The surgeon may operate on the upper and lower eyelids as necessary, removing excess skin as well as collections of fat under the skin that create puffiness and bagginess of the eyelids. Sometimes, the problem is aggravated by sagging of the eyebrows, and this may require correction with a brow lift (described elsewhere on this page).
Because eyelid skin is thin, you should expect some swelling and black-and-blue discoloration after surgery. Your eyes may be temporarily sensitive to light and susceptible to excess tearing or dryness. You may want to wear dark glasses for a couple of weeks to protect your eyes from wind and sun irritation and avoid eye strain from prolonged reading or television viewing. You will be able to resume wearing makeup and contact lenses shortly after your surgery. Within a few weeks, the thin surgical scars will become less visible and gradually blend into your eye's natural lines and folds.
As people age, the eyelid skin stretches, muscles weaken, and fat accumulates around the eyes, causing "bags" above and below. The surgeon closes the incisions with fine sutures, which will leave nearly invisible scars. Before surgery, the surgeon marks the incision sites, following the natural lines and creases of the upper and lower eyelids. Underlying fat, along with excess skin and muscle, can be removed during the operation. In a transconjunctival blepharoplasty, a tiny incision is made inside the lower eyelid and fat is removed with fine forceps. No skin is removed, and the incision is closed with dissolving sutures. After surgery, the upper eyelids no longer droop and the skin under the eyes is smooth and firm.