Ask the Expert: Eyelid Surgery [Q&A]

Dr. Angela Sturm shares her insight on frequently asked questions about eyelid surgery including what is the appropriate age to have it done and what to expect for the recovery process.

Q. Everyone in my family has heavy eyelids and I am starting to see it too. Am I too young to consider addressing this?

A. Changes in the eyelids are are genetic. Although you may notice these changes as you get older, they are primarily genetic. Therefore, there is not a specific age that people start to or “should” start thinking about this. We see patients from late 20s up to 80s that are candidates for eyelid surgery.

Q. What are the contraindications to eyelid surgery?

A. You would want to be very careful or avoid eyelid surgery all together if you have dry eyes or need eye drops on a regular basis. If you see an ophthalmologist for an ocular disease, you would want to get their evaluation and recommendations for elective eyelid surgery.

Q. What should I do before eyelid surgery?

A. We always have our patients get a full evaluation by an ophthalmologist to make sure there are not any underlying ocular findings that could become an issue for you or that would need to be addressed prior to elective surgery. Also, taking Arnica and vitamin C for about a week before surgery and a week after can help reduce bruising and swelling.

Q. Where are the incisions and are they noticeable?

A. The upper eyelid incisions are in the crease, so they are not visible most of the time. The lower eyelid incisions are immediately below the lower lashes and extend slightly past the edge of the eye and lie in a fine line, that we all have. The incisions are easily covered with makeup after the sutures are removed. Eyelid skin is very thin and heals extremely well. After a few short weeks, they are usually difficult to see.

Q. I already had upper eyelid surgery about five years ago but feel like they are heavy again. Is there a reason why this might happen?

A. This can sometimes happen if the cause of the eyelid heaviness was actually the brows instead of the eyelids. As the brows descend, the eyelid skin is moved down, like a window shade. Therefore, you would want to look at photos of you 10 or more years ago to see if your brows are lower since then. Alternatively, your surgeon may have been conservative on the amount of skin excised (which is much better than being too aggressive) and you may be able to have a small skin excision to open the eyes.

Q. What should I expect for the recovery?

A. Eyelid surgery is generally not painful. Your eyes may or may not feel “gritty” for a few days depending on the associated procedures or techniques used, but most people do not need pain medications. By the next day, most of my patients are up and doing things around the house. Since eyelid skin is so thin and delicate, everyone has some degree of swelling and bruising. The swelling starts to go down after two to three days and is usually minimal by a week. Most people have resolution of the bruising by a week, also.

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