Blepharoplasty

The eyes are among the most prominent and expressive facial features. As a result, they play a big role in how awake, open, and youthful you look. Unfortunately, the delicate skin around the eyes is typically one of the first areas in the face to display signs of aging, including wrinkles and sagging. If your eyelids are drooping or you have noticeable bags under your eyes, people may think you’re older and more tired than you actually are. It can be frustrating to unintentionally convey feelings of tiredness or stress due to aging eyelids, but these changes don’t have to be permanent.

Philadelphia plastic surgeon David Bottger, MD has years of experience performing eyelid surgery to help men and women look as energetic as they feel. If you’re interested in refreshing your appearance with a safe, effective, and popular surgery, contact Dr. Bottger online or by calling (610) 708-1537 to schedule your consultation.

What Is a Blepharoplasty?

Blepharoplasty is the technical name for upper and lower eyelid surgery, also called an “eye lift” or “eyelid lift.” An upper blepharoplasty deals with sagging upper eyelids, while a lower blepharoplasty targets unwanted bags underneath the eyes. These procedures can be performed separately or together, depending on individual need. During a blepharoplasty procedure, the contours of the eyelids are smoothed and tightened by removing loose, excess skin. In addition, bulging fat is repositioned and lax musculature may also be repaired if necessary. Every patient’s treatment plan differs, but the overall goal is to restore a more alert and youthful look to the eyes.

Eyelid surgery can be a great way to rejuvenate the appearance of the eyes, often leading to a brighter look overall. This treatment option can also be combined with other procedures, such as a facelift or facial fat transfer, for more comprehensive results. To see what’s possible with blepharoplasty, we encourage you to explore our before-and-after photos to learn about the difference eyelid surgery can make.

What Concerns Can Be Treated with Eyelid Surgery?

Blepharoplasty offers many improvements to the upper face for individuals showing signs of aging , such as:

• “Hooding” of the upper eyelids, which occurs when the skin and tissue above the eyes grows lax and begins to droop into your field of vision
• Extra skin accumulating along the corners of eyes
• Sagging lower eyelids, causing a look of fatigue despite getting adequate sleep
• Dark circles and bulging under-eye bags

Though eyelid surgery can refresh the upper face with powerful results, the procedure is not designed to address concerns in the mid- or lower face. Fortunately, Dr. Bottger offers many facial plastic surgery options, such as facelift, brow lift surgery and neck liposuction, to reduce aging in the face and neck more extensively. He can talk to you about your cosmetic goals and create the most ideal treatment plan to make your desires a reality.

• Be in good overall health
• Be a non-smoker (or able to quit for a month before and after surgery)
• A positive outlook on the procedure and realistic expectations

Realistic expectations are key when undergoing any kind of plastic surgery procedure. It’s important to understand that an eye lift (or facelift, rhinoplasty, etc.) will not make you look 25 again if you are in your 40s or 50s. It also won’t make you look like someone else. The procedure simply achieves a more youthful and refreshed version of yourself.

Does Blepharoplasty Remove Wrinkles?

Blepharoplasty can remove puffiness and sagging skin, as well as improve the appearance of wrinkles in the lower lids. Wrinkles at the corner of the eyes (“crow’s feet”), however, will not be completely removed with eyelid surgery. These wrinkles can be treated effectively with BOTOX^® Cosmetic. Eyelid surgery alone also cannot address wrinkles between the eyebrows (“frown lines”) or lines on the forehead. However, when combined with a brow lift, these wrinkles can be better addressed. In many cases, BOTOX^® Cosmetic combined with eyelid surgery will provide the best results as far as wrinkles around the eyes and forehead.

How is the Blepharoplasty Procedure Performed?

According to the American Society of Plastic Surgeons (ASPS), eyelid surgery is among the top five cosmetic surgical procedures performed in the United States. Blepharoplasty is usually performed as an outpatient procedure under local anesthesia with IV sedation. In some cases, depending on the extent of surgeries performed and the overall health of the patient, it may require an overnight stay at the hospital. The length of surgery depends on the type of procedure included in your treatment plan. There are two separate types of blepharoplasty to choose from depending on your needs: upper and/or lower eyelid surgery.

Upper Blepharoplasty

Upper lid blepharoplasty treats drooping or sagging excess skin on the upper eyelids. The incision is made in the natural crease of the upper eyelid, and excess skin and fat are removed. This can alleviate eyelid “hooding” for individuals who struggle with loose skin obstructing their line of sight. Upper eyelid surgery can also restore a smoother, more youthful contour in the upper lids to provide you with a brighter, more approachable appearance.

Lower Blepharoplasty

Lower lid blepharoplasty is designed to treat wrinkled, sagging skin in addition to prominent bags under the eyes. Herniated (or bulging) fat creating a baggy appearance can be repositioned or removed, leaving a smoother and more rested look. This can also adjunctively improve dark circles underneath the eyes. One form of lower eyelid surgery, known as “transconjunctival blepharoplasty,” uses an incision inside the lower eyelid, while the standard procedure involves an incision just below the lash line.

Dr. Bottger will advise you on which procedure would be best for your individual case. In all blepharoplasty surgeries, the incisions are well concealed within the natural anatomy of the eyelid region.

What Can I Expect From Recovery After Blepharoplasty?

It is important to remember that immediately following your surgery, you may experience significant bruising and swelling. There may also be some red discoloration around your eyes. This is temporary, and should fade over time. Don’t worry if you see color changes around your eyes – this is a perfectly natural part of the healing process. Typically, the red color fades to purple then to yellow before disappearing.
Remember also that all people heal at different rates. Skin type and lifestyle factors such as smoking will impact your rate of healing.

The initial healing process following an upper or lower blepharoplasty involves some swelling, bruising, and possible eye irritation. During this time, you should follow all of Dr. Bottger’s post-surgery instructions to make sure that the healing process goes smoothly. In general, you should try to keep your head elevated and use cold compresses to help with swelling. Eye ointment, saline drops, and pain medications also help with discomfort during recovery.

Most patients can return to light normal activities within a few days of surgery. Most swelling and bruising should resolve within two weeks, and you can use makeup to conceal any visible scars during this time. Contact lenses can be worn after ten to fourteen days.

Will I Have Visible Scars After Blepharoplasty?

All surgical procedures involve some amount of scarring. However, when performed by an experienced plastic surgeon, scars from a blepharoplasty are usually minimal and heal very well. Proper placement of the incisions is crucial to minimizing scar visibility after eyelid surgery, so be sure to visit a board-certified plastic surgeon for your procedure.

What are the Possible Risks of Eyelid Surgery?

You may be at an increased risk for complications if you have any of the following conditions, and should talk to Dr. Bottger about whether or not you are a candidate:

• Hyperthyroidism
• Dry eye syndrome
• Problems with tear ducts
• Graves’ disease
• Hypertension
• Diabetes
• Cardiovascular disease
• Glaucoma
• Detached retina

Potential complications following eye lift surgery can include unfavorable scarring, infection, bleeding or hematoma, pulling down of the lower eyelid (ectropion), or difficulty closing the upper eyelid. Dr. Bottger will discuss these complications and their likelihood of occurring with you during your consultation.

How Long Do Blepharoplasty Results Last?

In general, results from a blepharoplasty are very long-lasting, and most people do not require additional procedures. Fat removed does not grow back, nor does excess skin. However, having eyelid surgery performed does not stop the natural aging process from occurring. Over time, it is possible that new sagging and wrinkling can occur. As long as you take good care of your skin, the chances of needing a second blepharoplasty are slim. Factors that can impact the longevity of blepharoplasty results can include:

• The extent of the procedure performed
• Your natural skin condition
• Lifestyle
• Environment

How Much Does Blepharoplasty Cost?

The cost of a blepharoplasty procedure varies depending on whether you’re having upper eyelid surgery, lower eyelid surgery, or both. In addition, if you combine your blepharoplasty procedure with another surgery — such as facelift or brow lift surgery — this will also affect the price.

The skill and experience of your plastic surgeon also plays a role in eyelid surgery costs. While it might be tempting to “shop around” for the lowest-priced plastic surgeon, your risk of complications increases and the chances of obtaining a great result goes down if you don’t do your research and choose an experienced, board-certified plastic surgeon. Dr. Bottger offers plastic surgery financing plans for patients considering eyelid surgery. If you are worried about the cost, ask about options for financing. We want to make it as easy as possible for you to look and feel your best.

Are There Alternatives to Blepharoplasty?

Blepharoplasty primarily addresses drooping skin in the upper and lower eyelids, but the procedure does not treat the brow region. The brow and eyelids typically age simultaneously, meaning signs of aging present in one area are likely to be found in the other. If you’re often perceived as tired, angry, or stressed due to drooping eyebrows rather than sagging eyelids, a brow lift may be a more optimal procedure for your needs. Brow lift surgery can restore the eyebrows to their normal positioning as well as repair any lax musculature causing the brow to droop. Excess skin can also be removed to smooth frown lines and further achieve a more rested appearance.

Since the brow and eyelids age in tandem, patients commonly opt to undergo more comprehensive rejuvenation of the upper face with a dual treatment plan. This approach helps ensure a more harmonious improvement in the face and can yield the benefits of both procedures during one surgery and recovery period.

How is Blepharoplasty for Men Performed?

Eyelid surgery is considered one of the most popular procedures among male patients who desire a more vital and energetic appearance. Whether due to stress, poor skin health, or lack of sleep, many men find their eyes eventually begin to look aged through some combination of drooping skin, wrinkles, frown lines, or protruding eye bags. Blepharoplasty can be an excellent technique to reclaim a brighter, more confident, and more vibrant expression with little to no evidence of cosmetic surgery. Dr. Bottger is very diligent in making the eyes appear more rested and youthful while still maintaining a masculine aesthetic. If you wish to refresh your eyes as a result of increased tissue laxity in the upper face, Dr. Bottger would be happy to discuss possible techniques that can achieve the appearance you desire in a consultation.

If you are in the Philadelphia area and considering having upper or lower eyelid surgery, contact Dr. David Bottger at (610) 708-1537 to schedule your initial consultation today. Dr. Bottger is board-certified by the American Board of Plastic Surgery, and is a member of prominent professional societies, such as the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. We serve patients in Philadelphia, Newtown Square, and other nearby areas of Pennsylvania.