How Blepharoplasty Works and When to Consider It

Blepharoplasty is a minimally invasive cosmetic plastic surgery procedure that can involve only the upper eyelids, the lower eyelids, or both. It involves the removal of excess skin and fat from the eyelids. Through this procedure, it is possible to eliminate:

• wrinkles in the periocular area;
• bags under the eyes;
• eyelid ptosis (drooping of the upper eyelids).

"The eyelids can show early signs of aging, fatigue, or even metabolic disorders, as they are very delicate structures. For this reason, the orbital region is often affected by these signs even in young people," explains Dr. Marino.

Typically, those undergoing blepharoplasty are aged between 40 and 60 years old. "In some cases," notes the specialist, "an eyelid cosmetic procedure may also be requested:

• at a younger age, to address issues related to congenital or hereditary bags;
• over the age of 65, if the drooping of the upper eyelids has caused a significant reduction in the visual field."

Specifically, it may be useful in cases of:

• disorders and/or alterations of the eyelid;
• loss of firmness in the upper or lower eyelid;
• fat deposits in the eyelids;
• periocular wrinkles (like crow’s feet);
• bags under the eyes.

As mentioned, the blepharoplasty procedure can involve:

• the upper eyelids (upper blepharoplasty);
• the lower eyelids (lower blepharoplasty);
• both the upper and lower eyelids (complete blepharoplasty).

In upper blepharoplasty, after a precise preoperative marking, an incision is made along the natural crease of the upper eyelids, through which the following are performed:

• removal of excess skin;
• removal of fat pads (medial and middle) located in the upper eyelid area.

In lower blepharoplasty, on the other hand, the incision is made along the sub-ciliary edge of the lower eyelid. Through this incision:

• the three fat pads (medial, middle, and lateral) in this region are reshaped;
• excess skin and muscle are corrected.

"Finally, in complete blepharoplasty, incisions are made:

• along the natural crease of the upper eyelids;
• along the ciliary margin of the lower eyelids.

Excess upper skin and fat accumulations in the bags are removed, resulting in a rejuvenation of the gaze and the face," explains Dr. Marino.

"Since the area being treated is small and superficial, blepharoplasty procedures are performed under local anesthesia with sedation. This approach eliminates any potential discomfort associated with the infiltration of the anesthetic."

The duration of the blepharoplasty procedure ranges from 40 minutes to approximately an hour and a half, depending on the areas to be treated, and the patient can typically return home the same evening.

Blepharoplasty does not cause pain, and patients typically experience only:

• mild tightness in the eyelid area;
• slight swelling, which may last for about 4 or 5 days.

The sutures are removed 5 or 6 days after the procedure.

By the third day, it is possible to resume daily activities, and by the seventh day, work activities can also be resumed. After blepharoplasty, it is possible to be exposed to the sun; however, during the first two months, it is recommended to use a total screen protective cream and wear sunglasses to protect the area.

The results of blepharoplasty become definitive after 3 or 4 months following the procedure, once the scars have completely healed.

The procedure is safe and free of side effects, except for the possible formation of edema, which resolves within a few hours, or infections.