Eyelid surgery corrects drooping upper eyelids or puffy bags below your eyes. It is performed by removing fat and excess skin and muscle from the upper and lower eyelids.
The procedure can help treat:
- Puffiness in the upper eyelids
- Loose skin that hangs down from the upper eyelids
- Excess skin that hides the natural fold of the upper eyelid
- Excess skin and fine wrinkles of the lower eyelids
- Puffy bags under the eyes
If you are considering eyelid surgery, you will first meet with a facial plastic surgeon for a consultation. Please come to your initial visit with information about your medical history, including previous surgeries, present and past health problems, and any medications, vitamins or nutritional supplements you are taking or have taken at some time.
Your surgeon will evaluate any excess skin or fat around your eyelid area, the position of your eyebrows and the muscles around your eyelids. If you decide to have eyelid surgery and your surgeon thinks that you are a good candidate, he or she will explain the technique that will be used, the type of facility where the treatment will be performed, and the risks and costs involved.
Be sure to ask any questions you may have, and express your concerns and expectations related to the surgery. You will also be provided with specific guidelines on how to prepare for your procedure.
Eyelid surgery is performed in an office-based surgical suite, hospital or outpatient surgery center. If you are admitted to the hospital or surgery center, you will usually only stay one or two nights. The surgery itself usually lasts between one and three hours.
To keep you comfortable during your procedure, you will be given local or general anesthesia. Local anesthesia numbs the eyelid and surrounding area, while keeping you sedated but awake during surgery. General anesthesia keeps you asleep throughout the entire procedure. You can discuss which type of anesthesia you would like with your surgeon.
If your upper eyelids are being treated, your surgeon will make incisions along the natural creases of the upper eyelids. These incisions are made with a traditional scalpel or laser. The upper eyelid incisions extend from the upper inner corners of the eyelids to the "crow’s feet" region. Your surgeon will then remove excess skin, muscle and fat as necessary. The incisions are closed with tiny sutures (stitches), which are removed or dissolve in about one week.
If the lower eyelids are being treated, your surgeon will make an incision along the lash line and natural smile creases of the lower lid. Excess fat, muscle and skin are then trimmed away before the incision is closed with fine sutures (stitches).
Eyelid puffiness caused by excess fat may be corrected with a technique called transconjunctival blepharoplasty. During this procedure, an incision is made inside the lower eyelid and excess fat is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar.
Although rare, possible complications of eyelid surgery include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia.
You can help minimize certain risks by carefully following the advice and instructions of your plastic surgeon, both before and after surgery. Once the date for surgery has been set, your surgeon will provide you with specific instructions on how to prepare for surgery. These include guidelines on drinking, smoking, and taking and avoiding certain medications and vitamins. If you smoke, it is highly recommended that you stop smoking for a period of time before and after surgery. You should also arrange for someone to drive you home after surgery, and care for you afterwards until you are feeling better.
After the procedure, you will be taken into a recovery area where you will be closely monitored. In most cases, you will be permitted to go home after a few hours, although some patients stay overnight for one or two days. If you experience any discomfort, your surgeon will prescribe pain medications to keep you comfortable during the first few days of recovery.
In most cases, bandages are not required. However, you will experience some swelling and bruising. Cold packs can be applied to your eyelids, and you should keep your head elevated to control swelling. Bruising and swelling should begin to decrease after the first few days, but may not resolve entirely for up to one month after surgery.
Your eyes may feel tight and sore, especially the first week after surgery. In some cases, they may become dry and irritated, sensitive to light and itchy. You may also experience blurred vision from ointment that you will use to keep eyelids lubricated. During the first week, your stitches will be removed or dissolve.
Resuming Normal Activities
Your surgeon will provide you with specific instructions and guidelines for resuming your regular daily routine. Within the first week following surgery, you can use makeup and resume most of your normal, non-strenuous activities.
In most cases, after several weeks, most of your swelling and any vision problems will disappear. You will also be able to resume all normal activities and exercise, and wear contact lenses.
Your surgeon will schedule frequent follow-up visits in the months after surgery to check on your progress. If you experience any unusual symptoms or have any questions or concerns, please do not hesitate to call your surgeon’s office.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.