The eyelids are frequently the first to show the signs of aging resulting in a tired, sad appearance. This is very apparent because the eyes are the first structure that we notice in a person’s face. The problems we confront in the eyes are really two–fold. First, there may be excess skin in both the upper and lower eyelids. The excess skin of the upper lids may also be caused by sagging of the forehead and eyebrows. A brow lift should always be considered when evaluating the upper eyelids.
The second problem is the accumulation of fat which causes “Baggy” eye lids. This is frequently present in both the upper and lower eyelids. Initially the bags are noticeable only on awakening in the morning. As the problem becomes more severe, this puffy look persists throughout the day. This tendency is inherited and may appear very early in life, even in the teens and ‘20s, before the aging process becomes obvious. With eyelid surgery the removal of excess skin and fat pads will give a rested, youthful appearance, but does very little to change the fine lines and the crow’s feet. If the skin is pulled tightly in attempt to eliminate these fine lines, the lower lid will be pulled down and a deformity created. The normal almond shape of the eyes may be distorted, resulting in a “Hound dog” appearance. Some techniques such as the chemical peel or laser resurfacing are used to improve or remove these fine lines.

Procedure
The surgeon makes the incision in the fold of the lid (upper eyelids) (see diagram above). In the lower eyelid, they make incision in a natural crease immediately below the eyelashes. In cases where only fat has to be removed from the lower eyelids, the surgeons make the incisions on the inner surface of the eyelid.

In this way the patient avoids the temporary inconvenience caused by the healing of a skin incision. Some bruising and swelling occurs in the upper and lower eyelids and continues for seven to ten days. No bandages are required. After one week, the patients can use makeup to camouflage any residual bruising. Strenuous activities are restricted for a short time after surgery. The patient is not able to wear contact lenses for two or three days after the operation. If your job does not involve strenuous labor, he may return to work with sunglasses in one or two days.

Complications with Blepharoplasty
Excess tear formation may occur for a few days after surgery due to swelling. With this surgery the margin of the lower eyelid can be slightly pulled temporarily, especially in patients with poor muscle tone. If muscle tone is not good, the surgeons use additional techniques to tighten the lids to avoid this complication. Bleeding, scarring, and infection are quite rare.