As we age, our eyelids tend to droop as the skin over the eyes loses its elasticity. Medical conditions aside from aging also can cause a drooping eyelid. Many people opt to undergo upper eyelid surgery, or blepharoplasty, when the eyelid droops enough to impair vision. Other times, people opt for upper eyelid surgery for purely cosmetic reasons. Eyelid surgery can be done under local anesthesia with twilight anesthesia also known as IV sedation, or it can be done under general anesthesia.
Knowing what to expect from upper eyelid surgery is imperative to avoid unrealistic expectations about the process, the hoped for outcome and possible complications. When upper eyelid blepharoplasty is performed, an incision is used that is designed to follow the natural crease in the upper lid. The scar will not be obvious because it is hidden in the natural folds of the lid. The muscle, fat and excess skin that are contributing to droopy lids are removed and the area is stitched closed.
Swelling and bruising will occur post-surgery. Elevate your head, and place cold compresses on the surgery site. Your doctor may recommend that you use eye lubricants and drops, which should hasten your healing time. Several days after the surgery, the stitches will be removed.
Other possibilities that you need to consider before undergoing upper eyelid surgery is the chance that significant post-operative bleeding can occur internally around the eyeball, under the skin, or both. If this happens, you may have to undergo emergency surgery or additional treatment. When blood accumulates under the eyelids, it postpones healing and may result in scarring.
There also is the possibility that your eyes will become permanently dry following the procedure, because decreased tear production can be the result of a blepharoplasty. If you already have dry eyes, think twice about undergoing a blepharoplasty. Depending on the type of blepharoplasty surgery that is done, there is the possibility that the eye muscles, blood vessels and nerves — all deep structures — can be damaged during the process. The injury may be permanent or temporary.
You may experience chronic pain following eyelid surgery, and you may notice that there is some asymmetry to your eyes, although most people normally have asymmetric facial features to some degree. Difficulty closing one’s eyes following a blepharoplasty may occur because of increased dryness in the corneal area. This also may require further treatment or more surgery.