyelid skin or drooping of the upper eyelid itself (ptosis).
Are there alternatives to eyelid lift surgery?
Injections of BOTOX® Cosmetic can be a temporary, non-surgical alternative to an eyelid lift. These injections can reduce or eliminate wrinkling skin around the eyes by blocking the nerve impulses to temporarily paralyze the muscles that cause wrinkles. Meticulous medically directed skin care may also improve the skin tone, skin coloring, and reduce the appearance of wrinkles. Laser resurfacing and chemical peels are less invasive but very effective method to improve tone, wrinkles, and even contour.