When Should I Consider Eyelid Surgery?
The most common reason someone chooses to have eyelid surgery is vision impairment. As we age the skin and often the muscles develop laxity which creates a heaviness of the lids causing a reduction in vision. In this case it is usually considered a “functional blepharoplasty” or functional eyelid surgery. If the patient meets the criteria required by insurance it will usually be covered by the insurance carrier; if not it would be considered cosmetic eyelid surgery.
However, more and more people are deciding to address heavy eyelids earlier in life. Most patients say “people tell me I look tired” or “I cannot see my eye shadow when applied any longer”. It becomes an issue of looking refreshed. A blepharoplasty is a surgical procedure that can restore a youthful appearance to the eye area. The upper and/or lower eyelids are lifted and loose, or excess, skin and fatty tissue are removed from the eye lids. The procedure can be limited to the eyelids, but it may be recommended that it is combined with other procedures to improve your overall appearance. There is minimal bruising and swelling after eyelid surgery and down time is only a few days.
Functional blepharoplasty restores normalcy to an eyelid that has been altered by age, infection, degeneration or neoplasm (tumor). It can also be performed to improve vision. Functionally, the patient may complain of visual problems and eyestrain related to heavy upper eyelid tissue. The skin of the upper eyelids may rest across their eyelashes and block their vision, making them feel like they are looking through their lashes. Patients may report that they can improve their vision by elevating the flaps of skin with their fingertips.
Restoring vision is the primary goal of functional blepharoplasty. Patients undergoing functional blepharoplasty report improved vision, less eyestrain and also improved appearance. A consultation for functional blepharoplasty begins with an eye exam. Skin of the upper eyelids resting across the eyelashes is a clue that the vision may be compromised by the eyelid configuration. A visual field test will often confirm significant visual field loss. Formal visual field testing is performed both with the eyelids in a natural position and with the excess skin held off the eyelids. Most major insurance companies will pay for surgery when excess eyelid skin produces a greater than 50% loss of the superior field of vision.
Improving vision is only one of the reasons for blepharoplasty to be performed. In some cases, excess upper eyelid skin can push eyelashes into contact with the cornea and cause eye pain. Removing excess upper eyelid skin, since bacteria and debris can be trapped underneath the folds of tissue can help many people with intractable eyelid inflammation.
Functional blepharoplasty can significantly improve vision and enhance periocular (situated around the eye, as opposed to the term intraocular, which refers to within the eye) health in a wide variety of patients.
Cosmetic Blepharoplasty goals are to improve the appearance of the eyelids and the patient's overall sense of well being. The frequency of this procedure is increasing rapidly. Patients who desire cosmetic eyelid surgery often express the wish to restore a more rested and youthful appearance to their eyelids.
Cosmetically, patients may want to accentuate their eyes, improve their overall appearance, and instead of looking tired, they may want to restore a rested and youthful appearance. Female patients may report trouble putting on eye shadow, or their eyeliner becomes smeared across their upper lid.
The lower eyelid blepharoplasty is always considered cosmetic surgery. The removal of lower eyelid fat is performed through the inside of the lid and via a transconjunctival approach. This approach minimizes many of the complications seen with older blepharoplasty techniques. The transconjunctival lower eyelid blepharoplasty is probably the most common cosmetic procedure performed on men today.
After cosmetic eyelid surgery, the eyes appear more rested and vibrant. The results can be so natural that friends and co-workers will often comment on how great you look, but may not realize that surgery was performed.
