Blepharoplasty is eyelid surgery that removes fat, excess skin, and muscle from the upper and lower eyelids. The goal of eyelid surgery is to reduce the “baggy” or sagging tissues that often occur because of the aging process. The condition is hereditary and may develop earlier in life if it runs in the family. Although most eyelid surgery is done for cosmetic reasons, the procedure may also be done to correct functional problems such as impaired field of vision and difficulty in wearing glasses. Ophthalmic plastic and reconstructive surgeons perform the surgery, and it is usually an outpatient procedure performed under local anesthesia.

Preparation for the Exam

If you are a potential candidate for eyelid surgery, your regular eye doctor will probably refer you to an ophthalmic plastic surgeon. You will be required to provide your address and telephone numbers, insurance information, names of other doctors, a list of medications being taken, and past medical history. The plastic surgeon will also want to see medical records from your eye doctor. If you wear glasses or contact lenses, bring them to the appointment.

Keep in mind that insurance does not generally cover eyelid surgery unless you can prove that drooping upper lids interfere with your vision. It is your responsibility to check with your insurance carrier on the degree of coverage.

The Examination

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. For this reason, the doctor will spend some time talking to you about eyelid surgery, how it works, what the risks are, and what you should expect. Factors to be weighed include age, skin type, ethnic background, and degree of vision obstruction.

A few medical conditions make blepharoplasty more risky and, if you have any of these conditions, the doctor may run additional tests to determine whether or not those problems could increase the risk of surgery. Some of these conditions are thyroid problems such as Graves disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease and diabetes. A detached retina or glaucoma may also preclude eyelid surgery.

The doctor will examine your vision, assess tear production and do other tests as necessary to determine the overall suitability of your eyes for eyelid surgery. Upon completion of the exam, and if you are a good candidate for the procedure, the surgeon may discuss with you any additional, complementary surgery that could increase the success of the procedure. For instance, the doctor may recommend a simultaneous forehead lift to correct drooping brow, or skin resurfacing to remove the fine line wrinkling in the eye area. Eyelid surgery alone will not remove crow’s feet or other wrinkles, eliminate dark circles under the eyes or lift sagging eyebrows.

After you and your surgeon come to a mutual decision about eyelid surgery, you will discuss the technique indicated for you. The type of anesthesia, the surgical facility, any supportive surgery, and the risks and costs inherent in the procedure will be outlined.


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