Blepharoplasty – Eyelid surgery
Blepharoplasty is the surgical procedure to remove excess skin from the eyelids. With age, the skin of the eyelids loses elasticity and the muscles that support them weaken. As a result, excess skin and fat can accumulate on your upper and lower eyelids. This sagging can lead to drooping eyebrows, sagging upper eyelids, and under-eye bags. Besides the cosmetic concerns, this excess skin can reduce peripheral vision, particularly in the upper and outer parts of the visual field. Blepharoplasty can reduce or eliminate these vision problems, but more importantly, it will give your eyes and face a more youthful and alert appearance.
What is blepharoplasty?
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The term blepharoplasty refers to the operation of reshaping the eyelids in order to treat excess skin or fat.
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The operation can be performed both for aesthetic purposes to give the eyes and face a more youthful appearance, and for restorative purposes if the eyes close under the weight of the eyelids (ptosis).
Why undergo blepharoplasty?
Blepharoplasty may be indicated in cases of:
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Swollen or drooping upper eyelids.
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Excess skin on your upper eyelids, partially blocking peripheral vision.
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Excess skin on the lower eyelids.
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“Bags” under the eyes.
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Fat deposit on the skin of the eyelids (Xanthelasma)
Blepharoplasty can be performed at the same time as another procedure, such as a ptosis correction or repositioning of the eyelid margin (ectropion correction).
How much does blepharoplasty cost?
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Health insurance and mutual insurance coverage depends on whether the indication is aesthetic or functional.
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Surgery performed solely for cosmetic purposes will not be covered by social security.
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In the case of surgery for functional purposes (repairing a visual field), hospitalization costs are covered by social security and your supplemental health insurance. The surgeon's fees are covered up to €188 (sector 1), to which additional fees may apply (sector 2).
The pre-operative consultation
Before scheduling blepharoplasty, you will meet with an oculoplastic surgeon, that is, an ophthalmologist specializing in eyelids. The pre-operative consultation will focus on:
Your expectations
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A discussion about what you expect from the operation will help the surgeon to better understand your desires and to seek the best result.
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He will determine if the operation and the expected results are in line with your objectives and, if necessary, refocus your expectations on the possibilities of surgery.
A complete examination of the eyelids and eye
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This involves measuring eye movement and certain parts of the eyelids, as well as checking the ocular surface and your tear production.
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In the event of a reconstructive procedure, a visual field test will be performed. This is to prove that there is a reduction in your field of vision in order to validate reimbursement by social security.
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The examination concludes with photographs of the eyelids taken from different angles, helping to plan the operation and prove the medical indication for the operation.
Your medical history
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Your surgeon or the anesthesiologist will ask you about your previous surgical procedures.
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They may also ask you about past or present conditions such as dry eye, glaucoma, allergies, circulatory problems, thyroid problems and diabetes.
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The anesthesiologist will also ask you about your consumption of medications, vitamins, and dietary supplements.
Preparing for blepharoplasty
Your ophthalmologist or anesthesiologist will likely ask you to follow certain instructions:
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Stop taking anticoagulants and sometimes antiplatelet drugs (Aspirin, Plavix).
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Avoid taking any non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
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Stop smoking several weeks before the operation. Tobacco impairs your healing abilities.
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To free up time slots for postoperative follow-up, particularly for the removal of suture threads.
Arrange for someone to drive you to the clinic for the operation and bring you back a few hours later. Plan for someone to stay with you the first night after you return home.
The operation
Before the operation
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Blepharoplasty is performed on an outpatient basis. The surgeon will create pre-operative drawings with your participation to best tailor the operation.
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He will then numb your eyelids with lidocaine, a powerful anesthetic. You will likely feel a sensation of tightness and warmth in your eyelids at this time.
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If necessary, the anesthesiologist will administer products to help you relax.
During the operation
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For the upper eyelids – The surgeon makes an incision along the eyelid crease to conceal the scar. Excess skin, muscle, and possibly fat are removed. The incision is then closed with non-absorbable sutures.
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For the lower eyelids – The surgeon makes an incision just below the eyelashes, in the natural crease of the eyelid. He then removes excess fat, muscle, and loose skin before closing the incision.
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If your upper eyelid droops near your pupil, your surgeon may perform a blepharoplasty combined with a ptosis correction. The operation aims to tighten the levator palpebrae superioris muscle if its function is impaired.
After the operation
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After the procedure, you will spend a few minutes under observation in the recovery room to monitor your reaction to the anesthetic products.
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You will be able to return home 1 to 2 hours after the procedure.
Post-operative care and convalescence
After the operation, you may temporarily present:
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Blurred or double vision due to the lubricating ointment applied to your eyes.
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A tear.
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Sensitivity to light.
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Swollen and numb eyelids.
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Swelling and bruising resembling "black eyes".
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Pain or discomfort is rare.
Risks and complications
All surgery carries risks, including reactions to anesthesia. The risks and complications specific to eyelid surgery are as follows:
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Infection and bleeding of the sutures and skin.
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Dryness and irritation of the eyes.
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Difficulty closing the eyes (lagophthalmos)
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Visible or inflamed scars.
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Injury to the eye muscles.
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Abnormal scarring and skin discoloration.
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Skin retraction, and consequently of the eyelids, particularly the lower ones.
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Revision surgery is necessary.
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In exceptional cases, bleeding with orbital compression and loss of vision.
Frequently Asked Questions
How much does blepharoplasty cost?
Blepharoplasty can be performed for functional or aesthetic purposes. Reimbursement will depend on the indication:
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Functional blepharoplasty – Hospitalization costs are reimbursed by social security and your supplemental health insurance. The surgeon's fees are covered up to €188 (sector 1), to which additional fees may be added (sector 2).
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Cosmetic blepharoplasty – You are responsible for the clinic, anesthesiologist, and surgeon fees. Estimates range from €2,000 to €4,000 depending on the surgeon and facility.
What creams should I apply after blepharoplasty?
The creams to be applied vary depending on the postoperative period.
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During the first week, an antibiotic and anti-inflammatory ointment should be applied to a fresh scar.
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Once the stitches have been removed, in order to soften and erase the scar, a moisturizing cream can be applied every evening by gently massaging the eyelids (such as Topialyse® or Ilast®).
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In the year following the procedure, sun protection (total sunblock) must be applied if you expose yourself to the sun without protective glasses or a visor.
How to massage the eyelids after blepharoplasty?
- During the week following the procedure, gently massage your eyelids in the direction of the scar to avoid the risk of dislodging it.
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Next, you can freely massage the eyelid with your fingertip using gentle circular motions.