Type of Surgery
Information
Last updated: 11/24/2009
As people age, fat tends to deposit in both the upper and lower eyelids. The upper eyelids begin to droop (termed ptosis) and “bags” form under the eyes giving the face a tired look. These changes are not always associated with advanced...
age and can occur early in a person’s life. Unfortunately, this fat does not respond to diet or exercise thus people turn to surgery to correct the problem. Even though very little skin and fat is removed from the eyelids, the effect on a person’s appearance can be quite dramatic.
age and can occur early in a person’s life. Unfortunately, this fat does not respond to diet or exercise thus people turn to surgery to correct the problem. Even though very little skin and fat is removed from the eyelids, the effect on a person’s appearance can be quite dramatic.
Ptosis (drooping eyelid) can occur in a variety of congenital (present at birth) and acquired medical conditions. Ptosis can result from abnormalities in the muscles that lift the eyelid, hormone imbalances or neurological conditions. Blepharoplasty is medically indicated if the drooping eyelid is interfering with vision. While people with ptosis can usually see well enough when looking straight ahead, problems can develop when attempting to look up. Also, the muscles around the eye can become fatigued after prolonged reading. This could also become an important surgical consideration.
Another population of patients that seek blepharoplasty are Asian patients that are born without a crease in the upper eyelid called the pretarsal crease. The addition of this crease allows the placement of eyeliner and gives the eyes a “brighter” look. This is a purely cosmetic procedure but should not be misconstrued as an attempt to hide or disguise ethnicity—this is not the intent. In Western cultures, especially the United States, patient’s rarely request this surgery to mask ethnicity and, if that is the primary request, surgeons are usually wary of performing the procedure for this purpose.
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A graphic animation of what causes fat and sagging eyelids. The video describes what takes place during eyelid surgery (blepharoplasty).
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Blepharoplasty can be both a functional and cosmetic surgical procedure intended to reshape the upper eyelid or lower eyelid by the removal or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons. When an advanced amount of upper eyelid skin is present, the skin may hang over the eyelashes and cause a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision. Patients with a less severe amount of excess skin may have a similar procedure performed for cosmetic reasons. Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid "bags" and reduce the wrinkling of skin.
Blepharoplasty is performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid. Initial swelling and bruising take one to two weeks to resolve but at least several months are needed until the final result becomes stable. Depending upon the scope of the procedure, the operation takes one to three hours to complete.
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