Focusing on eyelid surgery: What you need to know

Over the years, eyelids can start to sag. Not only can they make a person look older, but they may feel very heavy. If you are experiencing droopy lids, you may wonder if an elective blepharoplasty, also known as eyelid surgery, is right for you.

Several changes occur in our eyelids as we age. By your late 30s or early 40s, the thin skin of our eyelids starts to lose its elasticity and begins to stretch, resulting in excess folds of skin that may actually hang down over the edge of the upper eyelids. In most people, this skin is the "first to go." You may feel an extra heaviness in the upper lid or feel the skin sitting on your lashes. In some cases, a forehead lift might also be advised to increase peripheral vision.

As we get older, the muscles beneath our skin also grow weaker, allowing fat to protrude through and cause bags, particularly in the lower eyelids. The levator muscle, which lifts the upper eyelids can become weak, causing the upper eyelid to droop. Fine wrinkle lines and creases appear in the delicate skin around the lids. The result is a tired, sleepy or sad look. These changes detract from the natural beauty of the eye area.

Aging around the eyes is to a large extent determined by heredity. Chances are, if a parent had saggy eyelids, you will, too. In 2012, eyelid surgery was the third most commonly performed cosmetic surgical procedure. In fact, the number of people who undergo blepharoplasty continues to grow each year, with an increase of four percent from 2011 to 2012. The procedure corrects drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin and muscle. It goes a long way in restoring a youthful appearance with minimal cost, risk and recovery time. In fact, many people choose blepharoplasty over a complete facelift.

These conditions are often treatable through blepharoplasty:

• Puffiness in the upper eyelids caused by excess fatty deposits
• Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
• Excess skin and fine wrinkles of the lower eyelid
• Bags under the eyes
• Droopiness of the lower eyelids

A physical examination must be conducted to determine what is causing the droopy lid. If it's a functional problem of the lid, the medical term is called a ptosis repair of the eyelid. If it's downward displacement of the brow, then the correction is to elevate the position of the brow with or without surgery of the upper lid. One must not assume that all eyelid droop can be corrected by blepharoplasty.

Good candidates for the procedure are adult men and women who have healthy facial tissue and muscles, do not smoke, and do not have a life-threatening illness or medical condition that could impact healing. The patient should have a positive outlook and realistic goals for improvement of the upper and/or lower eyelids and surrounding area.

Blepharoplasty may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital. It is a relatively low-cost procedure and recovery time is short. Under normal conditions, you should be able to return to daily activities within seven to 10 days. Initially, you may experience post eyelid surgery swelling, bruising, irritation or dry eyes and discomfort, which are controlled with medication, cold compresses and ointment.

To ensure you have both proper care and a positive experience, select your plastic surgeon carefully. Choose a plastic surgeon who is an ASPS member, which verifies their certification by The American Board of Plastic Surgery.

To find a board-certified plastic surgeon in your area, visit ASPS's Find-a-Surgeon tool.

During any consultation, ask specific, detailed questions, view several before/after photos of the surgeon's work, and obtain several referrals from past patients to inquire about their experiences. Board certified plastic surgeons will be happy to provide you with this information.