A surgical procedure that removes excess skin and fat tissue from the upper or lower eyelid and functionally corrects advanced lid sagging that restricts the visual field.
Indication
- Visual field restriction due to advanced upper-lid sagging (documented by visual field testing)
- Downward turning of the lashes due to dermatochalasis (excess upper-lid skin)
- Chronic forehead muscle contraction and headache from upper-lid weight
- Chronic conjunctivitis from lid margin friction
- Excess fat and skin after thyroid eye disease (Graves orbitopathy)
- Post-traumatic lid reconstruction
- Excess skin associated with congenital ptosis
Preparation
- Ophthalmologic examination and visual field test (for the upper lid)
- Schirmer test to evaluate tear adequacy
- Smoking should be stopped 2 weeks before the procedure
- Blood-thinner medications are discontinued under physician approval
- Makeup and contact lenses are removed before the procedure
How it's performed
- Performed under local anesthesia (with sedation) or short general anesthesia
- Incision is made along the natural crease of the upper lid or just below the lashes of the lower lid
- Excess skin, muscle, and fat tissue when needed are removed
- In thyroid eye disease or with a transconjunctival approach, access may be made from the inner surface
- The skin is closed with very fine absorbable sutures
- The procedure ends with cold compress application
Post-procedure
- Same-day discharge
- Cold compresses and head elevation for the first 48 hours
- Suture removal at 5-7 days
- Swelling and bruising subside within 7-14 days
- Sunglasses and sun protection for 4-6 weeks
- Sports and heavy activity may resume after 3-4 weeks
Risks
- Temporary dry eye (especially in those with pre-existing dryness)
- Temporary double vision or blurred vision
- Lagophthalmos (incomplete lid closure) — usually temporary
- Asymmetry and need for revision
- Hematoma, infection (rare)
- Very rare retrobulbar hematoma (requires emergency intervention)
FAQ
Is blepharoplasty covered by insurance?
When upper-lid sagging causing visual restriction is documented by a visual field test, it may be covered depending on the payer's criteria. The decision rests entirely with the payer's evaluation.
Are ptosis (lid drooping) and blepharoplasty the same thing?
No. Blepharoplasty addresses excess lid skin and fat; ptosis is a loss of function of the muscle that elevates the lid and requires a different surgery. The two conditions can occur together.
When can I wear contact lenses again?
Generally 2-3 weeks later, with physician approval. Glasses are preferred during recovery.
When can I return to work?
Returning to desk work after 7-10 days is generally appropriate; for public-facing roles, 2-3 weeks may be required.
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