What is Eyelid Surgery?

Eyelid surgery, more formally known as blepharoplasty, is a procedure that is performed to improve the appearance, and sometimes function of the eyes. The techniques employed during the procedure depend on the individual needs of the patient. For example, the procedure can involve removing excess skin, and sometimes fat and/or muscle, of the upper and/or lower eyelids to improve their appearance. The procedure can also be performed for functional reasons if the excess skin of the upper eyelids becomes so significant that vision is impaired.

During the aging process, the skin of the eyelids becomes redundant. When this happens, men and women often report that their eyes have a constant tired or sad appearance. For these patients, eyelid surgery can make the eyes look more youthful and refreshed.

Younger men and women often have different eyelid concerns, as they have not yet developed excess skin of the eyelids. Commonly reported concerns include puffiness in the eyelids and/or lack of definition of the upper eyelid fold. In these patients, different eyelid techniques are used to improve upon the areas of concern.

About the Procedure:

Eyelid surgery is most commonly performed under intravenous sedation. The skin incisions for upper and lower eyelid surgery are carefully designed to be concealed within the natural contours of the eyelids. The components of the procedure are tailored to the specific needs of the patient. Some patients only require removal of excess skin or fat, while others benefit from excision of skin and excess fat deposits and tightening of the muscles. Excision of lower eyelid fat can be performed through the skin incision under the lower lid lash line (subciliary incision) or through an incision on the inside of the lower eyelid (transconjunctival incision). The transconjunctival incision location can be useful for fat removal but does not allow for skin removal; therefore, a separate incision under the lower lid lash line (subciliary incision) is necessary for skin removal. Dr. Hewell and Dr. Fischer will discuss necessary incisions with you at your consultation.

Skin incisions are closed with sutures that are easily removed within 1 week of surgery. The results of eyelid surgery will be somewhat apparent immediately, but will emerge more significantly within the first few weeks as swelling and bruising subside. Eyelid surgery generates a long-lasting result. While we all will continue to age naturally, men and women who undergo this procedure normally report they have a more refreshed look compared to their peer group.


Incisions for upper eyelid surgery are camouflaged within the natural upper eyelid crease.

The lower eyelid skin incision is placed just under the lower eyelid lash line. This incision is called a subciliary incision. Sometimes an incision is needed on the inside of the lower eyelid to remove fat. This incision is called a transconjunctival incision and will not be visible to you.

A droopy upper eyelid is a condition known as ptosis. Ptosis can occur for many reasons. One of the more common causes of ptosis is a weakening or separation of the attachment between the muscle that opens your eye and the eyelid support structure (known as the tarsal plate). During your consultation, Dr. Hewell and Dr. Fischer will examine your eyes. If your ptosis is due to the aforementioned problem, this can be corrected at the time of your eyelid surgery.

Eyelid surgery is commonly performed alone, and in conjunction with facelift and brow lift procedures.

Stop taking aspirin, ibuprofen, naproxen, other anti-inflammatory drugs (known as NSAIDs), and herbal supplements for at least two weeks before surgery as they can increase your chances of bleeding and bruising. If you have high blood pressure (hypertension), you should make sure your blood pressure is well controlled with your medication regimen prior to surgery.

Dr. Hewell and Dr. Fischer see all of their eyelid surgery patients the day after surgery. Sutures are removed within the first week after surgery.

Strict adherence to the postoperative regimen outlined by Dr. Hewell and Dr. Fischer will optimize your results. Cold compresses on the eyes for the first few days can help minimize bruising and swelling. Diligent sun protection is also imperative to minimize appearance of incision lines.

Procedures 3



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