More than any other facial feature, your eyes reveal the most about how you feel. When your eyes are bright and alert, you appear energized, well-rested, and in control. However, if you have lower-eyelid puffiness, dark circles or drooping upper lids, others may assume that you are fatigued, angry or unhappy.

If you believe that your eyes are making you look tired, sad, or older than you really feel, cosmetic eyelid surgery (also called blepharoplasty) may be the right choice for you. Eyelid surgery can remove the excess fat and drooping skin of the upper eyelids, minimize bags under the eyes and tighten the lower eyelid skin. The result is a more alert and rested appearance.

You will find basic information about eyelid surgery here, however the best way to get complete answers to specific questions that relate to your individual needs is to have a personal consultation.

• Is Cosmetic Eyelid surgery right for me?
• What should I expect from the consultation?
• How is Cosmetic Eyelid surgery performed?
• How will I learn about the safety of Cosmetic Eyelid surgery ?
• What can I do to prepare for my surgery?

• How will I be cared for on the day of my surgery?
• How will I look and feel right after surgery?
• What should I know about my results?
• How long will I continue to see my plastic surgeon?

Is cosmetic eyelid surgery right for me?

Eyelid surgery is performed on men and women of all ages who want to improve their self-image. Most people have eyelid surgery to minimize the effects of aging. However, many people in their 20s or 30s may also benefit from the procedure.

Eyelid puffiness, drooping upper lids or fine wrinkles around the eyelids can make people appear tired, sad, or older than they feel.

You may be a good candidate for eyelid surgery if you have any of the following conditions:

Upper Eyelids

• excess skin that hides the natural fold of the upper eyelids
• loose skin that hangs down from the upper eyelids
• puffiness in the upper eyelids that creates a tired look

Lower Eyelids

• excess skin and fine wrinkles of the lower eyelids
• puffy "bags" and, in some cases, dark circles.

Eyelid surgery needs to be approached with extra caution if you have any of the following medical conditions:

• thyroid problems, such as hypothyroidism or Graves' disease
• lower eyelids that droop significantly and reveal the white beneath the iris (the eye's colored portion)
• eye problems, such as "dry eye", a detached retina or glaucoma
• high blood pressure or other circulatory disorders
• cardiovascular disease
• diabetes.

It's important to let your plastic surgeon know if you have any of these problems.

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Cosmetic Eyelid Surgery Consultation Specifics

A personal consultation is the first step for every patient considering surgery. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for the procedure.

You should arrive at the consultation ready to provide complete information about:

• previous surgical procedures
• past and present medical conditions
• medications you are taking, including herbal remedies or nutritional supplements.
• allergies, especially those that affect your eyes.

As part of the consultation, your surgeon will asses the amount of excess fat and skin in your eyelid areas, the position of your eyebrows, and the condition of the muscles around your eyelids.

Your plastic surgeon may suggest other cosmetic treatments to meet your appearance goals. For example:

• A sagging brow can be tightened and smoothed with a forehead lift.
• Crow's feet near the eyes can be minimized with a chemical peel or laser resurfacing.
• Dark circles beneath the eyes that can't be helped by blepharoplasty can be treated with a bleaching medication, chemical peel or laser treatment.
• Lower-eyelid muscle tone can be improved with additional eyelid surgery.

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How is cosmetic eyelid surgery performed?

The specific method used for your eyelid surgery will be determined by your features and your surgeon's preferences.

Upper Eyelids
Typically, the incision begins within the natural crease of the eye's inside corner and extends slightly beyond the outside corner into the crow's feet or laugh lines. Through this incision, excess skin and fatty tissue are removed. The incision line follows the natural contour of the upper eyelid, and is camouflaged when healed.

Lower Eyelids
Usually the incision is concealed just below the lower lashes. Through this incision, excess skin, muscle and fat are removed. Your surgeon may also make special adjustments. For example, the fat beneath the eye can be redistributed to eliminate puffiness or bulges. In some patients, the underlying muscle will be tightened.

Your surgeon may decide that the best approach for removing fat from the lower eyelid is with a transconjunctival blepharoplasty. In this procedure, an incision is placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. Laser resurfacing or chemical peel is sometimes used in conjunction with this procedure to minimize fine wrinkles near the eyes.

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How will I learn about the safety of cosmetic eyelid surgery?

Each year, thousands of people undergo cosmetic eyelid surgery and experience no major complications. However, you must fully understand the risks as well as the benefits of the procedure.

One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of eyelid surgery. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.

By carefully following your surgeon's advice and instructions - both before and after surgery - you can do your part to minimize some of the risks.

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What can I do to prepare for my surgery?

When the date for your procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after surgery. A number of points may be covered, including:

• avoiding certain medications that may complicate surgery or recovery
• stopping smoking for a period of time before and after surgery
• arranging for help and special care following surgery.

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How will I be cared for on the day of my surgery?

Cosmetic eyelid surgery may be performed in a hospital, an outpatient surgery center or an office-based surgical suite.

Frequently, local anesthesia and intravenous sedation are used for patients undergoing eyelid surgery. However, for some patients, general anesthesia may be the best choice. With either type, you'll remain very comfortable throughout the procedure. Your plastic surgeon will monitor your physical status throughout the operation and during your recovery.

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How will I look and feel after surgery?

After surgery, eyelids no longer droop and the skin under the eyes is smooth and firm.

When surgery is complete, you will be taken to a recovery area. You may experience any of the following:

blurred vision - This temporary condition is caused by the ointment that may have been applied to lubricate and protect the eyes.

tightness around the eyes - This sensation will diminish once the swelling goes down.

discomfort - Some discomfort is common after any type of operation. It can be controlled with pain medication prescribed by your physician.

bruising and swelling - The amount and duration of swelling and bruising varies greatly among individuals.

Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day

• In this earliest stage of healing, it's important to rest with your head elevated.
• Cold compresses on the eyes reduce swelling.

Within the first week

• Bruising around the eyes will reach its peak and then begin to fade.
• Healing may be accompanied by mildly blurred vision, excess tearing or dryness, light sensitivity or itching.
• You can begin to use makeup to conceal any discoloration.
• Stitches will dissolve or be removed.
• You may resume most of your normal (nonstrenuous) activities.

After several weeks

• Most of the swelling will subside and you'll begin to see the final result.
• Any vision-related symptoms will disappear.
• You may resume vigorous exercise, including bending and lifting.
• You may resume wearing contact lenses.

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What should I know about my results?

If you're like most people who have the procedure, you'll be very pleased with your new refreshed and alert appearance. You may find that you feel more confident in business and social situations. Friends and colleagues may tell you that you appear happier or more rested, without realizing that you had eyelid surgery.

Most traces of surgery will disappear after several weeks. However, the skin around your eyes must be treated with extra care for several months. When you go out during the day, you should wear sun block on your eyelids and darkly tinted sunglasses to protect your eyes from wind and sun irritation.

The results of cosmetic eyelid surgery are long-lasting. However, keep in mind that your face will continue to age. Your surgeon can advise you about the best way to maintain your results.

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How long will I continue to see my plastic surgeon?

After the initial healing period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to return for these checkups so that your surgeon can assess your long-term results and address any questions or concerns you may have.

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