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What Is an Upper Eyelid Blepharoplasty?

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Upper Eyelid Blepharoplasties Explained Getty Images

For those uninitiated with the knife and scalpel, there is simply no better time for a nip tuck than the winter. It's the perfect time to hideaway, heal, and emerge from the frosty season renewed and ready to face the world. And with every year that passes, there are new treatments and injectables that help those interested enhance their beauty and preserve their youth. One such treatment that has steadily been gaining traction over the last few years is the upper eyelid blepharoplasty. We consulted with Dr. Dara Liotta, double board-certified facial plastic and reconstructive surgeon, to get the details on what the procedure is, why it might be of interest, and more.

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What is an upper eyelid blepharoplasty?

A blepharoplasty is eyelid surgery, so an upper eyelid blepharoplasty is just that: a surgery that improves the appearance of the upper eyelid. It's generally performed when a patient has excess skin or a "puffiness" of the upper eyelid that hoods the eye, which can for example, leave less room for upper eyelid makeup. Dr. Liotta explains: "A common complaint that I hear when a patient is ready for upper eyelid blepharoplasty is that when they put on eyeliner or mascara, it gets on the skin of the upper lid. Or they have to pull up on the eyebrow to put the makeup on. This extra skin or puffiness can make the eyes look tired, or smaller." In essence, an upper eyelid blepharoplasty can help open up your eye and make you look more youthful and awake. "The goal of upper eyelid surgery is not to change the shape of the eye, but just to rejuvenate the area and make the eyes look brighter," says Dr. Liotta.

Who is a good candidate for this procedure?

Anyone who feels they have eyelid hooding or excess skin or fullness in the upper eyelid.

What are the benefits of this procedure?

According to Dr. Liotta, the goal of upper eyelid blepharoplasty is to make the eye look more open and alert, and to rejuvenate the eye area. Unlike non-surgical procedures, the results of upper eyelid blepharoplasty are permanent.

Are there any risks or contraindications to an upper eyelid blepharoplasty?

There is a risk of scarring. With this procedure, there is a small scare that is left in the crease of the eyelid, explains Dr. Liotta, but in general this incision heals very well. "Occasionally it remains a little red or slightly more pale than the surrounding skin—so if someone is looking for it, they may be able to see it." As a reminder, as would be the case with any scar on the body, it takes a full year for this incision to heal and for the scar to be permanent.

Additionally, taking too much skin or fat from around the upper eyelid can make the eye look hollow and older. This risk is called and "A-frame deformity." If too much skin is taken—which Dr. Liotta reminds only occurs in the most extreme of cases—one could have trouble closing their eyes. As such, it is crucial to seek out a surgeon with lots of experience with eyelid surgery.

What does recovery typically look like?

For 5 to 7 days after surgery, depending on the specifics of the procedure, there will be stitches in place in the upper eyelid crease. Once the stitches are removed, the incisions will most likely be red for between one to three months. It's OK to use makeup on incision lines a week after stitches are removed. "It can take 3 to 6 months to see the full results of upper eyelid blepharoplasty. The incisions and final scar is considered final after one year."

What are the post-op instructions for the upper eyelid surgery?

  1. There will be blue stitches in the eyelid crease that will be removed 5 days after surgery. Burning sensation is normal for the first 24-48 hours. If you have acute pain, notify the doctor immediately.

  2. Sleep with the head of your bed elevated (two pillows) to reduce pressure on the face and reduce swelling.

  3. Crushed ice in ziplock bags or frozen peas may be applied for the first 48 hours after surgery.

  4. You will use antibiotic ointment on the eyelid incision twice per day until your stitches are removed.

  5. You can wash your face and get the stitches and any tape that you have wet after two full days (48 hours). Just let the soap and water wash over the incisions and pat them dry.

  6. You may resume light exercise 10 days following surgery, moderate exercise in two weeks, and full exercise in three weeks.

  7. Avoid NSAIDS (Ibuprofen, Motrin, and Aspirin) for two weeks following the surgery.

Are there any procedures/treatments that one could get instead of an upper bleph for a similar impact?

"Botox can be used in the muscles around the eye to try to elevate the eyebrow and increase the upper lid space. This doesn’t directly get rid of excess skin or tissue in the upper eyelid (like surgery does), but by elevating the brow, it can help the look of the upper eyelid," explains Dr. Liotta. This is called a "Botox brow lift." In this treatment, Botox is used to relax the muscles that pull the brow down, allowing the brow to relax upward.

"The muscles that give you '11 lines', the vertical lines between the eyebrows that you see when you make a 'mean face', are called the corrugators. The corrugators are depressors of the medial (inner) part of the eyebrow. If you make a mean face and look in the mirror, you can see how the brow comes down in the inner part." Relaxing these muscles lets the inner and middle portion of the brow float upward. "The lateral depressor (muscle that pulls down the arch of the brow and outer corner of the brow) is the circular muscle that goes around the eye and that gives us crows feet when we smile. It’s called the orbicularis oculi muscle. Relaxing specific parts of this muscle allows the arch and lateral aspect of the brow to float upwards and can help give you more upper eyelid space," she explains.

Results vary based on patient anatomy, and the results are definitely not as dramatic as surgery, and are obviously not permanent.

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