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Blepharoplasty Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat–usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes – features that make you look older and more tired than you feel, and may even interfere with your vision. However, it won’t remove crow’s feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows.

The Best Candidate for Surgery

Blepharoplasty can enhance your appearance and your self-confidence. The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age. A few medical conditions make blepharoplasty more risky. These include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution.

Risks of Surgery

When eyelid surgery is performed, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon’s instructions both before and after surgery.

The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out; your surgeon can remove them easily with a very fine needle.

The Surgical Procedure

Blepharoplasty usually takes about an hour, depending on the extent of the surgery. If you’re having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.

In a typical procedure, Dr. Penne makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.

If you have a pocket of fat beneath your lower eyelids but don’t need to have any skin removed, Dr. Penne may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.

What to Expect After Surgery

There is usually little pain associated with this type of surgery. Swelling and bruising of the eyelids varies with each patient and is usually slight. Swelling and bruising usually lasts five to ten days.

After surgery, Dr. Penne will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with Tylenol. If you feel any severe pain, call Dr. Penne immediately.

Dr. Penne will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. You’ll be shown how to clean your eyes, which may be gummy for a week or so. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

Dr. Penne will follow your progress very closely for the first week or two. The stitches will be removed about a week after surgery. Once they’re out, the swelling and discoloration around your eyes will gradually subside, and you’ll start to look and feel much better.

Resumption of Physical Activities

Work and social activities are usually curtailed for a period of three to ten days following surgery. Driving may be resumed in two to three days. Most people are back to desk work after a long weekend. Working out may be resumed after two to six weeks.


Q: How does a person get rid of the constant “puffiness” under the eyes?
A: A lower blepharoplasty (lower eyelid surgery) can get rid of the pockets of fat that can cause the puffiness.

Q: Is there any way to alleviate the heavy feeling of the eyes that make it difficult to hold the eyes open?
A: Yes, upper eyelid surgery can alleviate the “heaviness” that people feel around their eyes when the excess skin of the eyelid weighs down on them.

Q: Where is the incision for eyelid surgery?
A: The incision for upper eyelid surgery is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner. For the lower eyelid, the incision is also hidden but below the lower eyelashes.

Q: How long do I need to take off from work after eyelid surgery?
A: It is suggested that you take off 3-5 days from work after eyelid surgery but refrain from strenuous activity for up to one month after the surgery.

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