None — Droopy Eyelids
As we age, the skin loses some of its elasticity and begins to droop and sag. In some people, one of the areas where drooping is more pronounced is around the eyelids. The skin just above the eyes may sag, overlapping the upper eyelid. If the lower area is affected, the sagging creates small bulges under the eyes. Erik Happ, M.D., Ocular Plastic Surgeon with Allegheny General Hospital in Pittsburgh, PA, says that although droopy eyelids are most commonly associated with aging, the condition can sometimes occur in younger people, especially contact wearers or others who chronically pull and manipulate the skin around the eyes.
Droopy eyelids are often considered to be a cosmetic problem. The condition can make the eyes appear sleepy, tired or old. However, in some cases, the sagging tissue can encroach over the eye and obstruct the field of vision.
Fixing Droopy Upper Eyelids
The procedure to fix droopy eyelids is called blepharoplasty. To work on the upper eyelids, the surgeon usually makes an incision within the eye fold, running from the inside corner to just beyond the outside corner. Excess fat and skin are removed and the incision is closed with stitches. The sutures are typically absorbable, or removed after seven days.
After the surgery, a patient may have a significant amount of bruising, swelling, discomfort and sensitivity to light. Most of these symptoms ease within one to two weeks. Some risks associated with blepharoplasty include: hematoma, infection, scarring and eye dryness or irritation.
Blepharoplasty is the third most common cosmetic surgical procedure performed in the U.S. According to the American Society for Aesthetic Plastic Surgery, more than 149,940 procedures were performed in the U.S. in 2009. Women account for more than 83 percent of patients. The average cost of blepharoplasty is $2,717.
Fiber Optic Laser for Blepharoplasty
Happ says some people are reluctant to have blepharoplasty because they don't want to be seen in public with swollen, bruised eyes. Now, he uses a different surgical tool for the upper eyelids called a fiber-optic laser. The pen-type device uses a carbon dioxide (CO2) laser to make the incision. Happ says the laser is a much more precise cutting tool than a scalpel. It also seals blood vessels as it cuts, minimizing bleeding. This greatly reduces the amount of bruising and swelling. The laser energy can also be used to shrink down excess fat deposits and fine-tune the look of the upper eyelids. Patients generally have less pain during surgery, so require minimal anesthesia.
Stitches are still needed to close the incision. However, most patients have little post-operative pain. There may be blurred vision and dry eye for the first week after surgery.
If blepharoplasty is done solely for cosmetic reasons, the procedure is usually not covered by insurance. However, insurance may cover the costs if the treatment is done to correct vision problems associated with droopy eyelids. Prior to surgery, Happ performs a visual field test to document the vision problems.
For general information on eyelid surgery (blepharoplasty) or other types of cosmetic procedures:
American Academy of Cosmetic Surgery American Society for Aesthetic Plastic Surgery
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