DEAR MAYO CLINIC: My droopy eyelids have worsened significantly over the past few years, but I’m hesitant to have surgery to fix them. What are the risks of having an eyelid lift, and how long is the recovery?
ANSWER: Blepharoplasty, also called an eyelid lift, typically includes removing extra skin, muscle, and fat from the upper and lower eyelids. The surgery can reduce vision problems caused by excess eyelid skin and make your eyes look younger and more alert. As with any surgery, risks are involved. Recovery from the procedure can take up to one month.
As you age, your eyelids stretch, and the muscles supporting them weaken. As that happens, extra fat may gather above and below your eyelids, causing droopy upper lids and bags under your eyes. If the skin around your eyes sags significantly, it can make it harder to see, especially in the upper and outer parts of your field of vision. Eyelid surgery may be able to reduce or eliminate these problems.
Blepharoplasty is usually performed on an outpatient basis. The procedure can be performed while you are awake. You receive medication to help you relax, and medication is injected into your eyelids to numb them. During the procedure, your surgeon cuts along the creases of your eyelids to trim sagging skin and muscle and remove excess fat. After the excess tissue is removed, your surgeon joins the skin with tiny stitches.
Blepharoplasty typically takes 30 minutes to two hours. It may take longer, however, if other procedures are combined with the eyelid surgery. Even if this is the case, most people can go home the same day as the surgery.
After surgery your vision may be blurry. It typically returns to normal after two or three days. Full recovery takes about two to four weeks. During that time, you may have some bruising around your eyes. As you recover, your eyes may be more sensitive to wind and light. You may notice some double vision or blurry vision from time to time during your recovery.
The benefits of blepharoplasty often include better vision and a more youthful appearance. For some people, those results last a lifetime. For others, droopy eyelids may recur and could require additional surgery.
Long-term risks from blepharoplasty include developing dry eyes, having difficulty closing your eyes, or other eyelid problems. Rarely, the surgery can injure your eye muscles. Everyone who undergoes the procedure has scarring, but in most cases, it improves to a point that it is not noticeable. You should protect your eyelid skin from too much sun exposure, especially while the scar is healing. Improvement in the scar can continue for as long as one year after surgery.
The likelihood that you will experience problems after blepharoplasty is lower if you do not have a chronic medical condition, such as diabetes or another illness that could slow healing. Nonsmokers and people who do not have serious eye problems also tend to have better outcomes from this surgery. Smokers should quit smoking at least one month before surgery to minimize the risk of complications and improve the outcome.
Having a well-trained, experienced surgeon who is familiar with blepharoplasty also may lower your risk for problems. You can find information about surgeons in your area online at the American Academy of Ophthalmology (aao.org) or the American Society of Plastic Surgeons (plasticsurgery.org).
Once you find a surgeon who you are comfortable with, talk with him or her about your concerns, and the benefits and risks of eyelid surgery. Your surgeon can help you decide if the procedure is a good option for you. — Robert Graham, MD, Ophthalmology, Mayo Clinic, Scottsdale, Arizona
