An upper blepharoplasty is a plastic surgery procedure aimed at correcting imperfections of the upper eyelids and, in the most severe cases, correct an excess amount of skin that may even go beyond the ciliary arch, creating in this way a curtain effect that impairs vision and makes the eye look heavy. The eyelids are muscle-tendon structures that cover and protect the eye.
They are covered externally by skin and internally by mucosa. The skin of the upper eyelids is very thin and delicate, thus it is often subject to early ageing and laxity compared to the rest of the face with tissue ptosis (blepharochalasis) and – in the most severe cases – limitation of the eyelid motility. Upper blepharoplasty is a kind of surgery aimed at modelling the skin and excess fat at upper eyelid level, making one’s look seem more relaxed and younger.
In many cases, even lower blepharoplasty may be required.
Why undergo this surgery?
The eyes are a very expressive area of the face and our look represents one of the main means of social communication. Upper blepharoplasty is the ideal surgery to rejuvenate and make one’s look and face seem brighter in case of too relaxed or drooping eyelids, a tired look of our ocular zone, lower orientation of the back of the eye with an entropion and an ectropion. Upper blepharoplasty makes relaxed eyelids younger and eliminates the bags, though it does not have a complete effect on wrinkles and on eyebrow ptosis. In these cases, even a lower blepharoplasty and/or temporal lift is required.
What needs to be done before surgery?
In order to achieve the best result, all possible variables of the surgery procedure will be taken into account depending on the patient’s anatomic characteristics, namely the shape of the eye, the level of relaxation of the eyelid skin, the presence of wrinkles, the presence of bags, the shape of the eyebrows and the general condition of the face.
How is the surgery performed?
An upper blepharoplasty surgery is done under local anaesthesia and lasts an average 60 minutes. The patient feels no pain during or immediately after the surgery. The incisions of the upper eyelid are made along the natural fold, thus there are no visible scars. After having removed all excess skin, adipose bags and possible muscle modelling, the surgery ends with the suture of the skin and the placing of patches. In order to have a better outcome, it is possible to combine lower and upper blepharoplasty. When necessary, it is even possible to execute an eyelid lift.
What happens after the operation?
Temporary local swelling, light pain, lachrymation, itching, dry eyes and sensitivity to light are normal during the first days after the surgery. These symptoms can be solved using normal analgesic drugs and eye drops. All stitches are removed in the first follow-up visit, about 6 or 7 days after the surgery. Patients return to normal daily activities after 3 days from surgery, while it is better to wait around 30 days before returning to sport activities.
The use of any specific type of medication is not indicated.
Residual scars follow the lines of minimal skin tension of the eyelids. They are hidden and invisible within the natural folds of the eyelid.
The outcome of the surgery depends on many factors: the patient’s initial clinical condition, their healing capacity, compliance with the surgeon’s post-operative indications. These indications are eye hygiene, use of cold packs and lubricating eye drops, avoid alcohol, use of contact lenses and sun exposure until complete healing. The outcome of blepharoplasty is obviously going to fade with time due to the natural ageing process.
What are the possible risks?
Possible, though rare, complications after the surgery may be haematomas and bleeding, infections, late healing of the surgery wound, bad scarring, change in skin sensitivity.