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Eyelid Surgery (Blepharoplasty) Blepharoplasty

What is Blepharoplasty?
Blepharoplasty
The eyes are central to one’s appearance.
"As we use the eye to see the world, so the world sees us through our eyes".

So what happens when the eyelids surrounding the eyes begin to show signs of aging?

This is a condition primarily caused by aging because, as we grow older, the eyelid skin stretches, muscles weaken, and yet more fat accumulates around the eyes. We have come to know this as “bags” under our eyes, or droopy eyelids.

Having these conditions can interfere with our vision, obstructing our view of the world. However, there is a surgical procedure that offers a solution.

Eyelids Rejuvenation, medically referred to as Blepharoplasty, is designed to remove fat, excess skin and muscle from the eyelids. It can be performed on the upper or lower eyelid, or both. This procedure is designed for those wanting to look younger, more refreshed and more alert. Even the slightest changes to the eyelids can help them look younger and vibrant.
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Ideal candidates for eyelid surgery:

are those who have droopy upper eyelids, and / or bags under the eyes. However these individuals, as in any cosmetic procedure, must also be physically healthy, psychologically stable, and have realistic goals and expectations.


Types of Eyelid Procedures:

There are various methods used to enhance eyelid appearance. It is important to note that each of these procedures carries its own set of risks and benefits.

Upper Eyelid Surgeryeyelid aging

Upper eyelid surgery can improve two common problem areas:
1.) excess skin on the upper eyelid itself, often called “hooding of the upper lid, and
2.) puffiness in the inner corner and middle of the upper eyelid caused by herniation (pushing forward) of fat.
- The hooding of the upper eyelid can obstruct your vision, so its removal could actually improve the quality of your peripheral vision.
- Puffiness in the upper eyelid can cause patients to look old and tired; and upper eyelid surgery can create a more alert and younger appearance.
- Upper eyelid surgery can enhance the shape, position, and depth of the eyelid crease.

N.B. A brow lift can add to the enhancement of the upper eyelid’s appearance by lifting sagging eyebrows. In conjunction with upper eyelid surgery, a brow lift removes skin hanging over the upper eyes.

Lower Eyelid Surgery
Lower eyelid surgery is performed to remove the puffiness found in the lower eyelid. Some people refer to this as “bags” under your eyes. The accumulation of excess fat and skin, resulting from age and other factors, causes that puffy appearance in the lower eyelid, which makes people look older and tired.
Removal of bulging fat in the lower eyelid can result in a younger, rested and alert appearance.
ascian eyelid
Asian Eyelid Surgery
Asian eyes have a different appearance than Western and Caucasian eyes. With Asian eyelids, the anatomical difference is that the orbital septum (the layer that holds back the fat) extends lower down towards the eyelid margin. This procedure is also known as double eyelid operation and Asian blepharoplasty. The surgeon performs the procedure similar, but not identical to, traditional eyelid surgery. Their goal is to enhance the patient’s eyelid appearance without taking away any ethnic features. Most surgeons do not advise patients to undergo eyelid surgery in order to “Westernize” their appearance.


What are the Benefits to Blepharoplasty?

There are many reasons why a person would want to undergo eyelid surgery. Even though reasons vary from person to person, the more common include:
- Improving peripheral vision
- Gaining a fresher,
- more alert appearance
- Restoring a youthful eyelid appearance
- Enhancing overall appearance
- Gaining a boost in self-confidence


N.B. Eyelid surgery will not remove crow’s feet or other wrinkles around the eyes, nor will it eliminate dark circles under the yes, or lift sagging eyebrows.


Where Do I Begin?

When you considering eyelid surgery should first find a qualified cosmetic surgeon, then you should have an ophthalmologist consultation before consulting the cosmetic surgeon.
For the consultation, it is important that you bring the record of your most recent eye exam, as well as your contact lenses or glasses. You must also inform us of any allergies you might have, or any vitamins or medications you are taking.
During the consultation, the surgeon and the patient discuss issues such as reasons for wanting surgery, desired outcome, various options available, the procedure itself, the risks, limitations, and benefits. The surgeon provides information about anesthesia options, the location and description of where the procedure will be done – in a hospital or office surgical suite – and associated costs. The patient’s medical history is taken, and examination of the area to be treated, which includes testing vision and assessing tear production, also takes place during the consultation.


How is This Procedure Performed?

Idea: remove or reposition fat, remove excess skin and muscle from the eyelids.

Time: This procedure usually takes one to three hours to perform, depending on the extent of the operation (if it involves the upper, lower or all four eyelids).

Anesthesia: Some patients are given local anesthesia, meaning they will be awake during the operation but numb to pain. General anesthesia, which puts patients to sleep, is also a preference of surgeons.

Techniques: depends upon the type of eyelid being treated.
In upper eyelid surgery, we create an incision that follows the natural lines of the eyelids, remove a crescent of excess skin and muscle, and any fat, then close the incisions with fine sutures, which will leave nearly invisible scars.

upper blepharoplasty


During lower eyelid surgery, the incisions are also made following the natural lines of the eyelids, just below the lashes in the lower lids. The fatty deposits are then typically repositioned (to prevent a hollow look) or removed from the inside of the lid. In some cases, when excess skin needs to be removed, a skin pinch is performed with an incision placed under the lashes to avoid making a conspicuous scar. As with the upper lids, fine stitches are used to close the incision.

lower blepharoplasty


Transconjunctival Blepharoplasty

For younger patients and those with thicker, more elastic skin, the surgeon may recommend transconjunctival blepharoplasty. During this procedure, a tiny incision is made inside the lower eyelid and fat is removed with tiny forceps. No skin is removed and the incision is closed with dissolving sutures.

transconjuctival blepharoplasty


After Blepharoplasty and Follow up:

The recovery period for eyelid surgery is approximately one week. In that time, patients must follow special post-operative instructions. This will help promote better healing, reduce chances of complications, and to add more comfort during recovery. For example, eye drops may be recommended because the eyelids might be dry, and eyes may burn or itch. Also, patients who wear contact lenses must avoid wearing them during the recovery period. Because the eyes will temporarily be sensitive to sunlight, wind, and other irritants, wearing sunglasses and sun block is highly recommended. Patients will also be instructed on how to clean their eyes while recovering.


What Are The Risks To Having Eyelid Surgery?

Many people have undergone eyelid surgery, with very few complications reported. However, eyelid surgery is still a very delicate procedure; one mistake could cost one’s vision. Hypothyroidism, Graves’ disease, dry eye, high blood pressure, cardiovascular disease and diabetes are just some of the medical conditions that can make eyelid surgery even more risky. A detached retina or glaucoma are also causes for concern.


What Are the Results of Eyelid Surgery and How Long Do They Last?

- Upper and lower eyelids are each performed differently and each displays a different result. Stitches will be removed after five to seven days and swelling fade out after one to three weeks.
dark halos
- Scars will still be visible six or more months after surgery in a slightly pink form, and then eventually fade to thin, nearly invisible lines. After undergoing eyelid surgery, your appearance is enhanced because the upper eyelids are no longer drooping and the skin under the eyes is smooth and firm.

- The results can last for many years, and in many cases, are permanent.


What Are the Costs of Eyelid Surgery?

Although price is a factor when deciding on surgery, the most important factor is that you feel you are getting a good quality, natural-looking result from the procedure.

Eye lids surgeries costs are variable according to the amount of sagging, upper, lower or both, type of anesthesia and the used technique. Usually the cost is ranging from 1500 to 2000 U.S. dollars. When dealing with costs, you also need to take into consideration the fact that the procedure may need retouch or associated with other procedures like brow lift or Botox injection. A comprehensive cost figure may be obtained while consulting with the surgeon. Make sure the total figure includes any and all associated costs.

In certain cases, eyelid surgery can be covered by medical insurance, if the procedure is needed for health reasons, including undergoing eyelid surgery to improve vision droopy eyelids or block your vision. Please check with your medical insurance provider for more information. While, for those undergoing eyelid surgery for cosmetic reasons, most medical insurance providers do not cover the procedure.


FAQ from patients when considering undergoing a Blepharoplasty?

To gain a more thorough understanding about eyelid surgery, and help form realistic expectations, it is recommended that the patient view before and after photographs of the surgeon’s previous patients. It is also important for patients to ask questions about anything they do not understand about the procedure.

Personality analysis by eyelids!
"If you look at the eyelids of people through the millennia who were seers, great philosophers, creative geniuses, writers ... you will note they that many had heavy eyelids".

Q - Is what I described realistic?
A - The blepharoplasty improve field of vision, enhance the eyelid sagging, restoring a youthful eyelid appearance and enhance overall facial appearance but will not remove crow’s feet or other wrinkles around the eyes, nor will it eliminate dark circles under the yes, or lift sagging eyebrows.

Q - Where is the eyelid surgery performed and how long will it take? beauty of eyelids
A - in hospital or clinic, and it takes 1 to 3 hours

Q - What is the meaning of success rate of 95 %?
A - i.e., the result will be satisfactory to patient and doctor in 95% of patients and 5% of cases will be retouched.

Q - In my case, what technique is most appropriate in helping me achieve my cosmetic goal?
A - according to clinical examination and age of the patient we can decide what is the most appropriate technique.

Q - What kind of anesthesia will be used during the surgery?
A - Usually local anesthesia but in some cases local anesthesia with sedation or general anesthesia may be needed.

Q - How much does eyelid surgery cost and what elements factor into that cost like hospital fees, anesthesia, and so on?
A - Usually range from 1500 up to 2000 U.S. dollars. This fee include surgeon fee, anesthesia fee and Hospital fee.

Q - How long will I stay in hospital after the surgery?
A - Blepharoplasty is day care surgery, i.e. you will leave the hospital 3 hours after the recovery.

Q - when could I return to normal life activity?
A - Second day after surgery.

Q - What is the surgeon’s level of experience in performing eyelid surgery?
A - Consultant with M.D. degree of plastic Surgery.

Q - What are the symptoms that may occur in the first five days after surgery?
A - Soreness pain which could be managed by pain killer’s medications and there may be swelling of the eyelids.

Q - What are the guarantees that the success of the process?
A - There is no doubt that the followers of the medical instructions and always reviews the main factors for the success of blepharoplasty. If not, the procedure is repeated at reduced cost.

Q - What percentage of patients experience complications with eyelid surgery?
A - 1 to 5% of cases experience swelling, haematoma, recurrence and scarring. Swelling and Haematoma are managed by hot fomentation and anti-inflammatory medications. Recurrence and scarring are managed by surgery after 3 months of last procedure at reduced cost.

Q - If you are not Egyptian, What is the minimum period for follow up?
A - Five days.

Q - What about eyelid surgery with Laser?
A - Laser could not be used for this procedures but it may be used as adjuvant to surrounding region.

Q - What are the contraindications of blepharoplasty?
A - There are no absolute contraindications but the patients should inform their surgeons about any allergies, serious medical conditions, and medications they may be taking. In the case of eyelid surgery, provide your most recent eye exam, and bring your glasses or contact lenses to the consultation.


Summary of Blepharoplasty:

The time of the procedure: from
two to three hours.
Type of anesthesia: local
anesthesia +/- sedation.
Location: hospital
or clinic without postoperative hospital stay.
Expected Side effects: few, such as mild swelling, aches, which treated by analgesics.
Recovery time: return
to work immediately and the final outcome within the three months.
Cost: variable, ranging from 1500 to 2000 U.S. dollars.
Results: Permanent.