How is it Done?


Maripaz Duque, M.D.

Plastic Surgeon


  Center of Skin Laser Treatments


Puffed eyes and drooping upper lids are both clear signs of aging and tiredness, even if you are young. In some cases extreme drooping upper lids may jeopardize vision.

Many young patients have puffy bags below the eyes because congenital or familiar reasons, or in some cases because of thyroid diseases that may produce bigger fat deposits around the eyes. The only way to get rid of it, is  surgery, procedure called blepharoplasty.  It will not get rid of the wrinkles around the orbit or the dark circles around the lower lids, but by removing the upper and lower baggy skin and the fat behind it, the eye and the lid will look younger and better.

Most of the patients looking for surgery are over 50 years, for this reason the plastic surgeon should be cautious about high blood pressure, cardiac problems, hypertension and others health problems. Chest X rays, cardiac examination and routine blood test must be done before the operation.

Eye diseases as glaucoma, dry eye, retinal problems, etc. must be discussed with the surgeon, and sometimes an ophthalmologic consultation should be done before surgery. The anesthesiologist will see the patient too.

The surgery should be performed under local anesthesia with light sedation or general anesthesia, always with the anesthesiologist taking care of the patient all the time,  in  a hospital or medical center with all the technical resources ready to be used in case of any complication during surgery or after it. 


Before surgery, the surgeon makes markings on both upper and lower lids to plan the operation. 


After the anesthesiologist inserts an IV line for sedative medication, he or she will insert a plastic tube in the nostrils for the oxygen delivery during surgery. 


The surgeon will clean the skin around the eyes and the forehead, put a drop of artificial tears inside the eyes to prevent any corneal ulceration and inject the local anesthesia under the skin both upper and lower lids. The IV sedation prevents pain during this procedure. 


Beginning with the upper lid, the excess skin is removed with a surgical blade and all the bleeding points are burned with an electrical device (coagulator). 


There are two fatty deposits under the upper lid skin and muscle. The surgeon identifies them and cuts them with scissors. All the bleeding points should be carefully coagulated in order to prevent the postoperative bleeding and visual impairment.


 The skin is stitched with a non-absorbable suture. 


 After that, the lower lid skin is cut along the under eyelashes line, again the fat deposits are clear and cut and if it is necessary a small strip of skin and muscle is retired. The skin is again stitched with a non-absorbable and fine suture. 


Both skin and fat tissue removed should be compared for size and amount between left and right sides before discarding them. 


During the surgery and after it, iced gauzes are placed over the eyelids  to diminish edema and postoperative bleeding. At the end, the surgeon leaves sterile tape over the sutures and covers the lids with iced gauzes. 


Because of the sedative medication, the anesthesiologist will ask you to stay 1 or 2 hours in the recovery room, and during this period your head should be elevated with pillows and the nurse will drop artificial tears inside the eyes every hour.

At home you must remain in bed for 4 to 6 hours, with your head elevated 45 degrees from the body and the iced gauzes on for 48 to 72 hours. If the pain is bad, your surgeon will give you some pain medication.

24 hours after surgery your eyelids will be puffed and bruised. This should last for about 1 week, but you’ll note you’re getting better each day. The sutures are pulled out on the 3rd or 4th postoperative day and some kind or physiotherapy session will be scheduled.









  The final results will be evident around 2 months after surgery.
Maripaz Duque, M.D.  
Plastic Surgeon





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