Lower blepharoplasty is a cosmetic surgery procedure done to correct eye bags and weakened skin under the eyes formed by excess fat accumulation and dislocation that occurs with increasing age, by birth or disease resulting in

• Aged or tired appearance or
• Lesser peripheral vision.

Upper blepharoplasty is a cosmetic surgery procedure done to correct drooping upper eyelids which occur with increasing age, by birth or disease causing

• an aged or tired appearance or
• lesser peripheral vision.

Blepharoplasty is recommended in patients with drooping upper eyelids or eyebags to

• Improve appearance
• Increase peripheral vision

• Candidates who are physically and psychologically healthy and have realistic expectations from the procedure
• Candidates with droopy eyes running in the family
• Candidates without medical conditions such as
• hypothyroidism and Graves' disease
• dry eye or lack of sufficient tearing
• high blood pressure or other circulatory disorders
• cardiovascular disease
• diabetes
• A detached retina or glaucoma, in which case the surgery can be done only if approved by an ophthalmologist

Though risks of complications occur in very rare cases, they may include

• Infection and scarring
• Difficulty closing the eyes
• Dry eye syndrome, requiring the use of artificial tears to lubricate the eye
• Retrobulbar hematoma, a rare complication where a pocket of blood forms behind the eyeball
• Ectropion, a rare complication in which there is a pulling down of the lower lids. In this case, further surgery may be required.
• Double or blurred vision for a few days
• Temporary swelling at the corner of the eyelids
• A slight asymmetry in healing or scarring
• Tiny white heads appearing after the stitches are taken out which can be easily removed by the surgeon using a very fine needle

• During the initial consultation, a thorough discussion on the expectations of the patient is understood.
• The doctor will test the vision and assess the tear production.
• The patient must provide any relevant information from his ophthalmologist or the record of the most recent eye exam. The patient must also bring the glasses or contact lenses used by him.
• Photographs are taken for further comparison after procedure.
• The doctor discusses and advises on options of anaesthesia, type of facilities and cost with the patient.
• The doctor provides guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing the face.
• The patient must arrange for transportation and assistance to leave for home after the surgery.

• The patient is made to sit upright after which the surgeon marks on the skin the areas where the incisions are to be made.
• A sedative is given through an intravenous line to relax the patient.
• A local anaesthetic is injected to numb the area of before surgery.
• Incisions
  • Lower Blepharoplasty
    An incision is made just below the eyelashes of the lower eyelid from where excess tissue is removed.
  • Upper Blepharoplasty
    Incisions are made in the natural creases or folds of the upper eyelids and the extra fat tissue is removed.
• The sagging skin and muscle are trimmed after which the incision is closed using either dissolving or permanent sutures
• To remove the eye bags, incision is made inside the lower eyelid and the excess fat is removed or moved back to its original place after which the incision is closed using either dissolving or permanent sutures

The procedure takes around 1-3 hours to complete.

The surgery is mostly done on an outpatient basis except for rare complex cases where a short stay in hospital is required after surgery.

• Some swelling and discoloration around the eyes is seen.
• Eyelids may feel tight and sore as the anaesthesia wears off, which may relieved by pain medication prescribed the surgeon.
• The surgeon lubricates the eye with an ointment and may apply a bandage
• An antibiotic ointment is applied to the line of stitches for several days after surgery.
• Antibiotics are prescribed to prevent infection
• The patient is instructed to keep the head elevated for several days
• Ice-cold compresses are applied to the eyes continuously for the first day following surgery, and several times a day for the next week to reduce swelling.
• The stitches are removed a few days after surgery after which the swelling and bruising may reduce considerably

• Aspirin or alcoholic beverages must be avoided for one week
• Patients must avoid limit strenuous activities, including bending and lifting for 3 weeks
• Patients can generally return to their normal routine within 7 - 10 days
• The surgeon must be informed immediately in the event of any serious pain
• The patient may experience excessive tearing, sensitivity to light, and temporary changes in the eyesight, such as blurring or double vision in the first few weeks.  Hence the patients are instructed to wear sunglasses and a special sun block made for eyelids while outside.
• The progress is monitored through regular checkups for 1-2 weeks
• The patient will be able to read or watch television after two or three days.
• The patient may not be able to wear contact lenses for about two weeks.

The scars may remain slightly pink for six months or more after surgery after which they'll gradually fade to a thin, nearly invisible white line. The final result is a permanent youthful look for the patient.

Blepharoplasty – Eye lid surgery

Ectropion - A complication of blepharoplasty, in which the lower lid is pulled downward, exposing the surface below.

Intravenous - Through the vein

Retrobulbar hematoma - A rare complication of blepharoplasty, in which a pocket of blood forms behind the eyeball.