Blepharoplasty (eyelid surgery, eyelid lift)

The eyes are usually the most attractive and first noticed facial feature. Although the common expression "the eyes are the windows to the soul" may be a philosophical or romantic notion, it does bear some truth. The eyes have a great deal to do with how others perceive us as they glance at our facial features. Eyes with excessive or sagging skin are frequently associated with a perception of old age, even when they occur in a young person. Excessive fat pads in the lower eyelids confer a "puffy" and tired appearance. Sagging brows framing the eyes falsely indicate a sad appearance. Many of these changes occur as part of the normal aging process as the skin loses some of its support and gravity prevails. Some of these features, however, may be inherited and can occur in a young person (example: excessive skin in the upper eyelid, prominent fat pads in the lower eyelids).

Blepharoplasty aims to reverse some of the unfavourable changes or features of the eyelids to provide a more refreshed and youthful appearance. Blepharoplasty may address the upper eyelids, the lower eyelids, or both. Regardless of which eyelids are rejuvenated, Dr. Samaha's goal is a natural, "unoperated" look which enhances the youthful glow of the eyes and the entire face. This procedure can be performed for both women and men.

Blepharoplasty can be performed alone or in combination with other esthetic facial procedures such as facelift or browlift. Blepharoplasty carries a high degree of success and the improvement can be significant and long lasting. Certainly, the aging process continues, but problems such as bags under the eyes or sagging skin of the upper eyelid are unlikely to return following the procedure, even with advancing age. Blepharoplasty is the most successful procedure for rejuvenation of the eyelids and area around the eyes.

The Day of the Surgery
Blepharoplasty is usually performed as an outpatient surgery. Dr. Samaha favours a local anesthetic with some relaxing sedative medication for the procedure (find out more about anesthesia options). Patients are able to go home within one to two hours following surgery. If blepharoplasty is performed in conjunction with another procedure (example: facelift), this period is slightly longer. Cold compresses placed on the eyes during and after surgery have a soothing effect. The eyelids and areas around the eyes are slightly swollen and discolored for a 7-10 days following surgery. Blepharoplasty is not usually associated with significant discomfort. Dr. Samaha will prescribe pain medication to be used as needed. Eye drops and gels are also prescribed to sooth the eyes and keep them moist. For the first few days following surgery, the eyes will fatigue more easily while reading or watching television.

There is no need for removal of stitches as the sutures placed by Dr. Samaha are self-dissolving, usually by 7 days. Water-based make-up can be applied at this time to conceal any residual discoloration. Follow-up appointments are then scheduled.

Accessory Procedures
For some patients, a blepharoplasty alone will achieve the rejuvenation they are seeking. However, in certain instances, an accessory procedure may be required to achieve the patient's goals for rejuvenation. One of the most important considerations in the region of the eyes is the position of the brow. A brow that is sagging will not be adequately addressed with a blepharoplasty alone and a brow lift may be required, which can be performed at the same time. The wrinkles in the skin on the temple at the corner of the eye (frequently referred to as "crow's feet") may be diminished but not necessarily eliminated with blepharoplasty surgery. Botox in jections are usually an effective treatment in these instances.

Frequently Asked Questions

What are the restrictions after surgery?
The main restriction is the avoidance of strenuous activity, which includes vigorous exercise and heavy lifting for one week after surgery. Other maneuvers that increase the pressure in the head are also to be avoided. These include straining and bending forward. Otherwise, patients may carry out usual activities.

How long is the recovery?
Recovery time varies depending on whether blepharoplasty is performed alone or in conjunction with another procedure. When performed alone, recovery time is usually about one week. If a facelift is done in the same setting, recovery may take an additional 4-5 days depending on the extent of the facelift (e.g. a mini-lift versus a complete facelift).

What about bruising?
Blepharoplasty is usually associated with some bruising. The location of the bruising is usually in the eyelids operated and area surrounding the eyes. The degree of bruising depends upon surgical technique and the patient's own tendency to bruise. The bruising will gradually fade in appearance and move in the direction of gravity. It is therefore expected that the discoloration from bruising will gradually diminish and migrate down the face in the first few days following surgery. Dr. Samaha uses advanced, minimally invasive techniques to minimize bruising and swelling after surgery. Patients who have a natural tendency to bruise easily will experience slightly more bruising in the initial recovery period.

Will I need another procedure in a few years as I continue to age?
A second procedure is seldom needed. This is because the problems addressed with blepharoplasty infrequently return.

Photos?
The Collège des Médecins du Québec prohibits physicians practicing in Quebec from posting testimonials from other patients or photos on a website or other media. For patients who wish to see examples of outcomes of particular surgical procedures, "before and after" pictures can be shown from Dr. Samaha's portfolio at the time of their visit. These are photos of patients who have undergone surgery and have agreed to have their pictures shown to help other patients who are contemplating a similar procedure.

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