This cosmetic eye lid surgery can be done in the office or an outpatient surgery center. Some light sedation either by pills or an IV is given along with a local anesthetic. After the surgery bruising and swelling usually lasts one to two weeks. There however is little or no pain or discomfort associated with this procedure or restrictions after the surgery. Patients typically heal well without evidence of a scar.

Just like the upper eyelids, the lower eyelids can have excessive skin. There can also be puffiness under the lower eyelids giving a tired look and a cosmetically unacceptable look to the patient. This puffiness is not from fluid and can be taken away by creams or medicine. That is because the puffiness is actually fat! Normally the fat surrounds and protects the eye. In these cases it has come forward to bulge under the skin.

Droopy eyelids are a common condition that can affect either the upper or lower eyelids. It is most often seen in patients over the age of 50. There are many different causes of droopy eyelids: three of the more common ones include 1) upper eyelid dermatochalasis, 2) eyelid ptosis and 3) brow ptosis.

With excessive skin hanging over the upper eyelids the vision may be blocked either in the center or off to the side. Sometimes the excessive skin will hang over the eyelashes causing them to irritate the eye or be in the patients view. With a weakened muscle (ptosis) often the eyelid droops so much that it blocks the pupil not allowing the patient to see in the upper visual field or even straight ahead. With either excessive skin or a weakened muscle, the patient often will unconsciously lift the eyebrows in an attempt to see better. Patients will often complain that people tell them they look tired even though they are not.

Dermatochalasis is the presence of excessive eyelid skin which is almost always progressive with aging. Ptosis is weakness in the muscle that raises the eyelid. Even the lashes may hang over line sight. The droopy eyelid may appear to get worse towards the end of the day as the muscle gets weaker. Brow ptosis is a sagging of the forehead and the eyebrows which causes the eyelids to secondarily droop. Patients may have more than one cause of their lid problem.

If the droopy lids interfere with vision and a patient’s activities (like driving or reading), eye lid surgery can be performed to improve vision. Insurances do pay in certain circumstances if the procedure is primarily to improve function (not appearance). The eye lid surgery improves vision while giving them the best possible cosmetic appearance. Sometimes the patient will have a small amount of excessive skin that bothers them cosmetically. They may feel it makes them look older or more tired then they really are. For them, a cosmetic eye lid or blepharoplasty (removal of the eyelid skin or fat) can be performed. Cosmetic eye lid surgery removes excess fatty tissue and tightens aging tissue around the eyes. Insurances usually don’t pay for cosmetic eye lid surgery. Blepharoplasty is one of the top five cosmetic surgical procedures performed. The same rules about cosmetic surgery vs. surgery to improve vision (or function) generally apply no matter what procedure is needed.