Blepharoplasty or Eyelid Surgery: Diagnosis, Procedure, & Recovery

Blepharoplasty or Eyelid Surgery

Blepharoplasty is a surgical procedure that involves removing droopy or saggy skin  (eyelid ptosis or blepharoptosis) and fat from the eyelids to improve their appearance and, sometimes, also improve peripheral vision. Most people choose to undergo blepharoplasty for cosmetic reasons, but it is also performed for the functional correction of the eyelids. When performed for medical reasons, the surgery is called functional blepharoplasty. 

Eyelid surgery, or blepharoplasty, successfully removes the sagging skin in the upper and lower eyelids, giving a younger and rejuvenated appearance.  This surgery is performed to address the following concerns- 

• If folds are created in the upper or lower eyelid and disturb the natural contour. 
• If there are clearly visible fatty deposits that make the eyes look puffy. 
• If there are bags under the eyes. 
• If the lower eyelids reveal the skin below the white part. 
• If you have excess skin and fine wrinkles around the lower or upper eyelids. 

To learn more about eyelid surgery, get in touch with Pristyn Care and consult our expert surgeons. 

Types of Blepharoplasty

Blepharoplasty can be performed on both the upper and lower eyelids, and there are several types of blepharoplasty procedures, each targeting specific areas of the eyelids. Here are some common types of blepharoplasty: 

• Upper Blepharoplasty: This procedure focuses on the upper eyelids. It involves removing excess skin and, if necessary, repositioning or removing excess fat deposits to create a smoother and more youthful upper eyelid contour and improve vision. 
• Lower Blepharoplasty: It addresses the lower eyelids and is mostly done for cosmetic reasons. It can involve the removal of excess skin, fat, or a combination of both to reduce puffiness, bags under the eyes, and wrinkles.
• Blepharoplasty with Transconjunctival Approach: This technique is usually used for lower eyelid blepharoplasty. The surgeon makes an incision on the inside of the lower eyelid (conjunctiva) to access and remove excess fat without creating visible external scars.
• Blepharoplasty with Transcutaneous Approach: It is an alternative surgical approach for lower blepharoplasty that involves making external incisions below the eyelashes instead of the conjunctiva. This incision allows the surgeon to remove and reposition the fat and excess skin to tighten the lower eyelid muscles. 
• Double Eyelid Surgery (Asian Blepharoplasty): It is a specific type of eyelid surgery, performed mostly for cosmetic reasons, that aims to provide creases in the upper eyelids. In people of Asian descent, there is only one eyelid crease called monolid. Thus, through the surgery, double eyelids are created to make the upper eyelid taller and according to the patient’s preference. 
• Laser Blepharoplasty: In some cases, lasers can be used to perform blepharoplasty, which can minimize bleeding and bruising and potentially lead to faster recovery times. It uses a CO2 laser instead of a scalpel to remove the excess skin. Laser blepharoplasty is often performed in conjunction with eyelid rejuvenation to improve the results. 

The surgeon will determine which type of blepharoplasty is the most suitable and effective for the individual based on his/her anatomy, overall health, severity of the condition, and personal preferences. 

Benefits of Droopy Eyelid Repair Surgery

People all across the world feel very enthusiastic about getting eyelid surgery or blepharoplasty because it offers the following benefits- 

• Improved Aesthetics: One of the primary reasons people seek blepharoplasty is to achieve a more youthful and refreshed appearance. The procedure can help reduce sagging skin, puffiness, and wrinkles around the eyes, giving the eyes a brighter and more vibrant look.
• Reduced Baggy Eyelids: Blepharoplasty can address excess fat deposits and loose skin that can create bagginess in the upper and lower eyelids. Removing or repositioning these tissues can result in a smoother and tighter eyelid contour. Thus, the individuals will no longer have the tiring look on their faces due to baggy eyes. 
• Enhanced Self-Confidence: Many individuals experience a boost in self-confidence and self-esteem after undergoing blepharoplasty. Improved eyelid appearance can lead to a more positive self-perception and greater comfort in social and professional interactions.
• Visual Field Improvement: In cases where severe upper eyelid ptosis obstructs the visual field, blepharoplasty can provide functional benefits by lifting the eyelid and restoring a clear line of sight.
• Restoration of Youthful Appearance: As we age, the skin and tissues around the eyes can become lax and droopy. Blepharoplasty can reverse some of these signs of aging, helping patients achieve a more youthful and rejuvenated overall facial appearance.
• Durable Results: The results of blepharoplasty are generally long-lasting. While the natural aging process continues, the improvements made through surgery remain, allowing patients to enjoy their rejuvenated appearance for more than a decade.
• Improved Makeup Application: Some individuals find that sagging eyelids can make makeup application challenging. After blepharoplasty, the smoother and more defined eyelid contour can make applying makeup easier and more effective.
• Enhanced Vision: In cases of severe upper eyelid ptosis, where the drooping eyelid obstructs the visual field, blepharoplasty can lead to an improvement in vision. This is particularly beneficial for patients whose daily activities are affected by the eyelid’s position.
• Natural-Looking Results: When performed by an experienced surgeon, blepharoplasty can produce natural-looking results that enhance the overall harmony of the face without giving an artificial appearance.
• Minimal Scarring: One of the major benefits of blepharoplasty is that the scars of this surgery are barely visible. The incisions are placed in the natural folds of the skin and under the lash line. Thus, the individual’s overall look is not compromised.

How to Prepare for Eyelid Surgery?

Once the surgery is scheduled, the doctor will provide detailed instructions for preparation. Though blepharoplasty is plastic surgery, the patient will need to consult an ophthalmologist as well. The best thing to do is to consult an oculoplastic surgeon (an ophthalmologist who performs plastic surgery). It is crucial to discuss the medical history of the patients along with expected goals for good results. 

The patients will be advised to follow the pre-operative instructions below:

• Provide a list of all prescribed and over-the-counter medications to the surgeon, including herbal supplements. The doctor may adjust the medications and ask the patient to stop using them for a brief period. 
• The patient needs to stop smoking (better to quit entirely) at least 2-3 weeks before the surgery to improve the body’s healing abilities. 
• Avoid consuming alcohol 3 days prior to the surgery.
• Start eating a healthy and balanced diet to support the body’s healing abilities and maintain hydration. 
• Stop taking blood-thinning medications, such as warfarin, aspirin, ibuprofen, etc., leading to the day of surgery, as they can increase the risk of excessive bleeding during the procedure. 

On the day of surgery, the patient needs to follow the instructions below:

• Practice fasting on the day of surgery and avoid eating or drinking for 6-8 hours before the surgery. 
• Wear comfortable clothes on the day of surgery, preferably something with buttons or zippers, to avoid pulling the clothes over the head and rubbing against the face. 
• Ask a friend or family member to come to the hospital/clinic and arrange for transportation before and after the surgery. 
• Avoid wearing makeup and using all skincare products on the day of surgery. Also, leave valuable items and jewelry at home. 

It’s important for the patient to openly communicate with the doctor regarding the instructions and follow them diligently for a successful surgery and smooth recovery. 

Eyelid Surgery Procedure

Before taking the patient to the operating room, the nurses will insert an IV line into the arm to administer fluids and medications. The patient is asked to change into a clean and sterile hospital gown. The step-by-step procedure will vary for each patient depending on the individual requirements.

The general overview of blepharoplasty is given below:

• The anesthetist will administer anesthesia to put the patient to sleep and numb the facial region. Either local anesthesia with sedation or general anesthesia will be used for the procedure. 
• In upper blepharoplasty, the surgeon makes an incision in the natural crease line of the upper eyelid. 
• In lower blepharoplasty, the surgeon makes an incision beneath the lower eyelash line. If suitable, the surgeon may use the transconjunctival or transcutaneous approach to gain access. 
• Excess skin, fat, and sometimes muscle are carefully removed or repositioned to achieve the desired aesthetic outcome.
• The surgeon may sculpt the fat deposits to reduce puffiness and create a smoother eyelid contour.
• If the muscles responsible for lifting the eyelids are weak or stretched, they may be tightened or repositioned to improve eyelid function.
• After modifications, the incisions are closed with sutures or surgical adhesive, and if necessary, sutures may also be placed beneath the skin to support the eyelids. 
• An ointment will be applied to the stitches, and a light dressing will be done to protect the incisions. 
• After surgery, the patient is transferred to a recovery room where his/her health is monitored until the effects of anesthesia wear off. 

In most cases, eyelid surgery or blepharoplasty takes around 1 to 2 hours and is performed on an outpatient basis, which means the patient is sent home on the same day after a few hours of observation. 

What to Expect After Eyelid Surgery?

Expect to feel slightly disoriented after the surgery due to the effects of anesthesia. As the surgery is performed on an outpatient basis, the patient will be kept under observation for a while and discharged on the same day. 

The patient may also experience the following side effects after the surgery:- 

• Blurred vision 
• Watery eyes 
• Light sensitivity 
• Double vision 
• Puffy or numb eyelids 
• Swelling or bruising around the eyes 
• Pain or discomfort

The medical team will give detailed instructions on how to take care of the eyes before discharge, along with the follow-up schedule. 

Results & Recovery After Blepharoplasty

Typically, it takes around 2 to 4 weeks to recover and 2-3 months to see the final results of eyelid surgery. Initially, there will be significant swelling and bruising in the treated area, due to which the results won’t be visible. Once the healing begins and the swelling and bruising start to subside, the results will start to become apparent. In a few months, the residual swelling will also go away, the skin will tighten, and the scar will also start to fade. 

Following post-surgery care instructions strictly is essential for a smooth and successful recovery after blepharoplasty. The general instructions patients will receive include the following: 

• Apply cold compresses to the eyes in the first 48 to 72 hours to manage the swelling and bruising around the eyes. It will also provide relief from the discomfort. 
• Take the prescribed medications, including antibiotics, anti-inflammatory medicines, painkillers, etc., as directed by the surgeon. 
• Use the prescribed eye drops or ointments to keep the surgical area clean and lubricated to prevent dry eyes.
• Keep the head elevated while resting, even while sleeping, to minimize swelling.
• Protect eyes from bright lights and wind by wearing sunglasses while going outside. 
• Avoid vigorous physical activity, heavy lifting, and bending over until the recovery is complete. 
• Avoid wearing makeup on or around the eyes until the surgeon gives approval. 
• Refrain from wearing contact lenses until the eyes heal, as they can be difficult to wear and cause irritation in the eyes. 
• Attend all scheduled follow-up appointments with the surgeon to monitor the healing progress and address any concerns.
• Protect the treated eyes from the sun’s UV rays by wearing sunglasses with proper UV protection.
• Resume basic activities within a week. But it’s important to avoid activities that can strain the eyes. 

The recovery duration will vary for each patient depending on the extent of treatment and his/her healing abilities. Throughout this period, it’ll be best to stay in touch with the doctor and clear all doubts regarding physical activities, skincare, diet, and others.

Risks & Complications of Eyelid Surgery

Like any surgical procedure, blepharoplasty (eyelid surgery) carries potential risks and complications. Before proceeding with surgery, the surgeon will inform the patient about these risks and also take several measures to prevent complications. The general risks and complications that may occur are: 

• Anesthesia Risks: The patient may experience reactions to anesthesia, due to which he/she may go into anaphylactic shock. That’s why the anesthesiologist will evaluate which anesthesia is most suitable for the patient beforehand. 
• Infection: There is a minor risk of infection during and after the surgery if the patient is exposed to environmental contaminants and bacteria. To prevent infections, patients are given antibiotics. In severe cases of infection, further intervention may be needed. 
• Hematoma and Seroma: In some cases, hematoma (blood accumulation) or seroma (fluid accumulation) may occur in the treated site. They may resolve on their own after some time or may require drainage. 
• Scarring: Most scars from blepharoplasty are well hidden in the natural creases of the eyelids. However, in some cases, the scars may heal abnormally or become keloid or hypertrophic, which will require surgery or other intervention. 
• Asymmetry: Achieving perfect symmetry is challenging, and some degree of asymmetry might persist even after surgery, despite the best efforts by the surgeon. 
• Dry Eyes or Irritation: Temporary dryness, irritation, or changes in tear production can occur after surgery. In some cases, these symptoms may persist longer than usual. 
• Ectropion or Entropion: These two complications are associated with lower blepharoplasty. Ectropion is the outward turning of the eyelid, and entropion is the inward turning of the eyelid. If it happens, it can impair the eyelid function and will require another surgery to fix the problem. 
• Overcorrection or Undercorrection: Sometimes, the results of the surgery may not fully meet the patient’s expectations, leading to overcorrection (tightening) or undercorrection (incomplete improvement).
• Numbness or Sensation Changes: Temporary numbness or altered sensation around the surgical area can occur but usually resolves over time.
• Vision Changes: It is an extremely rare complication in which the patient may experience vision changes after eyelid surgery. This may occur if the position of the eyelids or the natural function is affected. 

Besides these, some patients may also experience delayed healing, reaction to suture or stitches material, skin discoloration, etc. In most cases, the risks are mitigated by the surgeon, but complications may still occur. To reduce the risk of complications, patients are advised to adhere to the post-op instructions. 

Lifestyle Changes After Blepharoplasty

After undergoing blepharoplasty (eyelid surgery), making certain lifestyle changes can help facilitate a smoother recovery and enhance the results. Some lifestyle changes that patients should consider implementing include the following:

• Rest and Sleep: Adequate rest is essential for the healing process. Aim to get plenty of sleep and keep the head elevated to reduce swelling.
• Hydration & Nutrition: Maintain hydration and take a balanced diet rich in vitamins and nutrients to support healing and improve skin health. 
• Quit Smoking: It’ll be best for the patient to quit smoking entirely to get the best results and retain them for a long time. Smoking not only interferes with recovery but also causes faster aging by depriving the skin of essential nutrients. 
• Sun Protection: Do not go out in the sun as UV rays can cause pigmentation of the treated skin. If going out is mandatory, use proper UV protection, such as sunscreen, scarves, etc. 
• Scar Care: Once the stitches are removed and the scar starts to heal, the doctor may advise using scar reduction creams to ensure proper healing. Use the prescribed product as directed to ensure the scar fades away. 

The doctor will provide guidance to the patients regarding lifestyle changes to optimize the results of surgery. 

Blepharoplasty or Eyelid Surgery Cost in India

On average, blepharoplasty cost in India is Rs. 40000 to Rs. 70000. This is an estimated price for eyelid surgery, and the final cost may vary for each patient due to various factors, including:

• The severity of the condition. 
• The type of eyelid surgery recommended (upper, lower, unilateral, or bilateral).
• The surgeon’s consulting and operating fee. 
• The technique chosen by the doctor.
• Pre-op diagnostic tests and evaluations. 
• The choice of hospital/clinic and its associated expenses.
• Post-surgery care and follow-ups.

At Pristyn Care, we have a flexible payment system that allows patients to cover eyelid surgery costs in India through modes like credit cards, cheques, etc. Moreover, we also offer a No-Cost EMI service to the patients that divides the overall cost of treatment into easily payable monthly installments. To learn more about the payment options, give us a call. 

Is Eyelid Surgery Covered Under Insurance?

Eyelid surgery is covered under health insurance plans if it’s performed for medical reasons. It means that an insurance company will cover the cost when the surgery is reconstructive, not cosmetic. If the surgery is purely cosmetic, the insurance company will not provide authorization to claim the insurance. 

To get eyelid surgery covered, the patient needs to submit clinical evidence regarding the same stating the functional issues, and the documents must be signed by a certified doctor. Once the required documents are provided, the company will provide a pre-authorization claim and settle the bill through TPA (Third Party Administrator). 

The insurance policy will cover the cost of hospitalization, admission fees, discharge fees, bed charges, room rent, medical consumables, ICU charges, anesthesia fees, meal charges, pre and post-op consultations, surgeon’s fees, nursing fees, anesthetist’s fees, etc. To clearly understand the inclusions and exclusions of the policy, talk to the insurance provider. Know More about Is Eyelid surgery coverd under insurance 

Non-Surgical Methods for Droopy Eyelids

Eyelid ptosis, or drooping eyelids, can sometimes be addressed using non-surgical methods, especially if the ptosis is mild or the individual is not a suitable candidate for surgery. The patient should understand that while non-surgical treatments can provide some improvement, they might not offer the same level of correction as surgical intervention. Here are some non-surgical methods that can be considered for addressing eyelid ptosis:

• Botox Injections: The botulinum toxin(Botox) injections can be used to lift the eyebrows slightly, which can indirectly improve the appearance of mild eyelid ptosis. The toxins will relax the muscles and prevent contractions that pull the eyelids down. Thus, the eyelids appear slightly elevated. 
• Filler Injections: Dermal fillers can be strategically injected in areas around the eyebrows and temples to provide lift and support to the surrounding tissues. This can create a mild lifting effect on the eyelids.
• Thread Lifts: This method involves inserting dissolvable sutures beneath the skin to lift and tighten sagging tissues. While thread lifts can provide some elevation, their effectiveness might be limited in cases of significant ptosis.
• RF Microneedling is another effective alternative to blepharoplasty. It involves using radiofrequency to address the sagginess of the skin. A specialized device is used to create micro-injuries on the epithelial tissues to stimulate the growth of new and healthy skin cells. These new cells will be firm and give a youthful appearance to the eyes. 
• PRP Therapy or platelet-rich plasma is often combined with microneedling to boost the lifting effects and achieve better results. The plasma is used to improve collagen and elastin production, which improves the texture and tone of the upper and lower eyelids. 
• Skin Resurfacing is recommended for patients who have excessive deep lines around the eyes. There are various techniques of resurfacing that can make the skin firm and improve bagginess. The doctor may recommend laser skin resurfacing, photofacial, chemical peels, microdermabrasion, etc. 

Medication For Eyelid Ptosis

Medications are generally not the primary treatment for eyelid ptosis (droopy eyelids). However, there are certain medications that might be used in specific cases or as part of a broader treatment plan:

• Eye Drops: Lubricating eye drops can be used to relieve dryness and discomfort in cases where droopy eyelids are causing irritation. These drops don’t directly treat ptosis but can help with associated symptoms.
• Medications for Underlying Conditions: If the eyelid ptosis is caused by an underlying medical condition such as myasthenia gravis, medications aimed at treating that condition might be prescribed. These could include medications that improve muscle strength and neuromuscular transmission.
• Anti-Inflammatory Drugs: If the ptosis is related to inflammation or swelling of the eyelid muscles, anti-inflammatory medications might be used to alleviate symptoms.

Exercises for Droopy Eyelids 

The upper eyelid has a muscle that holds the eyelid in place and supports movements. In many cases, the muscle becomes weak, which causes the eyelids to droop. Patients who have droopy eyelids can try the following exercises to regain muscle strength and lift the eyelids to a certain extent. Some exercises that may be worth trying are: 

• Eyelid Lifts: Gently place the index finger on the upper eyelids and try to lift them. Resist the movement of eyelid muscles, hold for a few seconds, and then release. 
• Blinking Exercises: Blink both eyes rapidly for about 20-30 seconds. Then, close both eyes and relax for a few moments. 
• Eyebrow Raises: Raise the eyebrows as high as possible while keeping both eyes open. Hold for a few seconds, and then relax. 
• Eye Squeezes: Close the eyes tightly and squeeze them shut. Hold for a few seconds, then release. 
• Forehead Massage: Gently massage the forehead and the area around the eyebrows using circular motions. This can help relax the muscles in the area.

Remember, these exercises need to be repeated several times, and even then, they might not provide guaranteed results. In some cases, medical procedures or treatments might be necessary to address the issue effectively.