Blepharoplasty, or Eyelid Surgery: Myths and Facts

In almost all European countries, one of the most popular and in-demand cosmetic surgeries is blepharoplasty, that is, surgery on the eyelids (lower, upper, or both at once). The term derives from the Ancient Greek word blepharitis, which means – eyelid. Initially, blepharoplasty was performed only in cases of medical necessity, but a little later, as technology advanced, it began to be performed for cosmetic purposes as well. “The eyes are the window to the soul,” and blepharoplasty can help accentuate your natural beauty.

We asked Nonna Tomiševa and Māris Krūmiņš, practicing surgeons at the Microsurgery Center, to tell us more about blepharoplasty.

– In what cases might blepharoplasty be recommended for patients?

– The main reasons for undergoing eyelid surgery may include “bags” under the eyes, drooping eyelids, excess skin on the eyelids, “heavy eyelids” or, as they say, a “tired look,” as well as deeply etched wrinkles around the eyes.

Unfortunately, as we age—as well as due to prolonged exposure to the sun and failure to wear good sunglasses with UV protection—fine lines gradually form, and more serious problems may develop over time, because the skin around the eyes is very thin, and there is practically no fat layer in this area.

In such cases, blepharoplasty helps correct any cosmetic imperfections that have developed. Blepharoplasty is often performed in conjunction with a facelift (either a full facelift or one limited to the forehead area).

It should be noted that blepharoplasty may also be indicated for much younger patients, for example, in cases of congenital eyelid swelling.

– How is blepharoplasty performed?

– Local or general anesthesia is typically used for blepharoplasty. This depends on the complexity of the specific procedure and the patient’s health status. The procedure itself can last from 30 minutes to 1 hour. For upper eyelid surgery, the incision is made with a scalpel along the eyelid crease, while for lower eyelid surgery, it is made below the lash line. As a result, the postoperative sutures are virtually invisible.

If the skin is in good condition, blepharoplasty can be performed using the transconjunctival approach, in which the incision is made on the inside of the eyelid.

This procedure can take 20–30 minutes.

– How long does the patient need to stay in the hospital?

– Blepharoplasty is considered an outpatient procedure. Therefore, there is no need for a prolonged hospital stay. To reduce swelling and “cyanosis,” a special compression bandage is applied to the eyes for several hours immediately after surgery.

– How long does it take for a patient to recover from blepharoplasty?

– The postoperative recovery period lasts 10–14 days; during this time, you may experience increased eye sensitivity, tearing, and a “stinging” sensation in the eyes. During this time, it is not recommended to read, use a computer, or otherwise strain your eyes. You should also avoid wearing contact lenses, exercising, going to the steam room or sauna, and consuming alcohol. For a faster recovery, we recommend: emotional calm, leisurely walks in the fresh air, rest, and following all of your doctor’s recommendations.

– Are there any risks?

– Modern technologies used in blepharoplasty allow for the minimization of all risks. Before the surgery, you should consult with a doctor and undergo all necessary procedures to assess your health. Of course, you should consult with a specialized surgeon who has extensive experience performing such surgeries.

– How do you choose a surgeon or clinic? What should you look for?

– Blepharoplasty is often considered a procedure for “older” patients. That’s not the case. Many young women under the age of 30 meet all the criteria for this procedure, but due to a lack of knowledge and misconceptions, they first try various nonsurgical methods. And then, because they don’t achieve the desired results, they come to us. It’s important to understand that the main indication for surgery is not age, but rather the condition of the skin around the eyes. Wrinkles, fat deposits, drooping eyelids, sagging of the outer corners of the eyes, and eyebrow ptosis—these are all signs that surgical intervention is necessary. Blepharoplasty not only corrects these issues but also significantly rejuvenates the entire face. It is also a mistake to view blepharoplasty as a simple procedure. It is a serious surgical procedure that requires a careful, individualized approach and precise microsurgical technique, which is why the surgeon’s (microsurgeon’s) experience and high level of qualification are crucial here. If you are planning to undergo blepharoplasty, you should take the choice of clinic and surgeon as seriously as possible.

– Thank you for your advice.