Upper Eyelid Surgery
Cosmetic upper eyelid surgery or an “eyelid lift” is one of the most commonly performed plastic surgery procedures. Cosmetic eyelid surgery is performed to help improve a tired appearance, remove sagging upper lid skin, raise droopy upper lids, and help give a more refreshed look. Every patient is different, and what one patient needs for an “eyelid lift” is usually different from another. There are many variables in upper eyelid surgery, but the most commonly addressed issues are excess skin and puffiness (blepharoplasty), and raising droopy or low lids (ptosis surgery). Each is customized to an individual patient and either blepharoplasty, ptosis repair, or both may be indicated. Oculoplastic surgeons are experts at both blepharoplasty and ptosis surgery.
Upper Blepharoplasty (Upper Eyelid Lift/ Upper Eyelid Surgery)
Blepharoplasty is what most people think of when they hear the term “eyelid lift”. Upper blepharoplasty is an eyelid surgery that can significantly improve tired or heavy appearing eyelids. Blepharoplasty usually involves removing excess skin from the upper lid by making a small incision in the upper eyelid. The incision is hidden in the upper eyelid fold and is rarely noticeable after healing. Commonly asked questions about upper blepharoplasty
Commonly asked questions about upper blepharoplasty
What type or results can I expect from upper blepharoplasty?
Upper eyelid blepharoplasty helps the eyes appear more rested and youthful. Excess skin is removed with upper eyelid surgery, which improves sagginess and wrinkling. If there is puffiness, then upper eyelid surgery can address that as well. It is easier to put make up and eyeliner on since the redundant skin no longer gets in the way. Many patients also notice an improvement in their field of vision as well.
How long does upper blepharoplasty take to perform?
Upper blepharoplasty is a relatively quick procedure. Every patient is different, but the actual surgery usually takes about 30-45 minutes. However, you likely be at the office or the facility for a few hours on the day of your eyelid surgery.
What is the recovery like from upper blepharoplasty?
Everyone is different, but usually recovery is about a week or so. Most patients have little to no pain and can return to moderate activity the next day. If non-dissolving sutures are used, then they are usually removed in 5-7 days. Mild swelling and occasional bruising are normal and typically resolve quickly. The incision is hidden in the lid fold so it is hard to notice, and fades over a few weeks.
How do I know if I need a blepharoplasty, ptosis repair, or both?
Dr Vidor will be able to determine that during your consultation. He will take precise measurements to determine the position of the eyelid skin, margin (where the eyelashes are), eyelid fold, eyebrow, and eyelid muscle function. Sometimes Dr. Vidor will also place drops in the eyes to evaluate the eyelid muscle function. During your consultation Dr. Vidor will discuss all of your options and customize a treatment plan for you.
Where is upper blepharoplasty performed and what type of anesthesia will be used?
Upper eyelid surgery can be performed either in the office or in an outpatient surgery center. During your consultation, Dr. Vidor will discuss both options and help determine which is best for you. If performed in the office, Dr. Vidor will use local anesthesia to numb your eyelids to make sure there is no pain. If patients are anxious, an oral sedative can be given as well. If performed in the operating room, eyelid surgery is typically performed under twilight anesthesia.
Does insurance cover upper blepharoplasty?
It might. Insurance may cover upper eyelid surgery if your upper eyelids block a significant amount of your upper visual field. A visual field test can be performed to determine how much of your vision is blocked. I have already had eyelid surgery at another facility but my eyes still look tired.
Do I need blepharoplasty revision?
Possibly. There are many reasons why patients can still have a tired appearance after eyelid surgery. During your consultation, Dr. Vidor will be able to determine what can be done to address these issues and tell you if you are a candidate for revision eyelid surgery.
Ptosis Repair (Ptosis Surgery/ Eyelid Muscle Surgery)
Ptosis is drooping of the eyelid, in that the eyelid margin (where the eyelashes are) is low. It may be present on one or both eyelids. Many things can cause ptosis, but cosmetic ptosis is usually due to stretching of the eyelid muscle (levator) tendon. Ptosis surgery is a type of eyelid lift that helps open the eye. Ptosis surgery can be performed from an upper eyelid incision or from an incision on the inside of the eyelid. Ptosis repair may be performed by itself, with a blepharoplasty, or in combination with other eyelid surgery.
Commonly asked questions about ptosis surgery
What results can I expect from cosmetic ptosis repair?
Ptosis repair is an eyelid lift procedure that is designed to fix a “low” or “dropped” eyelid. The procedure raises the eyelid, so that the margin of the eyelid (where the eyelashes are) is higher. It is a type of eyelid surgery that is used to help “open the eye”. Cosmetic ptosis repair is usually performed to give an extra lift to the eyelid so that eyes appear less tired and more vibrant. Cosmetic ptosis repair is often performed at the same time as blepharoplasty to help give an extra little “lift” to the eyelid.
How is cosmetic ptosis surgery performed?
In general, there are two main types of cosmetic ptosis surgery, the external and internal approach. External ptosis repair involves a small incision in the upper eyelid fold. The slipped eyelid muscle (the levator muscle) is identified and advanced or reattached to its natural position. Internal ptosis repair involves and incision on the inside of the eyelid, so there is no visible incision. The eyelid muscle tendon is then tightened from the incision underneath the eyelid. Dissolvable sutures are used for internal ptosis repair.
What is the recovery like after cosmetic ptosis repair?
Most patients have very little discomfort after cosmetic upper eyelid surgery. As with blepharoplasty, most patients can go back to light activity the next day. Depending on the approach (internal or external), and if a blepharoplasty is performed at the same time, the sutures may or may not be dissolvable. If non-dissolvable, then the sutures are usually removed in 5-7 days. Swelling and bruising are usually mild and subside fairly quickly.
How long does cosmetic ptosis surgery to perform?
Cosmetic ptosis surgery takes usually takes about 45 minutes to an hour. The actual surgical time may be longer if cosmetic ptosis repair is performed in combination with other eyelid surgery such as blepharoplasty.
Should I have an upper blepharoplasty at the same time as cosmetic ptosis repair?
Cosmetic ptosis repair is frequently performed at the same time as upper blepharoplasty or other eyelid surgery. Every patient is different and what one patient needs for eyelid surgery is often different from another. At your consultation, Dr. Vidor will evaluate you and take measurements to determine what type or combination of eyelid surgery is right for you. Where is cosmetic ptosis repair performed and what type of anesthesia is used. As with blepharoplasty, cosmetic ptosis repair can be performed either in the office or in an outpatient surgery center. Upper eyelid surgery in the office is performed under local anesthesia. If performed in the outpatient surgery center, twilight anesthesia is used in combination with local anesthesia for cosmetic ptosis repair.
Does insurance cover cosmetic ptosis repair?
Insurance will cover ptosis repair if it blocks your field of vision. A visual field test can be performed to determine if ptosis surgery is considered medically necessary or cosmetic. Insurance will usually cover ptosis surgery if the lid blocks the visual field or pupil.
I have already had eyelid surgery elsewhere and my eyelids are still low. Do I need ptosis surgery?
Maybe. Ptosis is a common reason that some patients will still have a low or droopy lid after blepharoplasty or other eyelid surgery. Sometimes, a patient will have had a blepharoplasty performed, while both ptosis surgery and a blepharoplasty may have been indicated. Dr. Vidor commonly sees this and is and has a special interest in performing revision eyelid surgery. Ptosis repair after blepharoplasty is a common type of revision eyelid surgery that Dr. Vidor performs.