Eyelid-lifts are usually performed on an outpatient basis. A hospital stay is not usually necessary, as long as you have someone to drive you home. Eyelid surgery can be done under local anesthesia with sedation or under general anesthesia. The procedure takes about 2 to 2 1/2 hours for both upper and lower lids.
To correct the upper eyelid, the surgeon makes an elliptical incision across the eyelid crease. Excess skin is removed, exposing the underlying muscle. A thin strip of muscle is removed to help define the eyelid crease after surgery. A small amount of fat is also removed from behind the orbital septum, the plane of connective tissue separating the superficial part of the eyelid from the eye socket. The incision is closed with a single layer of sutures.
There are at least two methods of performing lower eyelid blepharoplasty to remove bags under the eyes and tighten the lower lids. The traditional approach requires an incision just below the lower lashes, where eyeliner is normally applied. The surgeon lifts the skin and muscle to expose two fat pads and removes a small amount of fat. Excess skin and muscle are then trimmed from the lower lid, and the wound is sutured closed.
If there is protruding fat but no excess skin beneath your eyes, then an "incisionless" blepharoplasty can be done. There actually is an incision, but it is hidden inside the lower eyelid. Through this incision, the surgeon exposes and trims the fat pads. The wound is left to heal naturally because stitches would be too irritating to the eye. This technique, called the "transconjunctival blepharoplasty," has gained in popularity in recent years.
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