Take years off your appearance with cosmetic eyelid surgery

By Judy Latta

Your eyes are probably your most prominent facial feature. They communicate to others — sometimes incorrectly — information about you, your mood and your feelings. Do your eyes convey attentiveness and vitality or do they express weariness? Droopy eyelids and/or bags under your eyes can make you look tired, disinterested and older than you actually are. Researchers at the University of Tennessee Health Science Center in Memphis found that when asked to assess the age and fatigue of another person, participants spent more time looking at a person’s eyes than at any other facial feature.

Skin care products can sometimes moderately improve the appearance of puffy, tired-looking eyes, but cannot repair damage suffered to the thin and delicate skin and muscles of the upper and lower eyelids. Cosmetic eyelid surgery, however, also known as an eye-lift or blepharoplasty, can effectively treat eyelid damage, often resulting in a rejuvenated, vibrant and youthful appearance. According to Dr. Lisa Ishii of the Johns Hopkins Division of Plastic and Reconstructive Surgery, “Eyelid surgery is one of the surgeries where I see remarkable and instantaneous results for treatment of the aging face.”

 

CAUSES OF SAGGING EYELIDS

Contrary to common belief, the primary cause of chronic puffiness around the eyes is often not lack of sleep or stress. As you age, the skin and muscles around your eye sockets can weaken. By your 30s or 40s (and sometimes as early as your 20s or teens), the extremely thin skin of the eyelids can start to lose its collagen and elasticity. As the muscles break down and your skin loosens, fat deposits can move into the region causing the skin around your eyes to appear bulging, swollen, wrinkly or droopy. This process often begins with what we commonly refer to as “crows’ feet.” Many people report that the skin around their eyes is the first area of their bodies to show signs of aging.

The weakening of the skin and muscles around the eyes is often hereditary. Chances are if your parents or other relatives have saggy-looking eyes, you may also, either now or sometime in the future. This problem can also be brought on or exacerbated by environmental factors such as excessive sun exposure, lifestyle factors such as smoking, or injury.

Although eyelid sagging is generally only a cosmetic issue, in some cases the weakening of the upper eyelid or extreme puffiness of the lower eyelid can become severe enough to impair eye sight, in particular peripheral vision. Additionally, researchers for the National Institutes of Health (NIH) warn that sometimes eyelid drooping can indicate a more serious problem. “Drooping eyelids may be due to a variety of conditions include aging, diabetes, stroke, Horner syndrome, myasthenia gravis, or a brain tumor or other cancer that affects nerve or muscle reactions.” NIH recommends that you should promptly contact your health care provider if you are experiencing any of the following.

• Eyelid drooping is affecting your appearance or vision
• One eyelid suddenly droops or closes
• Eyelid drooping is associated with other symptoms, such as blurry or double vision.

 

THE PROCEDURE

Eyelid surgery is generally a one- to three-hour outpatient procedure performed at a hospital, surgical center, or surgeon’s office. It can usually be performed under local anesthesia or sedation. The surgery involves an incision made to the upper eyelid, lower eyelid or both to allow excess skin and fatty deposits to be removed. The incision is typically made inside the eyelid or in a natural crease of the skin to minimize visible scarring. At the time of the operation, the surgeon can also perform a procedure to tighten the muscles and/or ligaments around the eye. Additional procedures that often accompany eyelid surgery to enhance results are: forehead lift, eyebrow lift, facelift, carbon dioxide laser resurfacing to address wrinkles and other skin imperfections, chemical peel to remove the appearance of dark circles and other imperfections, and Botox.

The American Society for Aesthetic Plastic Surgery (ASAPS) offers the following guidelines for outcome expectations following eyelid surgery: “Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months usually becoming barely visible. The results of aesthetic eyelid surgery are usually long-lasting, but they may be affected by heredity and lifestyle factors. Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur. The skin continues to age, however, and skin laxity along with the fine wrinkling of the eyelid area may, at some point, return.”

Because blepharoplasty is usually elective surgery, it is typically not covered by insurance plans. If, however, the problem is actually impacting your vision or due to a more serious medical condition, corrective procedures may be covered. Check with your insurance provider for details.

RISKS

According to the American Academy of Cosmetic Surgery (AACS), risks related to eyelid surgery are generally minimal: “The specific risks and the suitability of this procedure for a given individual can only be determined at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.”

RECOVERY

Post-operative pain related to eyelid surgery is generally mild and treated with prescription or over-the-counter pain medication. Antibiotics are used to prevent infection. Bruising, swelling and sensitivity to light are common side-effects of the surgery, but usually subside within about two weeks.

The American Society of Plastic Surgeons (ASPS) warns that it is imperative following eyelid surgery to be diligent with sun protection and to use darkly tinted sunglasses until you are completely healed. Additionally, as with other surgical procedures, post-operative eyelid surgery patients should allocate adequate time for rest and recovery, and should avoid over-activity. It is very important to follow your surgeon’s home care instructions to ensure a successful recovery and optimal results. Full activity can usually be resumed within about three weeks of the surgery.