Blepharoplasty is not one particular technique, but rather a variety of techniques which may be combined for each individual.
The surgeon must consider sexual, racial, and individual differences before choosing a surgical technique.
Eyebrow position should be corrected with the blepharoplasty if needed.
Blepharoplasty may be divided into procedures for the upper and lower eyelids.
The upper eyelid procedure begins with an assessment of the amount of redundant skin. The lower incision is made through the upper eyelid crease or at the site of the new eyelid crease. In women this is about 10 mm above the eyelid margin; in males, about 6 mm. After the skin is resected, a small strip of orbicularis oculi muscle is resected. This also helps form a scar band at the site of the new upper eyelid crease. The orbital septum is then opened and orbital fat removed. It is important to obtain excellent hemostasis at this point. The wound may be closed with simple interrupted or subcuticular sutures.
Successful blepharoplasty requires good postoperative care. If general anesthetic is used, patients should emerge from anesthesia smoothly without straining. The patients head should be elevated and ice packs applied to the eyes for 48 hours. Activities should be limited in the postoperative period to prevent delayed bleeding. To prevent bleeding, aspirin and non-steroidal anti-inflammatory drugs should not be taken in the postoperative period. Artificial tears and lacrilube are used to prevent any problems with exposure. Patients should perform eyelid exercises such as squinting and lower eyelid massage after suture removal. Patients should be told that about six to eight weeks is necessary before they return to normal. Men take longer to heal than women. Women should also avoid using makeup to prevent tattooing of the incision.