Blepharoplasty is a surgery that involves making small incisions in the eyelid area and removing any excess skin tissue, fat and muscle from the area. Tiny sutures are used to firm the skin and close the incision, thus creating an upper and/or lower eyelid that is firmer in appearance. Your surgeon will make the incision in areas of skin folding, which helps to make any scarring hard to distinguish for most patients.

The surgery takes a total of one to two hours and may take six months to one year for the incisions to fully heal and scars become less noticeable. However, swelling related to the surgery may diminish a week and a half post-surgery.

Who Is a Candidate for Blepharoplasty?

The hallmark of the right blepharoplasty candidate is significant drooping or bagging of the eyelids. In some instances, this drooping can be so significant that it interferes with your vision. Your plastic surgeon will evaluate your eye area, looking for:

  • Bag-like appearance under your eyes
  • Eyelid drooping that causes the white of your eye to show below the colored portion of your eye
  • Excess skin on the lower eyelids
  • Excess skin on the upper eyelids that causes the eyelids to droop
  • Puffy upper eyelids

Blepharoplasty is considered a cosmetic procedure in large part because of the surgery’s ability to make you appear younger and more refreshed. This procedure can be performed along with other cosmetic surgeries, such as a brow lift, facelift, or laser skin resurfacing, depending upon your overall health and appearance.

Blepharoplasty: Medical Necessity

While some blepharoplasty candidates choose the procedure for cosmetic reasons, the surgery also can be medically necessary. A condition called ptosis can cause your upper eyelid to sag so significantly that your eyelid affects your vision. Ptosis occurs due to damage to the nerves and/or muscles that control your eyelid. When this occurs, your insurance company may potentially pay for the procedure’s costs because it offers medical benefits to you to have the condition corrected and your vision improved.

Who Is Not a Blepharoplasty Candidate?

Some medical conditions that affect your healing may mean you are not a candidate for blepharoplasty. Because your surgeon wants to ensure the best possible outcome, operating if you have a complicating medical condition could have adverse effects to your health.

Examples of conditions that may not be desirable for blepharoplasty surgery include:

  • Diabetes
  • Chronic dry eyes or poor tear production
  • Heart disease
  • Disorders that affect your blood vessels or circulation
  • High blood pressure
  • Thyroid problems, including hypothyroidism or Graves’ disease

Disclosing to your surgeon all medical conditions and medications taken is vital to ensuring a positive surgical outcome. You also should disclose if you have had any adverse reactions to anesthesia in the past, including difficulty breathing.

Because you are required to take activity precautions and apply ointments to your eyes post-surgery, your surgeon will also consider how likely you are to be compliant with suggested treatments. If you feel like you are not able to perform post-surgery eye care, the procedure may not be for you.

Realistic Expectations for Blepharoplasty

Another important aspect of a blepharoplasty candidate is maintaining realistic expectations regarding surgical outcomes. While blepharoplasty can correct some aspects of eyelid drooping, it cannot address drooping eyebrows or wrinkling near the eyes that’s not affected by the eyelids.

Discuss your treatment goals with your physician who can use a variety of tools to help you understand how your appearance may be affected post-surgery. From showing you in a mirror to providing examples of previous blepharoplasty surgeries performed, these items can help you obtain a clearer picture of what to expect post surgery.

“Cosmetic surgery can be 90 percent art, 10 percent surgery,” says Dominic Brandy, MD, a cosmetic surgeon based in Pittsburgh, Penn. “Looking at before and after photos can help patients determine the artistic judgment of the surgeon, which can help them understand what to expect for their own results.”