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Eye Lid Lift / Blepharoplasty


Eye Lid Lift / Blepharoplasty

Facial expressions are affected greatly by your eyes, eyebrows and forehead. Your eyes help express a range of emotions. Your eyes are also important in interacting with others. It is natural to want your eyes to reflect your interest in others.

Eyelid surgery (blepharoplasty) can change the way your eyes look. You may want to consider eyelid surgery if:

  • Your eyes make you look sad or tired.
  • Your eyelids droop and feel heavy. Sometimes, droopy eyelids can make it difficult for you to see clearly.
  • Makeup does not stay on your eyelids because the excess skin makes the upper lids rest on your eyelashes.
  • You have puffy and bulging eyelids that create dark circles under the eyes.
  • Eyelid surgery can be done on your upper lids or your lower lids.

Upper Eyelid Surgery

Before surgery, an eye doctor (ophthalmologist) gives you an eye exam to check your vision. This is done to determine whether upper lid surgery would be purely cosmetic, that is, to improve appearance, or if it is functional, that is, to improve your vision. If it is functional, insurance may cover the expenses. Check with your insurance company before having surgery.

Upper lid surgery can be done alone or in combination with lower lid or other facial surgeries.

What to Expect:

Dr. Friedman makes incisions in the fold of the upper eyelid. The incisions extend from the inner corner of the eyelid to the smile line of the eye. After trimming away excess muscle, fat and loose skin, he closes the incision with small sutures. In most cases, the scars are not visible because they are hidden in the crease of the eyelid.

Lower Eyelid Surgery

The goal of lower lid surgery is to correct puffiness or bulging of the lower eyelids. The effect of doing this is to remove the shadow caused by the bulge. It is usually considered cosmetic (as opposed to functional) surgery and is generally not covered by insurance.

Lower lid surgery does not correct:

  • Dark circles under your eyes if your skin is actually discolored.
  • Crow’s feet (small, Y-shaped lines near the corners of your eyes).
  • Forehead expression lines or furrows between the eyes.
  • Talk to your facial plastic surgeon about other options if you are concerned about these things.

What to Expect:

During lower eyelid surgery, a small incision is made just inside the eyelid. If both fatty tissue and extra skin or muscle needs to be removed, the incision point is below the lower eyelashes. If the lower eyelid needs to be tightened, a canthopexy is done. Small incisions are made near the corners of the eyes through which a single suture tightens each lower lid.

Incisions are closed with stitches when the incisions are made directly under the lash line. Stitches are not needed if the incisions are made inside the lid.

Risks may include:

  • Infection.
  • Dryness or itchiness of the eyes. Eye drops or ointment may relieve these symptoms.  If you have dry eyes before surgery, you have a greater chance of having dryness  after surgery.
  • Light sensitivity. Wear UVA/UVB-rated sunglasses to protect your eyes as they heal.
  • Permanent drooping of an eyelid.
  • Discoloration and darkening of the eyelids.
  • Chemosis which is excessive swelling of the membrane that lines your eye and exposed areas (conjunctiva).
  • This is usually temporary. To lessen the chance of chemosis, sometimes your surgeon stitches together the outer third of the upper and lower eyelid. This temporary stitch is called a tarsorrhaphy.
  • Visual changes including blindness.
  • A scratch to the cornea (corneal abrasion). This is treated by covering the affected eye with a patch for approximately 1 week.
  • Abnormal upper lid position, eyelid asymmetry, or a lower lid that appears to be pulled downward (ectropion).
  • Some of these complications require additional surgery.


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