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Blepharoplasty Surgery

Oculoplasty eye conditions

What is a blepharoplasty eye surgery ?

This is one of the most common questions that and a oculoplasty plastic surgeon or a dermatologist face. Essentially, the dictionary blepharoplasty meanining is a surgery that is performed to improve or enhance the appearance of the eyelid. This can be performed on the upper eyelid or the lower eyelid depending on the requirement of the individual.  Another common question we get asked is blepharoplasty cost in Mumbai and more on that later.  The picture above is the blepharoplasty before and after picture.

Blepharoplasty upper eyelid

In an upper eyelid blepharoplasty, the excess skin on the upper eyelid is removed surgically in a precise and aesthetic manner and the eyelid fold is re-created to give a fresh, rejuvenated and younger appearance.

Blepharoplasty lower eyelid

In a lower eyelid blepharoplasty, the under-eye bags are removed or sculpted to give a fresh, rested look to the face.

But how does one know if they need a blepharoplasty and what causes these changes on the face?

Let’s discuss this step-by-step. As we age, the upper half of our face tends to droop and sag due to the effect of gravity and the lack of support under the skin in the connective tissue. In addition, as we age, the amount of fat that is stored under our skin and subcutaneous tissue also reduces. As a result, parts of the face that once appeared full and supple - such as the eyelid or the cheek slowly appear deflated and hollow. This results in a lot of loose skin and in the area of the upper eyelid, this is typically seen as eyelid hooding or a roll of excess skin that overhangs the upper eyelid and can even hide the eyelid crease. In some cases, the amount of skin is so much that it can even affect the peripheral vision. This is something that can be seen in the late 30s, the 40s and the 50s. So, in an upper eyelid blepharoplasty, the excess amount of skin and subcutaneous tissue is measured and accurately removed.  The eyelid fold or the crease is restored and the position of the eye brow may also be pulled up slightly to give a more natural and rejuvenated look.

Now about the lower eyelid – ‘puffy eyelids’ or ‘eyelid bags’ or a loose sagging skin under the lower eyelid - all of these are some of the common conditions that we see in our clinic. Very often these patients may have been recommended a filler injection or threads or laser on the face as a remedy to get rid of these. But before deciding on a particular treatment, we must know that there can be multiple reasons why lower eyelid bags appear - the most common being age and genetics.

In most cases, people with lower eyelid bags can recollect their parents or older relatives having a similar condition. This is a genetic trait that is seen across generations.

These ‘puffy eyelids’ can often give a tired look.  A look that people call ‘swollen eyes’ or ‘drunken eyes’. And this can be extremely disturbing. The reason for these bags is the weakening of a structure called the ‘orbital septum’ in the lower eyelid. Now, the fat that generally surrounds and protects the eyeball, starts protruding through this weakened septum and bulges out. This fat that bulges underneath the skin of the lower eyelid is what gives the appearance of under-eye bags.

Very rarely they can be other reasons for the appearance of eyelid bags as well such as thyroid related problems or kidney ailments which is why it is extremely important to investigate and check if one may be suffering from any of these conditions as well before directly deciding on getting a surgery done.

Under eye hollows or dark circles - can a blepharoplasty help ?

Many times, dark circles or under-eye hollows are not seen in isolation. They are often seen along with some other signs of ageing or photo damage on the skin. In some cases, a blepharoplasty may be combined with a filler injection a few weeks after the blepharoplasty to give an ideal result. In some cases, your doctor may recommend only a filler injection in the under-eye area to improve the appearance of dark circles. There is no one single treatment that can completely solve all problems and therefore based on the appearance of the eyes, the treatment is customised.

Is blepharoplasty a painful procedure?

No. Typically blepharoplasty is a surgical procedure that is done under local anaesthesia. This means that a medicine that causes numbing and loss of pain sensation is given in the eyelid area before starting the procedure. While you may feel a slight sensation of touch or you may be able to understand that your doctor is performing a procedure the sensation of pain and pressure will not be perceived by you. In addition, sedation may also be offered which can put the patient to sleep for the duration of the procedure. After the surgery your doctor will typically prescribe some painkillers that will take care of the swelling as well as the pain.

How long is the recovery following a blepharoplasty?

Typically following a blepharoplasty, the pain and the swelling subsides within the next 2 to 3 days after surgery. However, some bruising may persist for a few more days after surgery. In the case of an upper eyelid blepharoplasty, sutures are removed typically at one week after surgery. In the case of a lower eyelid blepharoplasty there are no sutures or scars on the skin and therefore recovery can be quicker. While one can expect to resume their normal day-to-day activities and their daily routine within a week following the surgery, healing will take place over the course of the next 2 to 3 weeks. One should ideally wait for at least a month after surgery to observe the complete effect of the blepharoplasty on the face.

Are there any scars or marks on the face in a blepharoplasty ?

In the case of an upper eyelid blepharoplasty, the surgical incision is hidden under the eyelid crease or the fold of the upper eyelid. In the case of a lower eyelid typically this is performed transconjunctivally. This means that the surgery is done from the inside of the eyelid - this eliminates any scar or an incision with a blade or any mark on the skin of the eyelid. Essentially, this surgery performed through a hidden scar - through the space between the lower eyelid and the eyeball. Therefore the surgery does not leave behind a mark or a scar on the face - the result is a natural, aesthetic and scarless recovery.

Who is qualified to perform a blepharoplasty?

Usually, a blepharoplasty is performed by surgeons who have specialised training in aesthetic and cosmetic surgery. This includes oculoplastic surgeons - who are essentially eye surgeons or ophthalmologists, who have an intimate knowledge about the eyelid and the surrounding area and additionally have received extensive training in the surgical procedures of this area of the face.

Eye Solutions has some of the best oculoplasty surgeons in Mumbai.  Dr Akshay Nair and Dr Rupali Sinha.

How long does a blepharoplasty surgery last?

Typically, a blepharoplasty surgery last between 60-90 minutes. As mentioned earlier since this is done under local anaesthesia most patients describe this to be a pain free experience.

What is Blepharoplasty cost in India ?

The blepharoplasty cost in Mumbai, India varies depending on a few things.  

Experience of your eye doctor 

Usually an oculoplasty specialist performs eyelid surgeries.  However, quite a few general ophthalmologists also perform this surgery.  A specialist doctor would be more expensive than a general ophthalmologist.  The main reason for this would be because of specialized training received by the specialist.  The specialist most likely performs only eyelid surgeries and thus may perform a cleaner surgery with better results.  Even the years of practice would make a difference in the cost of blepharoplasty.

Location of your specialist

Like for any other service some cities will be more expensive than others for the same service.  Simillarly some areas within the same city would be more expensive than some other areas.  

You must also know that blepharoplasty is considerred a cosmetic surgery.  Insurance companies are not very keen to reimburse patients for cosmetic surgery.  Unless ofcourse the droopy eyelid is causing visual disturbances.

In general however the blepharoplasty cost in Mumbai, India can range from Rs 40000 - 60000 per eyelid.  We mention per eyelid because the surgery may be needed in only the upper eyelid or only the lower eyelid of each eye or both the upper and lower eyelids.

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