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Blepharoplasty or eyelid surgery is designed to improve aging of the upper and/or lower lids. Excess skin and fat of the upper eyelid will be removed to improve heaviness of the upper lid. This will improve the show of eyeliner and eye shadow. The surgery is designed to open the eyes and rejuvenate the central third of the face. Upper and lower lid surgery may be performed together or separately and often in combination with other facial surgery.
Upper and lower eyelid surgery takes approximately 2 hours under general or local anesthesia with sedation. The upper eyelids take approximately 40 to 45 minutes and the lower eyelids approximately 1 hour. Recent technical changes in lower eyelid surgery result in suspension of the soft tissue and musculature of the lower eyelid to enhance the longevity of the lift. This substantially improves the transition between the eyelid and cheek improving the aging features of the cheek-lid hollowing. Stitches are absorbable without the need for removal. Tightening of the lower eyelid support is performed at the same time, to prevent sagging of the lower lid free margin. This tightening is responsible for the slight upswept appearance to the lower lid margin, which will return to a normal natural look, in approximately 2 to 3 weeks. Muscles of the brow are often thinned in conjunction with the upper eyelid surgery, to decrease furrowing or frown lines. This often requires additional postoperative BOTOX® or Dysport® administration for complete eradication. Incisions are made in the upper eyelid crease and below the lash line of the lower lids to minimize postoperative incision show.
Swelling and bruising are expected after surgery and will last approximately 2 to 6 weeks in most instances. Cold packs are used after surgery to minimize and control swelling, and extra pillows for head elevation is encouraged to shorten the recuperation. Blurring of the vision is expected for 48 to 72 hours after surgery. Television watching and reading should be limited. Showering is acceptable 24 hours after the surgery, and eye make-up wear may be applied after 1 to 2 weeks. Typical return to work is approximately 7 to 10 days, return to exercise is approximately 4 to 6 weeks, and smoking is prohibited in the postoperative period.