Eyelid surgery or blepharoplasty is a rejuvenation surgery of the eyelids. This procedure aims to reduce or remove excess skin, eliminate fat pockets, diminish dark circles and erase signs of fatigue while restoring brightness to the gaze. The incision is made using a laser which acts as a scalpel and allows for cutting with minimal bleeding.

Eyelid surgery (or blepharoplasty) is common as eyelid aging typically becomes noticeable from the forties onward, sometimes earlier depending on heredity. This aging can be due to various factors and is accelerated by sun exposure, menopause, smoking or lifestyle.

Eyelid surgery/blepharoplasty can address upper eyelids, lower eyelids, or all four eyelids simultaneously. It concerns both men and women, with the ideal age for intervention depending particularly on eyelid aging factors. Its purpose is therefore to remove excess skin, eliminate fat pockets, erase signs of fatigue and restore brightness to the gaze.

Lower eyelid surgery

For lower eyelid surgery, skin appearance, excess skin, its tone as well as the presence of bags must be assessed through appropriate clinical examination. Regarding dark circles (colored skin changes forming grooves under the lower eyelids), cosmetics can camouflage the problem. The hollow of dark circles can be reduced by hyaluronic acid injection in the tear trough, correcting the hollow that accentuates the perception of hyperpigmented skin.

Under-eye bags are small fat deposits without skin alteration. They can sometimes be congenital and visible in young people (sometimes as early as 20 or 30 years old).

Lower eyelid bag surgery (via transconjunctival CO2 laser approach) is performed through the inside of the eyelid. Through a very fine incision, the fat pockets are accessed and removed with laser.

Although two techniques are currently possible, the transconjunctival incision technique is more challenging but offers advantages of no visible scars, no sutures to remove, reduced swelling and especially no alteration to the gaze. These risks may occur with the more traditional technique involving an incision along the lower lash line extending to crow’s feet. Here, the surgeon removes fat pockets, performs skin redraping and removes excess skin.

The procedure lasts about 1 hour and is performed under local anesthesia preceded by mild anxiolytics. Postoperative effects include bruising and swelling for a few days.

Regardless of technique, scars are generally invisible. The patient wears a dressing for a few hours, replaced by ice compresses to limit eyelid swelling. With the traditional technique, sutures are removed around day 4-5. After surgery, under-eye bags typically don’t reappear for about 10 years.

However, transconjunctival blepharoplasty isn’t recommended for elderly patients with loose, wrinkled skin as it doesn’t allow for resection of eyelid skin. Postoperative recovery is mainly marked by swelling and bruising whose extent and duration vary significantly between individuals. Patients should expect not to be “presentable” for about a week.

Most frequently asked questions about eyelid surgery or blepharoplasty

What is eyelid surgery or blepharoplasty?
Eyelid surgery/blepharoplasty is a rejuvenation procedure aiming to reduce/remove excess skin, eliminate fat pockets, diminish dark circles and restore brightness to the gaze.

Who is this procedure for?
For all men and women bothered by drooping upper eyelids or under-eye bags. However, congenital under-eye bags may appear earlier (20-30 years) making intervention possible before forty. Eyelid surgery has evolved significantly in recent years, offering specific techniques for different problems.

Is general anesthesia required?
For eyelid surgery, anesthesia is local with sedation. Side effects are thus minimized and patients can go home the same day.

Is preoperative examination necessary?
Yes, as with any surgery. For blepharoplasty, an ophthalmological consultation helps detect potential dry eye or other anomalies which aren’t absolute contraindications but require precautions. Blood tests complete the preoperative workup.

Are scars visible?
For upper eyelids, the scar is placed in the eyelid crease (palpebral fold), becoming nearly “invisible” within weeks (3-4 depending on patients).

For lower eyelids using the transconjunctival technique (through the inner eyelid for isolated bags with minimal skin laxity), scars are externally invisible. With the traditional technique, the scar sits just below the lash line ending with an oblique lateral line. This facial area typically heals very well, making scars imperceptible over time.

What is postoperative recovery like?
Variable swelling and bruising lasting 1-2 weeks. Sutures are removed between days 3-5. Any crusting or secretions are cleaned with cotton swabs dipped in water. Artificial tears help lubricate eyes postoperatively to prevent corneal dryness and irritation.

When can social activities resume?
Normal activities can resume within days, avoiding physically demanding jobs or sports for at least 2 weeks. There’s no significant pain after blepharoplasty, though some discomfort, mild eye irritation or slight visual disturbances may occur. For proper healing, strict UV protection is recommended for at least 3 months.

When are results visible?
Immediately next day for upper eyelid excess skin. Once swelling subsides (5-10 days) for bags. Final results, as with any surgery, should be assessed at 3 months.

PHOTOS
While treatment result photos are widely available online, their display is now prohibited by the Belgian Medical Association and law. During consultation, we’ll provide personalized visual references to evaluate potential outcomes.

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