Eyelid surgery (which is blepharoplasty) is the surgical removal of fat from the upper and lower eyelids, along with the removal of excess skin and muscle. Blepharoplasty can correct sagging upper eyelids and bloated bags at the lower eyelids, as sagging upper eyelids and bloated bags under the eyes can make you appear older, tired, and even affect your vision. However, blepharoplasty cannot remove crow’s feet or other wrinkles, eliminate dark circles under the eyes, or lift sagging eyebrows. Upper blepharoplasty can turn your upper eyelids into double eyelids. Blepharoplasty can be performed alone or in conjunction with other plastic surgery procedures on the face, such as facial wrinkle removal or forehead wrinkle removal. If you are considering blepharoplasty, the following will be a basic introduction to the procedure, such as the timing of the procedure, how it is performed and the expected results of the procedure. However, not all questions can be answered because there are many factors that affect the outcome of blepharoplasty surgery, including patient and surgeon factors, so if you have questions that you do not understand, you can consult an experienced plastic surgeon in detail. A. Who is most suitable for blepharoplasty Blepharoplasty can improve your appearance and boost your self-confidence, but it may not achieve the ideal state you require or impress others. Therefore, it is important to carefully consider your expectations and discuss them further with your surgeon before deciding on surgery. The best candidates for blepharoplasty are those men and women who are in good health, mentally stable, and have realistic expectations. Most should be 35 years of age and older, however, those with familial drooping eyelids and bags can have them done earlier if they exist. Among the Chinese, this method can also be used for some young people with congenital single eyelids who want to become double eyelids through blepharoplasty to achieve her/his desired goal. Certain health problems can increase the risk of blepharoplasty, such as hyperthyroidism, dry eye disease, high blood pressure or other circulatory disorders, cardiovascular disease and diabetes. Patients with retinal detachment or glaucoma should also be cautious and should be further examined by an ophthalmologist prior to surgery. II. All surgery carries risks and some uncertainties If eyelid surgery is performed by a specialist plastic surgeon, complications are uncommon and usually minor. Nevertheless, the possibility of complications such as infection and anesthesia reactions still exists, so it is important to follow medical advice before and after surgery to minimize the risks. Some minor postoperative complications include blurred vision, double vision that can last for several days, temporary eyelid swelling at the corners of the eyes; minor asymmetry and postoperative scarring. Small white spots may also appear after removal of the stitches, etc., which can be easily removed by the surgeon with a fine needle. After surgery, some people may experience incomplete eyelid closure during sleep, which can last a lifetime in very few people. Another rare complication is lid ectropion, where the lower eyelid is pulled down and out. If this occurs, a second surgical treatment is required. III. Planning your surgery The first office visit is very important; the doctor needs to know your full health and check your vision. Be sure to tell your doctor if you have a history of allergies, as well as whether you normally wear glasses and how you see. Your doctor will carefully discuss with you your goals and expectations for the surgery. Whether both upper and lower eyelids will be operated on, or just one or the other; whether the skin will be removed along with the fatty tissue; and whether other procedures will be required. Your doctor will explain the specific procedure, the type of anesthesia, whether the procedure will be done on an outpatient or inpatient basis, and the associated risks and costs. If you have questions, be sure to ask your doctor, especially about your expectations and concerns regarding the results of the surgery. The doctor will tell you how to prepare for the surgery, including your diet and certain medications, smoking and facial cleansing methods. Following your doctor’s instructions carefully will make your blepharoplasty surgery go very smoothly. If possible, you should arrange for another person to take you home or stay with you in the hospital for 1-2 days after the surgery. The eyelid surgery can usually be performed under local anesthesia. You will remain awake during the procedure, but there is no pain in the area. (However, there can be some pulling or occasional discomfort). Some surgeons prefer to use general anesthesia so that you can sleep through the entire procedure. VI. Procedure Depending on the extent of the surgery, blepharoplasty usually takes between 1-3 hours. If both the upper and lower eyelids are operated on, the surgeon may do the upper lid first and the lower lid second. The classic procedure involves the surgeon making an incision along the natural crease of the eyelid, with the upper lid at the crease and the lower lid below the eyelashes, and the incision may be extended to the crow’s feet. After the incision is made, the skin is separated from the subcutaneous fat and muscle, excess fat tissue is removed, the sagging skin and muscle are trimmed, and the incision is closed with fine sutures. If there is only excess subcutaneous fat in the lower lid and no skin removal is required, then an internal eyelid incision blepharoplasty is performed, which is made on the inside of the lower lid and no scar is visible after the procedure. This procedure is usually performed on young people who have thicker and more elastic skin. VII. Postoperative care After surgery, your surgeon may cover the wound with petroleum jelly gauze and gauze. After the anesthesia wears off, you may feel tightness and pain in your eyelids, which can be controlled with pain medication. If the pain is severe, you should see your doctor immediately. Your doctor will tell you to elevate your head for a few days or apply cold compresses to reduce swelling and bruising. (The degree of bruising varies from person to person, and is heaviest in the first week after surgery and can last for 2-4 weeks). Your doctor will also teach you how to clean your eyes. Symptoms such as tearing, photophobia, and temporary loss of vision (e.g., blurred vision, double vision) may occur for the first few weeks. The surgeon will follow you closely for 1-2 weeks after the surgery. The stitches will be removed 5 – 7 days after the surgery. After the stitches are removed, the swelling and petechiae around the eyes can gradually disappear, which is going to make you look better and feel better. VIII. Return to normal You can watch TV 2 – 3 days after surgery, but you cannot wear contact lenses for 2 weeks, and even then, you may feel uncomfortable for some time. Most people can participate in general social activities (or go to work) 7 – 10 days after surgery. Depending on healing and medical advice, moderate makeup may also be worn to cover bruised spots. There may be photophobia, wind and other irritations for a few weeks, so you should wear sunglasses when you go out. Your doctor will tell you to keep your activities to a minimum for 3 – 5 days. you should avoid excessive activity for 3 weeks, especially activities that raise your blood pressure, such as bending, lifting and strenuous exercise, and you should also avoid alcohol. IX. The new you Healing is a gradual process and 6 months after surgery, the scar may be pale pink and may eventually lighten gradually to a nearly invisible white line. On the other hand, good results from blepharoplasty (a more refreshed, youthful appearance) can last for several years, and many people can keep it for a lifetime.