Blepharoplasty

What is Blepharoplasty

Blepharoplasty is a type of eyelid surgery that is performed to remove loose and droopy skin from around the eyes.

Loose and droopy skin around the eyes is common in older people. This is because the skin becomes less stretchy (elastic) as a person ages.

During this procedure, puffy bags above and below the eyes can also be removed. Puffiness may be caused by fat deposits or loose muscles around the eyes. You may have blepharoplasty on your upper eyelids, lower eyelids, or both. This procedure is performed for two reasons:

  • To improve your appearance.
  • To improve vision, if sagging upper eyelids begin to interfere with your ability to see.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Bleeding.
  • Infection.
  • Dryness of the eyes.
  • Trouble closing your eyes.
  • Eyelids that roll outward.
  • Scarring.
  • The need for more surgery.
  • Changes in your vision.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

  • Do notdrink alcohol.
  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Ask your health care provider how your surgical site will be marked or identified.
  • Plan to have someone take you home from the hospital or clinic.
  • Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
  • An IV will be inserted into one of your veins.
  • Your surgeon may mark your eyelids to indicate where the incisions should be made.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • Your surgeon will make incisions in the natural creases in the skin that is above or below your eyes.
    • If you are having upper and lower blepharoplasty, incisions will be made above and below your eyes.
    • If you are having lower lid blepharoplasty that does not require skin removal, an incision may be made just inside your lower eyelids (transconjunctival incision).
  • Any fat deposits or extra skin will be removed. Loose muscle tissue may be trimmed or tightened.
  • Your surgeon will close the incisions with very small stitches (sutures), a type of surgical glue, or tiny adhesive strips. Transconjunctival incisions will be closed with sutures that dissolve as your body heals (absorbable sutures).
  • Eye drops may be placed in your eye, and ointment may be put over your incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • You may have to use eye drops or ointment after your procedure.
  • Do notdrive for 24 hours if you were given a sedative during your procedure.

Summary

  • Blepharoplasty is a type of eyelid surgery that is performed to remove loose and droopy skin from around the eyes.
  • You will go home on the same day as the procedure.
  • Serious complications are very rare after this procedure.

Blepharoplasty, Care After

What can I expect after the procedure?

After the procedure, it is common to have:

  • Swelling.
  • Bruising.
  • Soreness.
  • Sticky, dry, and itchy eyes.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take or apply it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.

Use eye drops or ointment as told by your health care provider.

Incision care

  • Do notsoak or wash your face until your health care provider says that you can. Follow instructions from your health care provider about bathing.
  • Follow instructions from your health care provider about how to take care of your incision.
    • Make sure you leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer.
    • If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
  • Check your incision area every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.
  • If directed, put ice on the eye area to help reduce swelling and soreness:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.

Activity

  • Use a few pillows to keep your head raised (elevated) while you are sleeping or resting.
  • Do notbend over. Bending over causes your head to be lower than your heart and may increase swelling and bruising around your eyes.
  • Until your health care provider approves:
    • Do notdo any activities that take a lot of effort.
    • Do notlift anything that is heavier than 10 lb (4.5 kg).

General instructions

  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • To protect your eyes from the sun, wear dark sunglasses and a wide-brimmed hat. Do this until healing is complete. This helps to keep the suture areas from becoming discolored.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever.
  • You have dryness, pain, swelling, or bruising that is not getting better.
  • You have more redness, swelling, or pain around your incision.
  • You have fluid or blood coming from your incision.
  • Your incision feels warm to the touch.
  • You have pus or a bad smell coming from your incision.
  • You cannot close your eyes completely.

Get help right away if:

  • Your eyeball is bulging or your eyeball position is different from normal.
  • You have double vision or blurry vision that is not getting better.
  • You have any change in your vision.
  • You have severe eye pain.

Summary

  • After this procedure, it is common to have swelling and bruising around the eyes.
  • Follow instructions from your health care provider about how to take care of yourself at home.
  • Get help right away if you have double vision, or if your eyeball is bulging or its position is different from normal. These are emergency symptoms.
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