Eyelid Tuck: Upper, lower and both upper and lower

An eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the eyelids. It can be achieved with surgery to the upper lids, lower lids, or both. Eyelid surgery can address: loose or sagging skin that makes extra folds on your upper eyelids, fat deposits that make your eyelids look puffy, drooping lower eyelids, bags under the eyes, or excess skin and wrinkles of the lower eyelid.

This procedure is performed in a Kaiser Permanente procedure room with local anesthetic or in the operating suite with intravenous sedation or general anesthesia. There are different ways to do eyelid surgery and your surgeon will decide what is the best approach for you.

The incisions used for eyelid surgeries are located in the natural structures of the eyelids so scars are usually well hidden. Upper eyelid incisions are usually within the crease of the eyelid. Then excess skin can be removed, fat can be removed or repositioned, and muscles can be tightened. Lower eyelid incisions are usually just below the lower lash line. Then excess skin is removed and excess fat can be removed or repositioned. Occasionally, a transconjuctival incision is used, which is on the inside of the lower eyelid. Incisions are usually closed with sutures or skin glue.

Your Kaiser Permanente plastic surgeon will work closely with you. Be prepared to discuss your expectations and desired outcome. Make sure to address all of your questions and concerns.

Aspirin, Motrin, non-steroidal anti-inflammatory medications, and some over-the-counter herbal medications must be discontinued at least two weeks prior to surgery. These and other drugs and substances may cause excess bleeding and bruising. You can usually begin taking them again after a week or so.

If you are a smoker, it is important to quit at least four weeks prior to surgery and refrain from smoking until four weeks after surgery to ensure your wounds heal properly. Your plastic surgeon will discuss this in detail with you and you will also be given a sheet with a list of common medicines to avoid for a short period. Your plastic surgeon will detail the risks associated with surgery. Plan to have a family member or friend drive you to and from your surgery appointment and stay with you for at least one night following surgery.

Following your surgery, lubricating ointment and cold compresses may be applied to your eyes. In some cases your eyes may be covered with light gauze. It is important that your incisions are not subjected to excessive force, motion or abrasion during the time of healing. You will be given specific instructions on how to care for your incisions.

The immediate recovery will depend upon what type of anesthesia that your Kaiser Permanente plastic surgeon will employ for the surgery. Various anesthetic agents affect patients differently and will dictate the patient’s recovery. Some discomfort and pain is normal and is usually well controlled with pain medication prescribed by your doctor.

Healing generally involves some swelling, bruising and irritation, including dry eyes. Healing time is variable, but most patients experience moderate swelling and bruising that can last up to two weeks. It may take a few months before final healing is complete and can take up to a year for external scars to fully mature.