Blepharoplasty: Everything you wanted to know about eyelid surgery

Blepharoplasty is plastic surgery performed on the eyelids to remove excess skin and/or fat pockets that make the eyelid “heavy” and look aged. Marcelo Moreira, plastic surgeon, member of the Brazilian Society of Plastic Surgery and the American Society of Plastic Surgeons, explains that surgery, in general, improves and harmonizes the periorbital region (eye region), and can be performed by women and men.

Even because it is a surgery on the face, blepharoplasty generates many doubts, for example, about what its real indications are, what the recovery is like and what are the possible risks that the operation can offer. But, below you can see the clarification of plastic surgeons for these and other doubts.

indications

According to Luís Felipe Maatz, plastic surgeon, member of the Brazilian Society of Plastic Surgery (SBCP), blepharoplasty is indicated for women or men who have complaints regarding sagging skin or excess fat bags in the region around the eyes. .

In general, the results that can be achieved with blepharoplasty are:

• Removal of excess fat that appears as swelling on the upper eyelids
• Removing the sagging that creates creases in the upper eyelid
• Removal of excess skin and fine wrinkles on the lower eyelid
• Removing bags under the eyes
• Lower eyelid droop correction

In general, blepharoplasty provides a rejuvenated appearance, with a more rested and harmonious look.

However, it is worth noting that blepharoplasty may also have functional indications. In some cases, for example, the drooping of the upper eyelids can interfere with the field of vision, in addition to increasing visual fatigue (in certain cases, even generating headaches).

André Barbosa, plastic surgeon and medical director of All Clinik (Barra da Tijuca – RJ), adds that there is no specific contraindication for eyelid surgery. “The contraindication happens if the patient has a health condition that prevents any surgical procedure”, he explains.

Types of Blepharoplasty

Maatz explains that blepharoplasty is divided into: superior, inferior or complete (inferior and superior). It can be performed in the traditional way or with the help of a CO2 laser.

• Upper: Barbosa explains that, in upper eyelid surgery, excess skin and fat pockets in the inner corner of the upper eyelid (if any) are removed. “Some patients already have a ‘deep eye’, so we shouldn’t remove anything, as the look ages. The incision must be hidden when the patient’s eyes are open, so the correct positioning of the scar is very important”, he highlights.
• Inferior: Barbosa explains that, in this type of surgery, excess skin and fat bags (when they exist, as in the case of the upper eyelid) are removed. “When the patient is young and has no skin left over, an incision can be made inside the eyelid, in the ocular conjunctiva. But, the lower eyelid scar is very discreet, as it is positioned right next to the tarsus, so it is not apparent afterwards”, he comments.
• Complete: includes both the upper and lower eyelids.

Barbosa also points out that laser eyelid surgery is an option for the surgeon, and there is no significant difference when compared to conventional surgery.

Regarding prices, Maatz points out that, as with any surgical procedure, it is “tailor-made” for each patient. “The value is very variable. In addition, there are several factors that influence the final value of a surgery: choice of hospital, type of anesthesia, type of surgery (complete or partial) etc.”, he explains.

How blepharoplasty is done

Luís Felipe Maatz explains that the surgery can be performed under local anesthesia, with or without sedation, or under general anesthesia. “The full one (upper and lower) is about 90 minutes long,” he says.

“Cuts are made in less visible areas of the eyelids, removing excess skin and, if necessary, approaching the fat pockets (partial removal or repositioning of this fat). The use of CO2 laser can be associated with the performance of these same surgical steps”, explains Maatz.

“There is no study that proves that one technique is superior to the other. What matters most is the experience of your plastic surgeon in performing the procedure”, emphasizes plastic surgeon Maatz.

Scratchs

André Barbosa highlights as the main risks related to blepharoplasty:

• Removing too much skin on the upper eyelid, leaving the eye without perfect occlusion and, with that, generating dryness in the cornea, keratitis, etc.
• Removing excess skin on the lower eyelid, which modifies the shape of the eye, in addition to leaving the sclera apparent (the tarsus becomes “everted”, unnatural).
• Remove excess bag, which can leave the eye sunken, deep, with an aged appearance.

Marcelo Moreira emphasizes the importance of the patient looking for a doctor accredited by the Brazilian Society of Plastic Surgery. “If the doctor doesn’t have adequate training, he can remove a fat bag or too much skin, leave an ‘eye too deep’, among other problems”, he comments.

In general, however, blepharoplasty is a low-risk surgery, provided it is performed by a trained professional.

Preoperative care

Maatz explains the steps leading up to blepharoplasty:

• A consultation with the plastic surgeon is required to assess the patient’s wants and needs.
• If the patient uses any medication that interferes with clotting, it should be discontinued a few days before surgery.
• Tests will be requested that must be normal for the patient to be able to safely perform the surgery.

Thus, it can be said that the care is basically the same as requested in other surgeries.

Recovery

Maatz explains that the instructions for the post-worker, in general, are:

• rest;
• Use of cold compresses and lubricating eye drops;
• Simple analgesics.

Barbosa points out that, in the immediate post, he recommends the patient to make a lot of compress on the eyelids with saline solution or cold mineral water to avoid edema and hematoma. “It is necessary to avoid the sun at first, I usually release it at four weeks,” he says.

Moreira points out that, generally, the patient operates on Friday, for example, and on Monday, he can go back to work with dark glasses. “In the first month, the region is still swollen… Edema and purple vary greatly from patient to patient. But, in general, the result starts to be seen around 15 days after the surgery. But, the final result will probably be seen around 3 months”, he explains.

Before and after: the testimony of those who made it

Check out the testimony of some bloggers who have already undergone blepharoplasty:

My Blepharoplasty, by Dayane Pedrosa

In the video, Dayane says that she had surgery on one of her upper eyelids, shows how the scar was and reports her experience, which, according to her, was very positive.

All About My Blepharoplasty, by Kelin Uess

Here, Kelin shows the result of the blepharoplasty 8 months after the surgery. He follows the account of his experience and checks out details about the before and after, healing and post-op.

I had blepharoplasty, by Marina (Current Mothers)

In the video, Marina tells how she made the decision to have the blepharoplasty, how the pre-surgery was, and also the recovery.

My surgery – blepharoplasty, by Aninha (Me Conta Aninha)

Aninha says why she decided to have the surgery and shows what her eyes were like before the plastic surgery. She also tells about post-op care and answers questions that people often ask about this type of procedure. The result was incredible!

It’s very valuable to talk to other people who have undergone blepharoplasty, but it’s good to know that one person’s experience will never be the same as another’s. Each person faces the surgery in a different way, has their own goals, as well as a particular result.

Common questions

Check below the answers to the main questions related to blepharoplasty:

Does the surgery leave a scar?

Maatz points out that every surgery leaves some scar. “However, the blepharoplasty ones tend to be very discreet and almost imperceptible”, he says.

What is the best time of year to perform blepharoplasty?

According to Maatz, there are no major changes in the postoperative course or outcomes at different times of the year.

After how long is it possible to see the result of the surgery?

“We have already noticed the difference in the immediate post, but the final result is after three months, as there may be residual edema”, answers André Barbosa.

How is anesthesia performed in blepharoplasty?

“It can be only with local anesthesia, local anesthesia with sedation assisted by an anesthesiologist (my first option), or even general anesthesia”, explains Barbosa.

What are the adverse effects of blepharoplasty?

Luís Felipe Maatz points out that there may be some degree of dryness in the eyes after surgery.

How long does blepharoplasty last?

It depends on the type, according to Maatz. “The superior one takes about 30 minutes; the complete one takes about 90 minutes, for example”, he says.

When are blepharoplasty stitches removed?

“It varies from surgeon to surgeon. I remove it after three days, to prevent the stitch from marking the skin, and I leave a micropore tape for another five days, protecting the scar”, answers André Barbosa.

Now you know that blepharoplasty is an option, in general, for any adult person who is dissatisfied with the area around the eyes. The indication itself will come after consultation with a trusted plastic surgeon, accredited by the Brazilian Society of Plastic Surgery.

As well as choosing a good professional, having real expectations around the procedure is also essential for the result to be really satisfactory. Therefore, do not hesitate to ask all your questions with the plastic surgeon. This is true, by the way, for any type of surgery. Enjoy and learn about the main myths and truths about nose surgery.