Eyelid lift surgery, also called blepharoplasty, is done to repair sagging or drooping upper eyelids (ptosis).

Sagging or drooping eyelids occur naturally with increasing age. However, some people are born with droopy eyelids or develop diseases (such as myasthenia gravis) that cause eyelid drooping.

An eyelid lift is usually done while you are awake. You will be given medicine to relieve anxiety. The surgeon will inject numbing medicine around the eye so you do not feel pain during the surgery.

The surgeon will make tiny cuts into the natural creases or folds of the eyelids, and then remove any loose skin and extra fat tissue. After tightening the eyelid muscles, the surgeon places stitches in the area.

Eyelid repair surgery rarely requires a hospital stay. The surgery is done in a surgeon's office or as outpatient surgery in a medical center.

An eyelid lift is needed for those who have excessive eyelid drooping that interferes with vision.

Some people have an eyelid lift to improve their appearance. This is called cosmetic or elective surgery. The eyelid lift may be done alone or with other facial surgery such as a browlift or facelift.

Eyelid surgery will not remove wrinkles around the eyes, lift sagging eyebrows, or eliminate dark circles under the eyes.

Risks of an eyelid lift may include:

• Difficulty closing the eyes while sleeping (rarely permanent)
• Double or blurred vision
• Temporary swelling of the eyelids
• Tiny whiteheads after stitches are removed
• Slow healing
• Uneven healing or scarring

Medical conditions that make blepharoplasty more risky are:

• Diabetes
• Dry eye or not enough tear production
• Heart disease or disorders of the blood vessels
• High blood pressure or other circulatory disorders
• Thyroid problems such as hypothyroidism and Graves' disease

The risks for any anesthesia include:

• Breathing problems
• Reactions to medications

The risks for any surgery include:

• Bleeding
• Infection

Scars may remain slightly pink for 6 months or more after surgery. They will fade eventually to a thin, nearly invisible white line. The more alert and youthful look usually lasts for years. These results are permanent for many people.

You can usually leave the hospital the day of surgery. Before you leave, a doctor or nurse will cover your eyes and eyelids with ointment and a bandage. Your eyelids may feel tight and sore as the numbing medicine wears off. However, the discomfort is easily controlled with pain medication.

Keep your head raised up as much as possible for several days. Place cold packs over the area to reduce swelling and bruising.

Your doctor may recommend eyedrops to reduce burning or itching.

You should be able to see well after 2 to 3 days. Do not wear contact lenses for at least 2 weeks. Keep activities to a minimum for 3 to 5 days, and avoid strenuous activities that raise the blood pressure for about 3 weeks. This includes lifting, bending, and rigorous sports.

Your doctor will remove the stitches 2 to 7 days after surgery. You will have some bruising, which may last 2 to 4 weeks. You may notice increased tears, increased sensitivity to light and wind, and temporary vision changes (such as blurring or double vision) for the first few weeks.

Bosniak S. Reconstructive upper lid blepharoplasty. Ophthalmol Clin North Am. Jun 2005; 18(2): 279-89, vi.

Hoenig JA. Comprehensive management of eyebrow and forehead ptosis. Otolaryngol Clin North Am. Oct 2005; 38(5): 947-84.