Heavy upper lids, hooding that sits on the lashes, bags that never quite go away however much you sleep: these are the changes that lead people to ask about blepharoplasty, or eyelid surgery. For Hockessin residents, Eye Consultants performs the procedure through its office on Limestone Road in Wilmington, within a practice that also handles routine eye care, glaucoma and cataract surgery. That matters for an operation on the eyelids, because the health of the eye underneath is part of the plan. Here is what upper and lower blepharoplasty involve, how recovery unfolds and how to prepare.
Upper Lids, Lower Lids or Both
Blepharoplasty can be done on the upper lids, the lower lids or both in the same session.
- Upper blepharoplasty: the incision follows the natural crease of the eyelid. Excess skin, muscle and fat are removed, which can open up a hooded or heavy-looking lid.
- Lower blepharoplasty: the incision is made just below the lower lash line to remove excess skin and muscle. A hidden incision can also be used to remove or redistribute fat that creates under-eye bags.
Placing incisions in natural creases and just below the lashes helps them blend in as they heal.
When It Is About Vision as Well as Appearance
Blepharoplasty is often thought of as purely cosmetic, and for many people the goal is a more rested, open look. But when sagging upper lid skin hangs low enough, it can start to block the upper part of your peripheral vision. Removing that skin can help. If you find yourself raising your eyebrows to see better, or notice the heaviness most when reading or driving, mention it at your evaluation, because it may change how your case is assessed.
Is Eyelid Surgery Right for You?
Ideal candidates are generally:
- Adults, usually over 30, in good overall health
- Non-smokers
- Bothered by excess skin or fat on the upper or lower lids, or by under-eye bags
- Free of serious eye conditions
- Realistic about what surgery can achieve, with a positive outlook
If you are not ready for surgery, or your lid simply sits a little low, a prescription eye drop such as Upneeq may be worth discussing as an alternative.
Your Consultation, Step by Step
Your consultation begins with your general health and your eye history: previous eye surgery, dry eye, glaucoma or any other condition the surgeon needs to know about. Next comes an examination of the lids themselves, including how much excess skin there is, where fat has collected and how the lids sit when your eyes are open and relaxed. If the upper lids seem to be affecting your vision, that will be checked too.
Then the discussion turns to you. Say plainly what bothers you when you look in the mirror and what you hope will change. Your surgeon will explain whether upper, lower or combined surgery fits those goals, what the incisions will look like and what the weeks afterwards involve, so you can decide without pressure.
Surgery Day
Anesthesia is given at the start so you are comfortable throughout. Depending on whether one or both sets of lids are treated, the procedure takes anywhere from 45 minutes to two hours. Your surgeon closes the incisions at the end, and you will go home with aftercare instructions. Arrange for someone to drive you.
A Recovery Calendar
- The first few days: swelling, bruising, some discomfort, light sensitivity and blurred vision are expected. Use cold compresses, keep your head elevated when lying down and avoid lying on the treated area.
- The first two weeks: plan on one to two weeks off work. During this time avoid smoking, excess sun, rubbing your eyes and wearing contact lenses.
- Weeks four to six: continue to limit strenuous activity until you reach this point.
- The following months: swelling settles gradually, and full healing and final results can take a few months.
Preparing Before Your Procedure
If you smoke, talk to your doctor about stopping well before surgery, since smoking is something to avoid around the procedure. Line up help at home for the first few days, a supply of cold compresses and extra pillows so you can rest with your head raised. If you wear contact lenses, make sure you have an up-to-date pair of glasses for the two weeks you will be without them. A pair of sunglasses is also useful while your eyes are sensitive to light.
Combining Eyelid Surgery With Other Treatments
Some patients want to address other signs of aging around the eyes at the same time or later. Eye Consultants also offers Botox, Juvéderm, skin resurfacing and photofacials. Your provider can explain which of these complement eyelid surgery and how to time them.
Why the Eye Care Setting Matters
Eye Consultants was founded in Wilmington in 2009 by Dr. Heather Dealy, a board-certified ophthalmologist, and the practice provides medical, surgical and cosmetic eye care. Having your eyelid surgery planned by a practice that also manages conditions like dry eye and glaucoma means the health of your eyes is considered alongside the cosmetic result. You can meet the providers on the team page.
Eyelid Surgery Questions From Hockessin Patients
How long does the procedure take?
Between 45 minutes and two hours, depending on whether the upper lids, lower lids or both are treated.
When can I go back to work?
Most people take one to two weeks off. Jobs that involve heavy physical work may need longer, since strenuous activity is limited for four to six weeks.
When will I see my final result?
Swelling and bruising make the first weeks hard to judge. Full healing and final results can take a few months.
Can I wear makeup or contacts afterwards?
Avoid contact lenses for two weeks. Ask your care team when it is safe to wear eye makeup again, as it depends on how your incisions are healing.
When can I exercise again?
Light walking is usually fine early on, but strenuous activity should be limited for four to six weeks. Your care team will tell you when you can return to your usual routine.
Will the scars show?
Upper lid incisions sit in the natural crease of the eyelid and lower lid incisions just below the lashes or on the inside of the lid, which helps them blend in as they heal.
Schedule an Eyelid Consultation From Hockessin
The first step is a consultation to look at your lids, your eye health and your goals together. Request a consultation, get directions to the Limestone Road office, or speak with the scheduling team.