Eylid surgery can be both a functional or cosmetic surgical procedure intended to reshape the upper eyelid or lower eyelid by the removal and/or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons. When an advanced amount of upper eyelid skin is present, the skin may hang over the eyelashes and cause a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision. Patients with a lesser amount of excess skin may have a similar procedure performed for cosmetic reasons. Lower eyelid surgery is almost always done for cosmetic reasons, to improve eyelid "bags" and reduce the wrinkling of skin.
Eylid surgery is performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid. Initial swelling and bruising take one to two weeks to resolve but at least several months are needed until the final result becomes stable. Depending upon the scope of the procedure, the operation can take up to three hours.
The anatomy of the upper/lower eyelids, patients' skin quality, patients' age, and the adjacent bony and soft tissue all affect the cosmetic and functional outcomes after blepharoplasty. Factors which are known to cause complications after surgery include failure to recognize factors such as
- preexisting dry eyes - which may become exacerbated by disrupting the natural tear film
- loosness of the lower lid margin (edge) - which predisposes to lower lid malposition
- prominence of the eye in relation to the cheek complex - which predisposes to lower lid malposition
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