Eyelid Lift Surgery (Upper Blepharoplasty)

Eyelid Lift Surgery | Definition

Eyelid lift surgery is a minimally invasive plastic surgery that effectively restores a more youthful eyelid shape by enhancing the 3-dimensional configuration of the upper eyelid. It usually involves careful resection of eyelid skin plus fixation of the eyelid crease. Fat transposition or fat grafting is complementary to upper blepharoplasty as it may enhance the operation results.

Indications for surgery

It is appropriate to perform an upper blepharoplasty when upper eyelid excess skin interferes with peripheral vision and the patient’s quality of life.  It is also indicated when skin laxity and eyelid wrinkles become a cosmetic concern for the patient.

Duration of the procedure

Upper blepharoplasty is an outpatient surgery that takes approximately one hour, although it may be longer if adjunctive procedures, such as brow fixation or fat grafting, are performed.

Pre-surgery instructions

It is important to suspend medications that may affect blood coagulation, such as aspirin and NSAIDS, at least one week before a blepharoplasty. Doing so will prevent excessive bruising after the operation. Additionally, avoid applying make-up on eyelid skin the day before the procedure.

Post-surgery care

To help with discomfort and curb swelling, patients should apply cold compresses every 2 hours during the first postoperative day. Applying ophthalmic ointment on the incisions twice a day during the first week protects the wound and helps with healing. Patients also need to abstain from exercising and lifting heavy objects for seven to ten days. If non-absorbable sutures were used, the patient will need to see the surgeon for suture removal. This appointment is typically scheduled for day six after the operation.

Description of the operation

First, a marking pen is used to mark the upper eyelid crease. The amount of skin to be removed is carefully determined using the skin pinch method. Local anesthesia is then administered to both upper eyelids. After skin prepping and draping, a skin incision is performed along the markings, and a skin flap is removed. If fat sculpting was deemed necessary, it is performed at this moment. A monopolar cautery device is utilized to create a cicatrix at the lower edge of the incision. This step is crucial to define a smooth and uniform upper eyelid crease. Lastly, the skin of both upper eyelids is closed using non-absorbable sutures. Antibiotic ointment is applied to the eyelid incisions at the end of the procedure.