In upper eyelid surgery, incisions follow the natural lines of the eyelid - the creases above the upper eyelid. Excessive fat and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of a scar.
Upper eyelid surgery may be performed under a local anesthesia with an intravenous or oral sedative. Most patients complain of very little pain after upper eyelid surgery. Sutures are removed in 5 to 7 days. Normally eye makeup may be applied after one week.
Eyelid puffiness in the lower eyelids is caused primarily by excess fat and is usually corrected by a transconjunctival blepharoplasty. The incision in this procedure is made inside the lower eyelid and excess fatty material removed. Usually, no sutures are needed to close this kind of an incision. If sutures are needed, they are invisible to the eye and are also self-dissolving. No scar results since the incision is inside the eyelid. Transconjunctival blepharoplasty may be combined with a chemical peel of the lower eyelid skin to reduce the wrinkles and tighten excess skin in this area.
Excess skin combined with eyelid puffiness may require a different approach to lower eyelid surgery. In transcutaneous blepharoplasty, the surgeon makes the incision on an inconspicuous site just below the lash line. Excessive fat and loose skin are removed and the incision is closed with fine sutures. Your surgeon can help you determine which procedure is right for you. If any sutures are placed, these are removed in 5 to 7 days. Lower eyelid swelling can last longer than upper eyelid swelling, but patients are generally presentable within one week of surgery. Pain is normally very minimal.
Lower eyelid surgery is usually performed under twilight anesthesia.
For the first 48 hours after this type of surgery, cold compresses are applied to the eye area to reduce swelling and bruising. Strenuous exercise is avoided for two weeks. There is little or no pain after surgery. Sutures are removed in 5 to 7 days.
Upper and lower eyelid surgery is almost always performed at the same time to achieve maximum improvement in the appearance of the eyes.