The eyelids are one of the first areas to show dramatic aging. The skin begins to sag, muscles start to weaken, and skin tissue droops around the eyes. Shadowy hollows appear below the eyes, while bags and excess fat appear more prominent. Loss of elasticity in the upper eyelid causes the lid to descend downward and rest on the eyelashes, negatively effecting appearance and vision.
In the upper eyelids, for an upper eyelid lift, a hidden incision is made in the natural crease of the eyelid and the excess skin and muscle is removed. Any excess fatty tissue is also removed at the same time, and sutures are used to gently close the incision.
In the lower eyelids, for a lower eyelid lift, if puffiness is the only problem without much excess skin, an incision can be made inside the lower eyelid to remove or reposition the bulging fatty pads. This avoids the traditional skin incision and is called transconjunctival blepharoplasty (internal incision). If, however, there is significant excess skin in addition to puffiness on the lower eyelid, the traditional incision just below the eyelashes is used to allow for removal of that excess skin and is called external blepharoplasty (slightly visible external incision).
Most patients are back to their normal routine within a few days, although complete recovery may take 2 to 3 weeks. Swelling, bruising, and some discomfort are part of the recovery process and can usually be alleviated with cold compresses and a mild pain reliever.