Understanding Plastic Surgery of the Eyelids

There is no facial feature quite as important as your eyes when it comes to expressing your thoughts and emotions. Drooping or overhung upper eyelids and sagging lower lids can happen to anyone. Eyelids are often a tell-tale sign of aging; however, even young people are affected. Chronic allergies can cause eyelids to swell which increases the development of overhanging upper lids or “bags” under your eyes. Your genetics do play a part but too much sun exposure, excess squinting and habitual eye-rubbing can promote sagginess.

The good news is that eyelid problems can be treated very effectively through a procedure called blepharoplasty. This is a relatively simple procedure that removes excess skin, muscle and fatty tissues. Many of Dr. Sharma’s patient’s will combine blepharoplasty with other facial plastic surgery procedures, such as a browlift or facelift. 

If you suffer from sagging upper or lower lids, blepharoplasty will make a dramatic difference and give you a fresher, brighter and more youthful appearance. 

In the image below, Dr. Sharma performed an Upper and Lower Blepharoplasty on this patient along with fat transfer to her cheeks. For the purposes of this article, notice the significant improvement one month after her surgery in the appearance of her eyes.

There is a video of the actual surgical procedure on Dr. Sharma’s YouTube Channel. 

In this image, a patient of Dr. Sharma's underwent Upper & Lower Blepharoplasty
to improve the appearance of her eyes. Notice arrows #1 and #2 on the day of the surgery
and then notice the improvement one month after.

Why Do Your Eyelids Sag or Droop?

Over time, everyone experiences changes in the eyelids. Even blinking can affect your eyes – yes…blinking! – because every time you blink, the skin and muscles of your upper eyelids stretch just a tiny bit. Little elastic fibers in the skin draw back your eyelids back to their natural position. A good example to liken the process to is an elastic band – think about what happens when you stretch it out and snap it back repeatedly. Over time, the skin and muscles of the upper eyelid will get longer. 

This image uses an elastic band to demonstrate the way your eyelids blink.
Your upper eyelids stretch a tiny bit and then drawn back to their natural position
by little elastic fibers.

Think about it, you’ll probably blink billions of times of the course of your lifetime. Eventually, a little fold of skin could develop as the excess skin bulges outward and hangs over the lid. Sometimes, if this gets severe, you may find your field of vision is obscured by the drooping upper lids and if you’re a woman, you might find it hard to apply your makeup if your eyelids droop or sag.

Think about how many times your eyelids blink over the course of a day.
then, think about how many times these tiny elastic fibers stretch over the course
of 30 years.

Often times, people refer to sagging in the lower lids as “bags under the eyes”. Nearly everyone develops some degree of sagging in this area because of age and gravity. Your eyes are surrounded by a protective layer of fatty tissue encased in a membrane that holds it tightly in place. Over time, the membrane will weaken, allowing the fatty tissue to slip downward. Skin and muscle are stretched by the protruding tissue which produces puffy bulges that are impossible to hide with cosmetic products.

One of Dr. Sharma's patients who underwent Upper Blepharoplasty.

The problem seems worse in the morning when you wake up because fluids collect in the fatty tissue while you are lying down. Gravity may draw the fluid away after you get up but if you have a large amount of excess fatty tissue; it will take a long time to clear up. 

How Blepharoplasty is Performed

Incisions in the upper lids are made in the crease above each eye (see Figure 1). Excess muscle, fat and loose skin is then removed and fine sutures are used to close those incisions. The resulting scar will normally fade to a fine line that virtually disappears into the eyelid crease.

Figure 1 - External incisions are hid in the crease of the eye

Figure 2 - Internal incisions are not visible because they are done on the
inside of the lower eyelid.

Eyelid surgery is usually performed under intravenous sedation and local anesthesia. Most people can go home the same day! Dr. Sharma frequently performs eyelid surgery under local anesthesia only. He has performed this procedure under local anesthesia thousands of times!

You may experience some mild swelling or bruising of your eyelids after surgery, but this usually subsides quickly. Dr. Sharma recommends using a cold compress and to keep your head elevated when you lie down to help reduce swelling which will speed the healing process. If you have any discomfort after surgery, it can be controlled quite effectively with mild pain medications. 

Dr. Sharma in surgery performing Upper and Lower Blepharoplasty.

Eyelids heal quite quickly and scars usually are pretty inconspicuous. Women can completely camouflage any remaining marks with eye makeup after they have healed adequately. Most men find that the scars disappear into their natural “smile” lines. 

Sometimes, it may help to wear sunglasses for a few days to cover the swelling and as a reminder not to touch your eyes while they are healing. If you wear contact lenses, you must wait two to three weeks before you can resume wearing them. 

For more information about upper and lower blepharoplasty procedures with Dr. Sharma, please feel free to contact his offices at (305) 456-5727 to schedule your free consultation.