Blepharoplasty (Eyelid Lift)

Blepharoplasty or eyelid lift is the most common cosmetic operation that Dr. Lieberman performs. When you meet someone for the first time, you make eye contact as the eyes are a focal point for the face and invite the most attention. Unfortunately, they are one of the first areas of the face to exhibit aging. Excess skin, due to a natural decrease in laxity, can cause a droopy, bulging upper eyelid and a wrinkled, “crepe paper” appearance to the lower eye area. Genetic predisposition, sun exposure, smoking and obesity can contribute to this premature aging process as well. The end result is that you appear more tired and older than you are. You never get a second chance to make a first impression!

Who is a candidate for blepharoplasty?

The ideal candidate is someone who is in good overall health, a non-smoker and without serious eye conditions. During the consultation appointment, your doctor will discuss how much excess skin, fat and muscle can be removed or tightened and what realistically can be expected. The goal of blepharoplasty is to look rejuvenated and rested without anyone knowing what was done. A person will simply appear refreshed and naturally enhanced. The procedure will not alter an entire appearance or change the structure of the face. It also will not appreciably benefit the fine, crepe-like wrinkles on the upper or lower lids. It is impossible to tighten the skin that much without risking the ability to close the lids correctly. Often times Botox injections can reduce the appearance of the lines extending from the outside corner of the eyelid radially into the temple (commonly referred to as crow’s feet). Another issue that cannot be addressed by blepharoplasty alone is excess upper eyelid skin that is partially due to descended eyebrows. Droopy eyebrows (brow ptosis) made need to be addressed with a brow lift either alone or in conjunction with blepharoplasty.

Blepharoplasty procedure

Blepharoplasty can be performed on the upper lids or the lower lids or on both sets of lids. The procedure is done in our office under local anesthesia with sedation. There is minimal downtime and the results are quickly evident.

For the upper eyelids, your surgeon makes an incision that is hidden in the
natural crease and extends slightly beyond the outside corner to the
beginning of an existing “crow’s foot”. Through this incision, excess skin is removed and any fat herniating into the lids will be addressed. In women, your surgeon might remove a small strip of muscle to give a defined crease that facilitates makeup application. Because the incision follows the natural contour of the upper eyelid, the scar is generally inconspicuous.

Upper Lid Incision

Lower Lid Incision

The lower eyelids are approached through an incision made just below (about 2 mm) the lash line. Dr. Lieberman will excise excess skin and remove bulging fat to improve the lower eyelid contour. The amount of skin that is excised is determined at the time of the surgery by having the patient move his/her eyes to ensure proper lid closure.

Once the preoperative sedation takes effect, the procedure takes approximately 45 minutes per lid. When the surgery is complete, your surgeon will apply steri-strips (very thin surgical tape) along the incisions to support the wound and these will be in place for a week. For the 24-hour period after the procedure, it is important to apply ice to the eyes to help reduce any swelling or bruising. A bag of frozen peas or corn resting on a thin towel works nicely! Postoperative discomfort is generally minimal. Dr. Lieberman will take out some of the sutures on post-operative day 3 and the remaining ones on post-operative day 5. Once all of the sutures have been removed, it is important to apply sunscreen daily so that the scars will heal as delicately as possible.

Depending on the type of employment, most patients can return to work within 2 to 3 days, but should avoid strenuous activity for 2 weeks. No contact lens and no eye makeup for the first week. To help with any bruising or swelling, all patients will be started on Arnica and Bromelain 2 days before the procedure and will continue on them for 5 days following the surgery. Until the sutures are removed, use of lubricating eye drops as needed will help to minimize any dry, scratchy feeling.

Before Surgery

Pre-operative Planning

One eyelid done, one to go!

6 Weeks After Surgery

Before Surgery

6 Weeks After Surgery

Before Surgery

10 Weeks After Surgery

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