By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient's field of vision. Blepharoplasty cannot be used to raise the eyebrows or reduce the appearance of wrinkles, crow's feet or dark circles under the eyes.
The procedure is performed in an outpatient surgical center with local anesthesia and lasts 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars.
Stitches are removed after three or four days and most people return to work in ten. Contact lenses may not be worn for two weeks. Eyes can be sensitive to light and wind and may be slightly irritated for a short while; your surgeon may prescribe eye drops and cool compresses to counteract these discomforts.
Botulinum toxin, sold under the brand name BOTOX® Cosmetic, is a synthetic chemical that can be used to block nerve signals for treatment of a wide range of conditions. Although most commonly known for its cosmetic applications, BOTOX Cosmetic injections are an effective treatment for many medical conditions, including muscle spasm disorders such as blepharospasm, which results in forcible closure of the eyelids.
BOTOX Cosmetic injections are administered, with no need for anesthesia, directly into the affected muscle. The injection effectively blocks nerve signals sent to the muscle to prevent it from contracting and to reduce pain.
Patients may need anywhere from 1 to 10 injections during a single treatment session in order to successfully block nerve signals. The results of treatment are often most effective during the first 2 to 6 weeks after the injection and, according to the manufacturer, will last for up to 4 months. Results can be maintained through routine follow-up injections.