What You Should Know about Blepharoplasty


Eyes are called the ‘window to the soul’ because it is through the eyes that we understand a person’s feelings or emotions. Our eyes play a role in facial beauty and perception of aging.  Aging is a natural phenomenon and unavoidable, and as we age, the functionality of our eyes declines. The cells undergo wear and tear over time by diet, stress, and environmental toxins. These cause changes in elasticity, texture, and skin tone of eyelid muscles.


What is blepharoplasty or eyelid surgery?

Blepharoplasty is an eyelid surgery performed to remove excess skin or orbital fat. The procedure is indicated to correct disorders that involve eyelid, orbit, and lacrimal apparatus. Blepharoplasty is also done for cosmetic purposes or facial rejuvenation. Double eyelid surgery is popularly performed in people with Asian descent to create a crease in the upper lid. People with droopy eyelids and tired eyes may also benefit from blepharoplasty.


At what age do eyelids start to drop?

child blepharoplasty

Aponeurotic ptosis or involutional ptosis is a condition where an eyelid starts to drop due to aging. This occurs when tendon-like tissues that help lift the eyelid are overstretched over time. Eyelids start to sag down when a person reaches 50 years old. However, chronic use of contact lenses or people who had eye trauma or surgery may experience an early presentation of involutional ptosis.


Is double eyelid surgery safe?

Blepharoplasty including double eyelid surgery are generally safe. The success rate of blepharoplasty is very high and the risks involved are very low.  A thorough physical examination including a detailed ophthalmic assessment is conducted before the surgery.


What can you expect from blepharoplasty?


Blepharoplasty can be performed under local, sedation, or general anesthesia depending on the patient’s health status, the extent of the surgery, and the surgeon’s preference. A typical upper blepharoplasty takes an hour while lower blepharoplasty involves a longer surgical time. A simple eyelid surgery only requires local anesthesia and can be performed in the clinic. However, a combined and more invasive surgery such as blepharoplasty with a mid-face lift or brow lift with fat repositioning is carried out under general anesthesia.


On the day of surgery, the surgical site is determined and marked preoperatively. The surgeon will perform a skin pinch test to confirm the accuracy of the preoperative markings.  A local anesthetic agent is injected superficially followed by incision of the skin using a blade or a cautery. Eyelid fats and muscles are resected to decrease heaviness on the surrounding structure. The incision is then closed using absorbable sutures and/or glue.


What are the pros and cons of blepharoplasty?

The success of blepharoplasty largely depends on the complexity of the anatomical structures of the eyelids. Whether performed to correct a deformity or to enhance look, blepharoplasty has its pros and cons.


Blepharoplasty provides a long-lasting improvement of eyelids. It is one of the most successful eyelid surgical operations where patient satisfaction is highest. It is a great way to improve vision, remove excess fats, get rid of eye puffiness, and provide a younger-looking face. The result of blepharoplasty lasts from 7 years to a lifetime. Depending on how quickly you age, repeat surgery may not be required. The scars are also hidden and virtually invisible for an aesthetic outcome.


As expected in any other surgery, people who undergo blepharoplasty experience bruising and swelling around the surgical site. Complications such as infection, wound dehiscence, hematoma, scar abnormalities, and vision loss may occur but the chance of these potential risks is very low. Patients receive proper education and support following surgery including limitation of physical activity and administration of cold compress and antibiotic treatment. Pain, redness, and swelling around the surgical site are foreseen outcomes and should go away in a few weeks. However, recovery may be longer for complex and combined surgery.


What are the after-care instructions following blepharoplasty?

sunglasses-eye surgery

After blepharoplasty or eyelid surgery, patients are advised to:

  • Protect eyes by wearing sunglasses when going outdoors. Avoid too much exposure to sunlight weeks after surgery.
  • Limit physical activity. Avoid heavy lifting, bending, strenuous activity, and sex for a period of 3 to 4 weeks or as directed by the doctor.
  • Avoid the use of contact lenses. Use eyeglasses, instead.
  • Have adequate sleep and rest. Sit upright as much as possible. Sleep with 2 to 3 pillows to alleviate swelling at the operative site.
  • Avoid driving for a few weeks due to altered vision.
  • Take a half-bath instead of a full shower until further advice by the doctor.
  • Avoid a high-salt diet after surgery. Salt retains fluid and may aggravate symptoms of swelling.
  • Contact the doctor immediately when experiencing fever, nausea, vomiting, increased pain,  prolonged bleeding, presence of discharge at the surgical site, and vision loss.


Can I prevent my eyelids from dropping?


Aging is a natural process we continue to endure as we age. We cannot stop aging but there are ways how we can slow it down and prevent our eyelids from aging prematurely.


  • Clean  face regularly and gently. Wash face after heavy perspiration.
  • Apply moisturizer. Moisturizers keep skin including the area around the eyes supple and hydrated.
  • Protect skin from overexposure to the sun. Take a mineral sunblock as it contains lesser chemicals that are irritating to eyelids.
  • Consume a well-balanced diet. Eating plenty of colorful fruits and vegetables keeps skin and eyes healthy.
  • Avoid touching eyelids oftentimes. The skin around the eyes is very thin and sensitive. Avoid touching or rubbing eyelids unnecessarily.
  • Skip smoking and alcohol. Nicotine and alcohol are very dehydrating agents and can speed up the drooping of eyelids.
  • Do facial exercise. Facial exercise such as raising eyebrows or simply, smiling can prevent eyelids from sagging.


Blepharoplasty is becoming a common cosmetic procedure in all ages to correct any ophthalmic deformity such as ptosis, to look younger, and to keep eyes in harmony with the rest of the face. Blepharoplasty plays a role in facial rejuvenation that seems to bring up confidence in people and able them to perform socially better.


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