Blepharoplasty

Our eyes are such an important part of our face and convey much more than words could alone.  As we age, the eyelid skin and muscle around the eyes can become loose and baggy which causes a sad and tired look in some people.  Droopy, upper eyelid skin can also obstruct people’s vision.  In addition, fat can start to push forward which can make the upper lids look heavy and produce lower eye bags and puffiness. Blepharoplasty surgery is performed to cosmetically and functionally rejuvenate the eye area, by tightening and lifting excess and wrinkly eyelid skin and reducing under-eye bags and puffiness.  By rejuvenating the eyelids, patients look more alert, awake and refreshed.

The goal for a upper blepharoplasty is to create more definition to the supratarsal fold, exposing smooth pretarsal skin, while refining volume and contour of the supratarsal lid.

Lower lid blepharoplasty goals are to restore a youthful appearance with the lower lid just touching the inferior edge of limbus, lateral canthus being elevated ~1-2mm above the medial canthus, recontour or excise redundant fat, tighten skin, and smooth the lid-cheek interface.

Blepharoplasty surgery can be performed to the upper eyelids, lower eyelids, or both upper upper and lower eyelids at one surgery.  This depends on the patient’s goals and the examination at the consultation.

Blepharoplasty alone may be an option if you have:

• Baggy or droopy upper eyelids
• Excess skin of the upper eyelids (Dermatochalasis) that interferes with your peripheral vision
• Excess crepey skin on the lower eyelids
• Bags under your eyes
• Do not have dry eyes
• Do not have eye pathology
• Have good brow position
• Have good general health
• Do not smoke

Upper Blepharoplasty

This is performed in office or in an outpatient surgical facility under local anesthetic. The position of the eyelid crease is marked with you sitting. Your face is cleansed and the further markings using a small caliper are designed. Local anesthetic is then injected to the upper eyelid region. A precise incision is made in the upper eyelid, excess skin/muscle and underlying fat is then removed, and the resulting scar will be hidden in the eyelid crease. You will have non-absorbable stitches that will need to be removed at 5-7 days after surgery.

External Lower Blepharoplasty (Transcutaneous approach)

This is performed in an outpatient surgical facility under local anesthesia/sedation or general anesthesia.  This procedure is performed when there is excess lower eyelid skin that needs to be removed/tightened. An incision is designed to the lower eyelid that is most often just below the lash line. Local anesthetic is injected to the lower eyelid region. The skin and muscle are gently lifted to expose the excess fat that can be removed or re-draped to improve the eye bags or tear trough deformity of the lower eye. The excess skin is then carefully re-draped and trimmed. At times, fat grafting may be performed to improve the contour/hollowing of the lower eye region.  A tightening stitch is then placed to the outside of the eye (lateral canthus) to support the lower eyelid during recovery to decrease risk of outward turning of an eyelid margin (ectropian) and for long-term rejuvenation of the lower lid.  Non-absorbable sutures are placed which are removed 5-7 days after surgery.

Internal Lower Blepharoplasty (Transconjunctival approach)

This is performed in an outpatient surgical facility under local anesthesia/sedation or general anesthesia.   This is performed in patients that have lower lid eyebags and puffiness but do not have loose skin that needs to be removed. Local anesthetic is injected to the lower eyelid region. Eye protectors are placed and a small incision inside the lower eyelid is made. Following this,  lower eyelid fat is carefully removal or re-draped. At times, fat grafting may be performed to improve the contour/hollowing of the lower eye region. A tightening stitch is then placed to the outside of the eye (lateral canthus) to support the lower eyelid during recovery to decrease risk of outward turning of an eyelid margin (ectropian) and for long-term rejuvenation of the lower lid.  There are no sutures to remove.

Cold compresses are then applied at the end of the surgery. We recommend applying small sealed plastic bags of frozen peas that will nicely conform to the eye region. This should be applied for 10-15 minutes as needed.  You will be asked to apply a thin film of polysporin to the incisions and to clean the incision daily.  There will bruising after surgery that will take 2-4 weeks to resolve. Swelling will be present which will resolve at 3-8 weeks.   Strenuous activity should be avoided for two weeks, however, walking is fine. By 4 weeks, normal activity can resume.

After surgery you may temporarily experience:

• Blurred vision from the lubricating ointment applied to your eyes
• Watering eyes
• Light sensitivity
• Double vision
• Puffy, numb eyelids
• Swelling and bruising similar to having black eyes
• Pain or discomfort

To take the next step to learn more about blepharoplasty surgery, request a consultation with Dr. Ho by calling our office at 604.273.1034 or contact us through the website to schedule an appointment. We look forward to hearing from you.