Blepharoplasty — what you need to know
An experienced plastic surgeon’s viewpoint by
Dwight V. Galloway M.D.
Blepharoplasty, or plastic surgery on the eyelids, is the best operation that plastic surgeons, eye plastic surgeons or facial plastic surgeons do, dollar for dollar, pain for pain, and risk for risk. This operation takes about one hour and fifteen minutes to perform and can be done on an out patient basis under either general or local anesthesia. It works just as well on men as on women and takes about fifteen years of aging off the eyelids and makes you look about eight years younger and much less tired. Often the patient’s complaint is that friends and colleagues ask them if they are tired when they are perfectly rested. Also the “hung over” look in the morning is because of the fluid from your feet and legs goes into the fat pockets in the lower eyelids during the night and makes you have “dark circles”, which are actually just a shadow from the fat bulges. The scars are hidden in the upper eyelid fold and just below the lower lid lashes and in the crows feet wrinkles beside the eyes. Women can cover them with make up in the early stages of healing but after a few months that is not necessary. For people in the public eye, where first impressions are so important, looking tired or angry is a real problem that can be tremendously improved with a blepharoplasty. The risk to the operation is pulling down of the lower lid, called an ectropion. And makes many surgeons fearful of performing the operation, but is rare with a well trained and experienced surgeon. This is my favorite operation in plastic surgery at over 3,000 patients and 12,000 eyelids. The excess skin and fat is removed and the skin and lower lid tightened to help smooth the surface and treat the sagging from aging. Most people have enough changes in their eyelids by age forty to be candidates for elective blepharoplasty but some in their teens have hereditary fat pockets that can benefit from the surgery. Most patients wait until their mid fifties to get the surgery and miss 10 to 15 years of advantage. The 15 years aging that comes off remains off and your eyes will look like they would have at 60, when you are 75. Very often a blepharoplasty is combined with a face lift but if you are going to do only one, or in stages, young eyes on an old face look great, but the reverse looks terrible. So do the eyes first. The usual age for needing a face lift is 45 but for certain jobs that require youth, such as Hollywood actors, their surgery is done in their early thirties.