Eyelid Surgery: The Eyes are the Windows to the Soul
Eyelid Surgery: Its Purpose and Ideal Candidates
It has been known for more than 40 years that an observer looking at a face spends the majority of their time analyzing the eyes, nose, and mouth. In “Eye Movements and Vision” By Alfred Yarbus ( Plenum Press, NY, 1967), saccadic eye movements were measured when subjects viewed various photographs. Due to their central role in expression, most subjects devoted the majority of their time to the eyes, mouth then noses, when assessing a face visually. The eyes are of particular importance to observers, due to their central role in expressing mood.
Eyelid surgery, also known as a blepharoplasty is a cosmetic procedure performed on the eyelids and skin above the eyes to improve the appearance of the eyelids. Eyelid surgery can treat various issues in the eye region such as loose or sagging skin, puffiness or bags under the eyes, hanging upper or lower eyelids, wrinkles in the lower eyelid and excess skin in the lower eyelids.
People who wish to improve their eyelids should consider an eyelid rejuvenation procedure if they are in good health. The surgery is best for those who don’t smoke and do not have dry eye conditions. Most patients have a general idea of which areas they would like to correct. Dr. Westreich may recommend other treatment areas on the surrounding face, such as eyebrow position or midfacial volume loss if he believes it will provide a more balanced overall result.
Eyelid surgery can help to reshape or re-open eyelids. For example, in the case of sagging skin, the upper eyelid’s contour is hidden by being partially or fully covered with a redundant fold of skin, which, in some cases can block vision. A patient suffering from upper visual field loss can improve their ability to see through an upper eye lift. When the lower eyelid hangs, it interferes with tear drainage, leading to a dry eye. This too can be corrected through blepharoplasty. The most common reason for lower eyelid surgery is to remove excess fatty deposits that lead to puffiness of the eyelids and a tired appearance.
Eyelid Surgery Recovery
The recovery time will vary from one patient to the next based on the type of condition they have. Generally, swelling and bruising will last to about 7-10 days for the lower lids and 5-7 days for the upper lids; this can often be concealed with makeup towards the end of the first week. The incision for an upper eyelid blepharoplasty usually fades completely. This can take 1-3 months to achieve. Lower eyelid incisions usually fade after one month and are typically concealed below the eyelashes or inside the eyelid itself. Swelling will fade over two weeks following both upper and lower blepharoplasty. Dry and irritated eyes can be common in the first week.
Patients can quicken their recovery by sleeping with their head elevated for at least a week, applying cold compresses within the first three days and taking prescribed medications. Squinting exercises help muscle function return more quickly, which can lead to less swelling. Light exercise such as walking may also help to speed up the recovery.
Bad vs Good Eyelid Surgery
Good surgical outcomes in eyes are, like in most other facial cosmetic surgeries, related to appropriate procedure choice and reasonable surgical conservatism. For eyelids, over-excision of skin or fat can lead to problems closing the eyelid, lower eyelid malposition, or a hollowed look to the eyes. Attractive upper and lower eyelids have a smooth but full contour to them. Lower lid tightening procedures can produce an unnatural angulation to the lower eyelid. Dr. Westreich typically prefers muscle suspension techniques for lower eyelid support over eyelid tightening procedures for this reason. In general, a balanced look to the face overall is important for achieving a harmonious surgical result.
The best candidates for eyelid surgery alone are patients with a youthful facial appearance and eyelids that are out of balance with the rest of the face. Other patients may benefit from eyelid surgery in conjunction with other facial rejuvenation procedures, such as skin treatments, botox, and fillers, face or neck lifts or midface lifts.