Blepharoplasty is surgery of the upper or lower eyelids or both. The main focus of blepharoplasty is removal of excess skin and soft tissue of the upper and lower lid along with removal of fat pads that herniate from the orbital cavity to present as bags beneath the eyes.

Upper eyelid surgery is usually done simultaneously with lower eyelid surgery, but either can be done as an isolated procedure. In addition, eyelid surgery is frequently done in conjunction with other facial plastic procedures under the same anesthesia. Upper eyelid surgery involves a small incision placed in the normal skin crease of the upper lid with removal of the excess skin and soft tissue, as well as the herniated fat in the upper eyelid. The incision is closed with a combination of non-absorbable and absorbable sutures to give the most acceptable closure.

Occasionally, the excess tissue involving the upper eyelids can lead to decreased peripheral vision for the patient. In these cases, an optometrist may document the vision problem, and insurance may cover the expense of the upper eyelid blepharoplasty.

Lower eyelid surgery can be thought of as a continuum from no-external-scar lower eyelid surgery (transconjunctival blepharoplasty) to a lower lid blepharoplasty involving an external excision that is hidden in a natural skin crease line. In transconjunctival blepharoplasty, the primary problem is fat herniation from the orbit with a minimal amount of other skin and soft tissue excess. Occasionally, a small amount of skin can be removed simultaneously with the transconjunctival blepharoplasty, and a periorbital skin resurfacing (chemical peel) can be performed at the same time. Also, lower lid canthoplasty is frequently performed to better position the lower lid margin and reverse the gravity effects of aging.

In general, surgery around the eyes is used to eliminate sags and bulges, whereas skin resurfacing is used to improve the appearance of fine wrinkles and sun-damage around the eyes. It is understandable that skin resurfacing is frequently indicated for patients with aging skin to decrease wrinkles. In general, the external incisions involving the eyelids heal with very little difficulty and usually are not noticed, because these incisions are hidden within natural skin crease lines. Skin resurfacing can provide the final touch with a slight tightening of the periorbital skin, along with an improvement in the amount of fine wrinkling and crepe-like appearance of aging skin.

Occasionally, other adjunctive procedures are performed around the eyelid, depending upon the individual needs of the patient. For example, patients with drooping brows may be candidates for simultaneous endoscopic browlift and blepharoplasty. We will discuss your individual case at the time of the consultation.