Blepharoplasty - Procedure


Blepharoplasty is usually 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. Incisions may be made from the inside surface of the lower eyelid (transconjunctival blepharoplasty); this allows removal of lower eyelid fat without an externally-visible scar, but does not allow excess skin to be removed. External skin resurfacing with a chemical peel or carbon dioxide laser may be performed simultaneously. This allows for a faster recovery process.

The operation typically takes one to three hours to complete. Initial swelling and bruising resolve in one to two weeks but at least several months are needed until the final result becomes stable. Blepharoplasty's effects are best appreciated by comparing before and after photos of surgical patients.

The anatomy of the eyelids, skin quality, age, and the adjacent tissue all affect the cosmetic and functional outcomes. Factors which are known to cause complications include:

  • dry eyes - which may become exacerbated by disrupting the natural tear film
  • laxity (looseness) of the lower lid margin (edge) - which predisposes to lower lid malposition
  • prominence of the eye in relation to the malar (cheek) complex - which predisposes to lower lid malposition
Transconjunctival blepharoplasty of the right lower eyelid.
An incision is made on the inner eyelid surface. A suture holds the inner eyelid tissue over the eye.
Fat is held with forceps (left) and clamped with a hemostat (right). A small retractor (bottom right) keeps away extra tissue.
The fat is cut away with surgical scissors (right).

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