Eyelid surgery, or blepharoplasty, is a surgical procedure that improves the appearance of the upper lids, lower lids or both. It can improve the appearance and function of the skin and tissue surrounding your eyes. It can reduce excess skin of the upper lids which restores a youthful appearance. Sometimes the extra skin is so significant that it can impair your vision. Occasionally we contour excess fat of the upper lids to give an improved appearance. In the lower lids, excess skin and fine wrinkles can also be removed.
Cause of Excess Upper Lid Skin (Dermatochalasis)
Excess upper lid skin can have a number of causes. It is due to a loss in the elasticity of skin and connective tissue of the upper lids. It is usually familial and gets worse as we age. There are some systemic diseases that may also predisposes people to develop excess upper lid skin.
How Does Dr. Evans Perform Eyelid Surgery (blepharoplasty)?
It really depends on what needs to be done. During your consultation, board-certified plastic surgeon Robin Evans, MD will assess your skin and subcutaneous tissue to determine the operation that’s best for you. Upper eyelid surgery incisions tend to be very well hidden in the natural crease of the lids. We will walk you through getting the best scar and result possible.
Am I a Good Candidate for Eyelid Surgery?
You can improve your outcome if you have a healthy lifestyle. This includes regular exercise and healthy eating habits. The ideal candidate also does not smoke and does not have an eye condition such as dry eyes. Having a positive outlook and clear, specific goals in mind also helps.
Does Dr. Evans do the Surgery in the Office or the Operating Room?
It really depends on what needs to be done. Typically upper lid surgery is done in the office under freezing. However, lower lid surgery is often done in the operating room to reduce risks.
Is the Procedure Covered by Government Insurance (MSP in BC)?
The medical services plan (MSP) in British Columbia has very clear criteria on who is eligible for upper eyelid surgery to improve peripheral vision. It is important to remember that if your operation is covered by MSP, it is a functional operation first. The goal of an MSP covered operation is to improve your peripheral vision. MSP does not cover cosmetic surgery. A cosmetic procedure has the goal of improving your appearance first. Lower eyelid rejuvenation surgery for appearance is not covered by MSP.
Sometimes a dropping in the position of the eyebrows makes the excess eyelid skin worse. Dr. Evans will ensure that we are treating the problem and come up with a comprehensive plan for you, which may involve the addition of a brow lift.
What Are the Risks of Eyelid Surgery?
There are risks that are specific to eyelid surgery. In your consultation Dr. Evans will discuss the specific risks with you. In the upper lids, the incisions tend to heal very well but there is always a risk of poor healing or scarring. Eyelids are never perfectly symmetric and there can be asymmetries in the postoperative result as well. In the upper lid surgery, incomplete closure is also theoretically possible.
In the lower lids, there is always a risk of scarring to the lower lids that makes it turn over (ectropion). In order to reduce this risk, Dr. Evans performs a pinch technique and often performs the procedure in the operating room to reduce risk and improve outcomes.
What is Recovery like After Eyelid Surgery?
Typically 3 weeks. Initially patients feel swollen and bruised. The swelling is the worst on the third day after the operation. Using ice packs does help with the swelling in the first few days. The operation is typically not very painful and Tylenol/Advil is usually all that is required. Although meticulous technique is used, bruising can still occur in some people. The bruising typically takes 3 weeks to resolve. Scars tend to be a little red for four months, this is normal scar maturation. Makeup can be worn to reduce the appearance during the scar maturation phase.