Eyelid Surgery

Some medical conditions make eyelid surgery more risky. They include thyroid problems, such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabeted. Also be careful with a detached retina or glaucoma.


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In the initial consultation, the surgeon or a nurse will test the patient's vision and the production of tears. The patient should provide any relevant information from his ophthalmologist or the latest eye exam records. If the patient wears glasses or contact lenses, these should be brought along.

The surgeon will explain the techniques and anesthesia, the type of facility where the surgery will be performed, and the risks and costs involved.

The surgeon will give specific information on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding vitamins and medications.

Eyelid surgery is usually done on an outpatient basis, It rarely requires an inpatient stay. The patient should arrange for someone to drive him home after the surgery and to help out for a few days if needed.

Eyelid surgery is usually performed under local anesthesia, which numbs the area around the eyes, along with oral or intravenous sedatives. The patient will be awake during the surgery, but insensitive to pain. However, some tugging or discomfort may be felt. Some surgeons prefer general anesthesia; in that case the patient will be asleep during the operation.

In a typical procedure, the surgeon makes incisions following the natural lines of the eyelids; in the creases of the upper lids and just below the lashes in the lower lids. The surgeon seperates the skin from underlying fatty tissue and miscle, removes excess fat and often trims sagging skin and muscle. The incisions are then closed with very fine sutures. If the patient has a pocket of fat beneath the lower eyelids but doesn't need to have any skin removed, the surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside the lower eyelid, leaving no visible scaar. It is usually performed on younger patients with thicker, more elastic skin.

After surgery the surgeon will probably lubricate the eyes with ointment and may apply a bandage. The eyelids may feel tight and sore as the anesthesia wears off, but any discomfort can be controlled with prescribed pain medication. The patient should call the surgeon immediately if any severe pain is felt.

The surgeon will instruct the patient to keep his head elevated for several days and to use cold compresses to reduce swelling and bruising. Bruising varies from person to person; it will be worst during the firt week and lasts from two weeks to a month. The surgeon or a nurse will show how to the eyes should be kept clean. The doctor may recommend eyedrops, since the eyelids may feel dry at first and the eyes may burn or itch. For the first few weeks the patient may also experience excessive tearing, sensitivity to light and temporary changes in your eyesight, such as blurry or double vision.

The stitches will be removes two days to a week after surgery. Once they're out, the swelling and discoloration around the eyes will gradually subside and the patient will start to look and feel much better.

The patient should be able to read or watch television after two or three days However, contact lenses can not be worn for about two weeks and even then they may feel uncomfortable for a while. Most people feel ready to go out in public and back to work in a week to ten days. By then, the patient is able to wear makeup to hide the bruising. The patient may still be sensitive to sunlight, wind and other irritants for several weeks, so the patient should wear sunglasses and a special sunblock when going out.

It is especially important to avoid activities that raise the blood pressure, including bending, lifting and rigorous sports. Also the patient may have to avoid alcohol, as it causes fluid retention

The scars may remain slightly for six months or more. Eventually they'll fade to a thin, nearly invisible white line. The positive results of eyelid surgery, the more alert and youthful look, will last for years and are permanent for many people.


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The minor complications that occasionally follow eyelid surgery include double or blurred vision for a few days, temporary swelling at the corner of the eyelids and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after the stitches are taken out; the surgeon can remove them easily with a very fine needle.

After surgery some patients may have difficulty closing their eyes when they sleep; in rare cases this may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.

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