Blepharoplasty is the technical term for eyelid surgery performed to remove excess skin and/or fat from the eyelids either for aesthetic reasons, or to improve vision.
The surgery is almost always an outpatient procedure. It can be performed under local anesthetic in the office setting, or with light sedation at a surgery center. Small incisions are made usually in the naturally occurring eyelid crease (to camouflage the scar), and tissue is carefully removed according to each patient's individual needs. Sutures are placed to close the incision. Recovery from sedation is generally quick (approximately 30 minutes, depending on the patient), and patients return home without patches or heavy dressings on the eye. Most patients have minimal discomfort in the recovery phase, other than mild scratchy or irritated feeling in the eyes. Any bruising and swelling is minimized by frequent use of ice packs in the first 72 hours. For a typical patient, the substantial portion of bruising and swelling is resolved by approximately 1-2 weeks.
Eyelid muscle drooping (ptosis) or excess folding of the skin (dermatochalasis) can be caused by many things. Most commonly, with aging, skin and soft tissues lose their elasticity and volume, leading to the appearance of excess or drooping skin and/or muscles around the eye. In severe cases, this drooping or excess skin can block the vision by obscuring the superior visual field. In this instance, most insurance companies consider surgical repair by blepharoplasty or ptosis repair to be a medical necessity.
From an aesthetic standpoint, it is important to recognize that a youthful appearing eye is full rather than hollow. You may have seen people who have unfortunately had overly aggressive removal of fat and skin from their eyelids. This creates a skeletonized appearance to the eyes, leaving a much more aged appearance than the original dermatochalasis. In severe cases of excessive skin removal, patients can actually have difficulty closing their eyes, which is a potentially vision threatening problem.
The assessment of medical necessity for eyelid surgery requires specialized testing and evaluation by a qualified physician. Oculoplastic surgeons are specialists in eyelid surgery and can evaluate your particular case with relevant testing. These physicians are also uniquely qualified to perform your eyelid surgery (whether it be for medical or cosmetic reasons), since this is a primary focus of their training.
