Eyelid Surgery (Blepharoplasty)

Treatment

Eyelid Surgery (Blepharoplasty)

Eyelid surgery is a surgical procedure that addresses excess skin, puffiness and tissue changes in the upper and lower eyelids. Its medical name is blepharoplasty. Depending on each person’s needs, it can be performed on the upper eyelids alone, the lower eyelids alone, or both areas together.

Changes around the eyes can make the face look more tired than it really is. In some people, excess skin on the upper eyelid can also affect the field of vision. Surgical planning takes into account not only appearance but also eyelid function and eye health.

What Is Eyelid Surgery?

Blepharoplasty involves removing excess skin from the eyelids and, where necessary, reducing or repositioning fat tissue. The goal is to create an eye-area appearance that suits the individual’s facial structure while preserving the protective function of the eyelids.

Not every change around the eyes has the same cause. Excess skin, prominent fat and laxity of the supporting tissues may each require a different approach. For this reason, the procedure is not planned solely around removing visible excess; the relationship between the surrounding tissues is also assessed.

Upper Eyelid Surgery

Upper eyelid surgery is performed to address excess skin that has gathered over the natural crease of the eyelid and, where necessary, prominent fat tissue.

Excess skin can cover the eyelid crease and create a heavy look around the eyes. In advanced cases, it can restrict the upper or peripheral field of vision. If such a complaint is present, visual function is assessed separately.

Incisions are usually planned within the natural fold of the upper eyelid. When determining how much tissue to remove, care is taken to ensure the eye can close comfortably and that the surface of the eye remains protected.

Lower Eyelid Surgery

Lower eyelid surgery may be considered for under-eye bags, excess skin and irregularities in the transition between the lower eyelid and the cheek.

It is not necessary to remove all of the fat tissue during the procedure. In some patients, repositioning the fat can help smooth the volume transition in the area. Where necessary, the supporting structures of the lower eyelid are also addressed.

The surgical approach may be made just below the lashes or through the inner surface of the eyelid. The inner-surface approach reaches the fat tissue without an external skin incision; however, this method alone does not remove excess skin. The choice of technique is based on examination findings.

Are Drooping Eyelids and Sagging Skin the Same Thing?

In everyday language, the term “drooping eyelids” can be used for several different conditions. Excess skin on the upper eyelid, a downward shift of the brow and a low-set eyelid margin should be distinguished from one another.

Ptosis is when the upper eyelid margin sits lower than normal. It may be related to the function of the structures that lift the eyelid and may require a different surgical intervention than simply removing excess skin.

A drooping brow can also increase the bunching of the upper eyelid. For this reason, the forehead, brows and eyelids are examined together during the assessment.

Who Is a Good Candidate for Eyelid Surgery?

Blepharoplasty may be considered for people who are bothered by changes in their eyelids, whose general health is suitable for surgery and who have realistic expectations about the results.

The examination particularly focuses on the following:

• Excess skin on the upper or lower eyelid.
• Under-eye bags.
• Eyelid position and closure function.
• Existing eye conditions.
• Health issues that may affect healing.
• Smoking and the person’s expectations.

Serious eye conditions or factors that affect healing may require the surgical plan to be modified or postponed. Candidacy is not determined by age or outward appearance alone.

Assessment Before Eyelid Surgery

Before surgery, the eye area is examined and a medical history is taken. You should share information about dry eye, glaucoma, thyroid disease, allergies, diabetes and any previous eye surgery.

Where necessary, tear production, eyelid measurements and the field of vision are evaluated. Photographs taken from different angles assist with surgical planning. If there are findings related to eye health, an ophthalmologist’s assessment may be requested.

All medications, vitamins and herbal supplements should be disclosed to the physician. No medication, including blood thinners, should be stopped without the advice of the relevant physicians.

Required tests, the anesthesia plan and preparation regarding smoking are tailored to each individual. Transportation and the need for a companion after surgery should also be arranged in advance.

How Is Eyelid Surgery Performed?

Before the procedure, the areas to be treated are identified and surgical markings are made. Local anesthesia, sedation or general anesthesia is chosen according to the scope of the surgery and individual assessment.

On the upper eyelid, the tissues are accessed through the natural fold; on the lower eyelid, through the area suited to the chosen approach. After the necessary skin and fat adjustments are made, the incisions are closed appropriately.

The length of the operation depends on whether the upper or lower eyelids are treated, whether both areas are treated together and whether additional procedures are performed. Suitable patients may be discharged on the same day after observation; the follow-up plan is determined by the surgical team.

Recovery After Eyelid Surgery

Recovery varies depending on the scope of the procedure and the individual’s tissue characteristics. The appearance in the first few days does not reflect the final result of the surgery.

1. The First Few Days

   Swelling, bruising, tenderness, watering or dryness may occur around the eyes. Temporary tightness and discomfort may be felt at the incision sites.

   The drops and ointments recommended by your physician should be used, and eyelid care should be carried out as instructed. If cold compresses are recommended, the method and duration should follow the surgical team’s instructions.

2. Returning to Work and Social Life

   Many people are ready to return to social activities within approximately 10–14 days. However, the visibility of bruising, the type of work and the scope of the surgery can affect this timeframe.

   It takes longer for swelling to subside and for the tissues to heal completely. The result may take several months to settle; minor differences in the early period should be evaluated at follow-up visits.

3. What to Keep in Mind During Recovery

   Avoid rubbing your eyes or putting pressure on the surgical area. Wait for the period specified by your physician before resuming contact lenses, eye makeup, swimming or strenuous exercise.

   Protecting the eye area from sun and wind can be beneficial. Returning to driving depends on your vision becoming clear, the medications you are taking and your physician’s assessment.

Does Eyelid Surgery Leave Scars?

Scars form wherever surgical incisions are made. On the upper eyelid, the incision is placed in the natural fold; on the lower eyelid, depending on the technique used, it is placed just below the lashes or on the inner surface of the eyelid.

Scars from external skin incisions may become less noticeable over time. However, the appearance of a scar depends on skin characteristics and wound healing. A completely scar-free result cannot be guaranteed.

What Are the Risks of Eyelid Surgery?

Like other surgical procedures, blepharoplasty carries certain risks. Potential complications include:

• Bleeding and infection.
• Dry eye and irritation.
• Difficulty closing the eyes.
• Downward pulling or outward turning of the lower eyelid.
• Changes in sensation and visible scarring.
• Asymmetry and the need for revision.
• Anesthesia-related complications.

In rare cases, serious vision problems may develop. Sudden loss of vision, severe new eye pain or rapidly increasing swelling after surgery require urgent evaluation. These symptoms should not be considered part of normal recovery.

Are the Results of Eyelid Surgery Permanent?

The effects of eyelid surgery can last a long time. However, surgery does not stop the natural aging of the eye area. Over time, skin laxity may recur or the appearance of the eyelids may change.

Because the longevity of results varies from person to person, it would not be accurate to give everyone the same timeframe. Sun protection and regular follow-up are part of post-operative care.

What Determines the Cost of Eyelid Surgery?

The cost of eyelid surgery can vary depending on whether only the upper eyelids, only the lower eyelids or both areas are operated on. The surgical approach, anesthesia, hospital conditions and additional procedures also affect pricing.

Based on the plan created after the examination, it should be clarified whether tests and follow-up services are included in the price. It is not appropriate to quote an exact price before the scope of the procedure has been determined.

Frequently Asked Questions About Eyelid Surgery

This content has been prepared for general informational purposes. Suitability for surgery, the treatment plan and results may vary from person to person.