Eyelid Surgery questions

Upper blepharoplasty removes excess skin and some fat through the crease of the upper lid. Lower blepharoplasty treats bags and lower lid skin through an incision below the lashes or inside the lid.[1][2]

It treats lower lid fat through an incision on the inside of the lid, 4 to 6 mm below the margin, with no skin removed. It was described in 1924 and popularized in the 1990s.[1][2][3]

Both are done. Removing fat can leave a hollow lid, so surgeons often move the fat over the orbital rim into the tear trough. In 232 patients this eliminated the tear trough in more than 85%.[1][2][3]

Not if the lid muscle has stretched. That is ptosis, which needs a levator advancement or Muller muscle resection, often in the same operation.[1][2][3]

A heavy upper lid can come from a low brow. After upper blepharoplasty alone, the brow dropped in 34.2% of 70 patients. A browpexy can be done through the same incision.[1][2][3]

Permanent vision loss followed about 1 in 22,000 cosmetic eyelid operations in one survey and 1 in 30,000 in another. Most bleeding starts within 3 hours, and pain or pressure are the most common symptoms.[1][2]

Dry eye symptoms were reported by 26.5% of 892 patients, and lasted beyond 2 months in 2% of another 202. A meta-analysis of 12 trials found upper blepharoplasty reduced dry eye symptoms overall.[1][2][3]

Sutures come out within a week, and most patients are presentable in 10 to 14 days. Final healing takes a few months.[1][2]

It creates an upper lid crease, which about 50% of Asians lack, by linking the lid skin to the levator. It is done through an incision or with buried sutures.[1][2]

A canthopexy tightens the outer corner of the lower lid to prevent malposition and ectropion after lower blepharoplasty. It raised the risk of chemosis in one 892-case series.[1][2][3]