There are several approaches to eyelid surgery which is also called blepharoplasty. One method removes excess skin from either the upper or lower lid as well as the underlying fat pad when indicated. The surgeon makes an incision along the crease in the eyelid, peels back the skin and punctures the underlying tissue to remove the fat pad. The pad is then cauterized (heat sealed). Loose skin is removed from the exterior, if necessary, and the incision is sutured. The procedure takes about two hours and can be performed with local anesthesia on an outpatient basis.
The second type of blepharoplasty procedure may benefit patients with protruding fat under the eye and not too much extra skin. This surgery is performed by entering just inside the lining of the lower eyelids. This approach eliminates the visible scar but does not remove excess skin.
The third type of blepharoplasty may be performed with a laser instrument. The intense energy produced by the laser causes blood to coagulate, which may diminish bleeding and swelling during and after the operation. This is a relatively new approach that is gaining widespread acceptance.