Overview

Eyelid surgery (also called an eye lift or blepharoplasty), reduces bagginess from lower eyelids and removes excess skin from the upper eyelids.

This surgery is usually done for cosmetic reasons. It's also an effective way to improve sight in older people whose sagging upper eyelids get in the way of their vision.

As skin ages, it gradually loses its elasticity. A lack of elasticity plus the constant pull from gravity causes excessive skin to collect on the upper and lower eyelids. Excess skin on the lower eyelid causes wrinkles and bulges. On the upper eyelids, an extra fold of skin can hang over the eyelashes and block your sight. The fat that cushions the eyeball from the skull can also cause bulges in the upper and lower eyelids. The thin membrane that holds the fat in place weakens with age, letting the fat come forward into the lids like a hernia.

The best candidates for an eye lift are people who are in good health and who have realistic expectations. Most are 35 years or older, but if baggy eyelids or droopy eyelids run in your family, you may decide to have the surgery done sooner.

Eyelid surgery can enhance your appearance and help build your confidence. However, it may not result in your ideal look or alter your facial structure. Before you decide to have surgery, think about your goals and discuss them with your surgeon.Upper eyelid surgery can last at least 5 to 7 years. Lower eyelid surgery rarely needs to be repeated. Of course, your eyes will still age after the procedure.

You will need to arrange for another person to drive you home after your surgery. You should also have someone stay with you the night of the procedure. Expect and plan to stay home from work and limit your activities for several days after surgery while your eyelids heal. Some people have dry eyes after surgery, but that rarely lasts more than 2 weeks. If you have dry eyes that last more than 2 weeks, contact your doctor.

An eyelift usually takes about 2 hours if both upper and lower eyelids are done together. Your doctor will most likely use local anesthesia (a painkiller injected around the eye) with oral sedation. If you are having the procedure done at a hospital or surgical center, you will most likely receive IV sedation. If you're having all four eyelids done, your surgeon will probably work on the upper lids first. Your surgeon will usually cut along the natural lines of your eyelids. Through these cuts, your surgeon will separate the skin from the underlying tissue and remove the excess fat and skin (and muscle if indicated). Next, the surgeon will close those cuts with very small stitches. The stitches in the upper lids will stay for 3 to 6 days. The lower lids may or may not require stitches, depending on the technique used. 

Surgery on the lower eyelids may be done using one of several techniques. In one method, your surgeon makes a cut inside your lower eyelid to remove fat. That cut won't be visible. Your surgeon can then soften fine lines in the skin using a C02 or erbium laser. 

Another method involves making a cut along the eyelash margin. Through that cut, your surgeon can remove excess skin, loose muscle, and fat. The cut line fades after a short time. After either of these procedures, your surgeon may recommend laser resurfacing.

You'll have stitches in both lids that will remain for as long as a week. 

Swelling and bruising are common. Your eyelids should look normal within a week or two.