St. Louis Eyelid Surgery and Cheek Lift Specialist
An eyelid lift (called blepharoplasty) removes or repositions excess fat, skin, and muscle from the eyelids. It can correct drooping of the upper eyelids (called an upper blepharoplasty) and/or the puffy bags below the eyes (called a lower blepharoplasty). These eyelid problems make people look older and chronically tired and may even interfere with vision.
An eyelid lift won't remove crow's feet or other wrinkles, eliminate dark circles under the eyes, or lift sagging eyebrows. (Other procedures are required for treating these problems.) While blepharoplasty can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage.
Sagging in the upper cheek area is not uncommon as we age, and a cheek lift is typically done at the same time as an eyelid lift. Basically, a cheek lift is an extended lower blepharoplasty. An eyelid lift can be done alone or in combination with other facial procedures such as a facelift or browlift.
Most patients requesting an eyelid lift are 35 or older, but droopy upper eyelids or baggy lower lids sometimes run in families. Patients with hereditary drooping or bags may decide to have eyelid surgery at a younger age.
A few medical conditions make blepharoplasty more risky, including thyroid problems (such as hypothyroidism and Graves' disease), dry eyes or lack of sufficient tears, proptosis ("bug eyes"), high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; if you have these problems, check with an ophthalmologist to see if a blepharoplasty is safe.
The surgeon makes incisions along the natural lines of your eyelids: in the creases of your upper lids and just below the lashes on the lower lids. The incisions may extend into the crow's feet or laugh lines at the outer corners of the eyes. If the cheeks are to be lifted, the lower lid incisions are modified to access the cheek tissue in an extended lower blepharoplasty. Working through the incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes or repositions excess fat, and often trims sagging skin and muscle.
The incisions are closed with very fine sutures, which are removed 2 to 7 days after surgery. Once the stitches are out, the swelling and discoloration around the eyes gradually subsides.
If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty, which is usually done on younger patients with bulging fat deposits under the eyes but no skin excess. In this procedure the incision is made inside the lower eyelid and therefore leaves no visible scar.
After surgery, the eyes are lubricated with ointment and a bandage applied. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication prescribed by your surgeon. If you feel any severe pain, call your surgeon immediately.
What To Expect After An Eyelid Lift
You should keep your head elevated for several days and use cold compresses to reduce swelling and bruising. Bruising varies from person to person but usually reaches its peak during the first week and gradually subsides between 2 to 4 weeks. Keep activities to a minimum for 3 to 5 days and do not engage in strenuous activity for about 2 weeks. It's especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports.
You should be able to read or watch television after 2 or 3 days. However, you won't be able to wear contact lenses for about 2 weeks, and even then they may feel uncomfortable for a while. You'll be shown how to cleanse your eyes, which may be gummy for a week or so. Since your eyelids may feel dry at first and your eyes may burn or itch, eye drops are recommended to ease the discomfort. For the first few weeks you may experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision. Your surgeon will follow your progress very closely for the first week or two.
Most people feel ready to go out in public (and back to work) in 7 to 10 days. By then, depending on your rate of healing, you'll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks so wear sunglasses and a special sunblock made for eyelids when you go out.
Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they'll fade to a thin, nearly invisible white line.
Length Of Surgery
1 to 3 hours, depending on number of eyelids getting surgery
Usually outpatient unless other procedures are performed
Temporary discomfort, tightness of eyelids, swelling, bruising. Temporary dryness, burning, itching of eyes. Excessive tearing, sensitivity to light for first few weeks.
Temporary blurred or double vision. Infection, bleeding. Swelling at the corners of the eyelids. Dry eyes. Formation of whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery). Blindness (extremely rare).
Reading: 2 or 3 days.
Back to work: 7 to 10 days.
Contact lenses: 2 weeks or more.
Strenuous activities, alcohol: about 2 weeks.
Bruising and swelling gone: several weeks.
Duration of Results
Several years; sometimes permanent.