Blepharoplasty is performed for functional reasons if excess skin in the upper eyelids causes the eyelids to droop to such an extent that the visual field is restricted. The decision to operate depends on the height of the eye socket and the location of the margins of the upper eyelid and the skinfold.
The operation cannot be performed in public health care if the indication for surgery is purely cosmetic. Before the operation, the suitability of the type and technique of surgery will be assessed. If there is excess skin in the upper eyelid also because the eyebrows or the forehead have descended, eyebrow or forehead lifting may also be needed.
The operation is performed under local anaesthesia and involves removing excess skin from the upper eyelids. At the same time, any bulging fat will be reduced by cauterizing or, more rarely, by moderate surgical reduction. Descended eyebrows will be corrected during the same procedure if this is a principal reason for the excess upper eyelid skin.
After monitoring, you will be discharged from hospital. Application of cold or cool compresses will be started immediately after the procedure to reduce bruising and swelling. This should be continued at home with application of the compresses as frequently as possible during the first day and for 15 to 20 minutes of every waking hour during the first three days.
Physical exertion and bending down (e.g. to put your shoes on sitting on a couch) are absolutely forbidden during the first three days. You should sleep with your head slightly raised (using a couple of pillows).
Skin sensation may at first be reduced on the upper eyelid skin or eyelash margin. This usually resolves within 3 to 12 months. Any tendency to dry eye symptoms may be increased during recovery. You can use moistening eye drops to treat this.
Scar reactions vary individually, and it may take several months for scars to become lighter. You can use silicone gel to soften the scar, as necessary. However, eyelid wounds normally heal very quickly, within a few weeks, and scars disappear in the lid crease.
Surgical wounds in eyelids are closed with removable intracutaneous stitches with tape attached at the ends. It is common for the wounds to ooze bloody tissue fluid during the first couple of days. You can rinse/shower the wounds carefully with lukewarm water 24 hours after the operation. Dry the tapes lightly with a towel. You will need to use a protective antibiotic eye ointment for 3 to 5 days.
The stitches will be removed after one week, in outpatient care, and the new narrow tapes then placed can be removed 1.5 to 2 weeks after the operation. Bruising will persist for 1 to 2 weeks. You can start carefully applying some makeup on your upper eyelids 1.5 to 2 weeks after the operation. You can go to the sauna or swimming after 2 weeks.
Ordinary analgesics will be sufficient to treat the pain.
When to seek medical advice
Contact one of the following if
- there is profuse bleeding from the wound or swelling, particularly if only on one side
- there is increasing pain, heat, redness or swelling of the wound, particularly if only on one side
- there is purulent discharge from the wound
- you have had fever exceeding 38 degrees Celsius for 24 hours
- your visual acuity is becoming worse, particularly if only on one side
- Day Surgery Unit
- Surgical Outpatient Clinic
- At other times, Accident & Emergency Clinic
- or your own health centre.