Blepharoplasty Eyelid Surgery | Pristyn Care

Risk Factors

Risk factors affecting blepharoplasty candidacy and outcome include:

• Active smoking impairing wound healing and skin flap viability
• Dry eye syndrome which may worsen after lower blepharoplasty
• Thyroid eye disease causing eyelid changes
• Blood-thinning medications requiring pre-operative management
• Unrealistic expectations regarding surgical results
• Previous eyelid surgery affecting tissue quality and healing

Who is at Risk

Patients in their 35s to 65s with drooping upper eyelids affecting vision or appearance, persistent under-eye bags, or significant lower eyelid skin excess are ideal candidates. Those with a family history of early eyelid aging and those seeking facial rejuvenation are common candidates for blepharoplasty.

Diagnosis

Pre-operative assessment for blepharoplasty includes:

• Visual field testing if upper eyelid drooping affects vision
• Detailed eyelid examination including skin, fat, and muscle assessment
• Tear film assessment to evaluate dry eye risk
• Photographic documentation for surgical planning
• Medical history review including eye conditions and medications
• Discussion of realistic expectations and desired outcomes

Blepharoplasty Treatment Approach

Blepharoplasty is typically performed under local anesthesia with sedation as a day-case procedure. Upper blepharoplasty involves an incision in the natural eyelid crease, removal of excess skin and fat, and fine suture closure. Lower blepharoplasty may use a subciliary external incision or transconjunctival internal approach. The procedure takes 1 to 2 hours and is usually performed as a day-case surgery.

The Blepharoplasty Procedure

Blepharoplasty is performed as follows:

• Local anesthesia with sedation or general anesthesia is administered
• For upper blepharoplasty: incision is made in the natural eyelid crease
• Excess skin is precisely marked and excised
• Herniated fat pads are removed or repositioned as needed
• The incision is closed with very fine sutures
• For lower blepharoplasty: incision is made below the lower lash line or inside the eyelid
• Fat pockets are addressed and excess skin is trimmed
• Fine sutures or tissue glue close the incisions

After Surgery Care

Post-operative care after blepharoplasty includes:

• Cold compresses applied gently to reduce swelling and bruising
• Head elevation during sleep for the first 2 weeks
• Eye lubricating drops to manage temporary dryness
• Suture removal at 5 to 7 days post-surgery
• Avoidance of contact lenses for 2 to 3 weeks
• Final results visible at 2 to 3 months as swelling fully resolves

Complications of Blepharoplasty

Possible complications of blepharoplasty include:

• Swelling and bruising lasting 2 to 4 weeks
• Dry eyes requiring lubricating drops post-surgery
• Temporary blurred vision
• Asymmetry of the eyelids requiring revision
• Scarring if wound healing is suboptimal
• Ectropion – outward turning of the lower eyelid in rare cases
• Infection at the incision sites
• Rare risk of vision changes requiring immediate evaluation