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Eyelid Procedures

Your eyes are usually the first thing that people notice about your appearance. They are probably the most important aspect of facial attractiveness. Even with a good night’s sleep, loose skin over your eyes or fat bags under your eyes can make you look tired, sad, or older than you really are. As we go through life, even if we have taken care of ourselves, the skin around our eyes stretches and wrinkles. Fatty deposits cause the upper lids to sag while under the eye, the tissue can bulge forward and become discolored. In severe cases, vision can become partially blocked. Typically, these unwanted characteristics come with age, beginning in the late thirties and early forties, but hereditary factors can cause a much younger person to appear prematurely aged. Also, exposure to the sun, use of alcohol, smoking, and less than optimal nutrition all accelerate the signs of aging.

BlepharoplasY & Eyelid REJUVENATION 

Blepharoplasty is commonly referred to as an eyelid lift, but it’s not actually a lift. The eyelid skin is not pulled up during the procedure. Instead, excess eyelid skin is removed in order to restore the appearance of the eyelids. Fat can also be added or subtracted to the eyelids in order to improve the look and function.


Today, with numerous advances in an eyelid rejuvenation procedure called blepharoplasty, your doctor can help restore a more youthful, alert and healthy look to your eyes. Sometimes referred to as a “mini-face lift,” blepharoplasty has become one of the most popular cosmetic procedures for both men and women because of its high-level of patient satisfaction. Blepharoplasty can be performed on both the upper and lower eyelids.

The First Step 

As a rule, insurance does not cover cosmetic surgery. However, if your eyelids are encroaching upon your field of vision, the procedure may be covered as “medically necessary” surgery. Before surgery, your surgeon will evaluate the condition and health of your eyes. Specifics regarding your vision, tear production, use of contact lenses, use of medications, and personal expectations will be discussed. This information, along with other factors such as your age, skin type, and ethnic background, will allow both you and your surgeon to come to a mutual decision regarding the surgical technique, amount of surgery, and type of anesthesia to be used. Complications can occur with any surgery, however with  blepharoplasty, serious complications are rare and can usually be corrected. Be sure to ask your doctor any questions you may have regarding risks and complications before giving your consent for blepharoplasty.












During Blepharoplasty 

Blepharoplasty is generally performed using local anesthetic. You may be given a mild sedative to help you relax. Depending on the amount of tissue to be removed, you could be in the operating suite for several hours. When performed on the upper eyelids, your doctor will remove the excess skin, muscle, and fatty tissue that tend to accumulate in the inside corner of the eye, next to the nose. The incisions are made along the natural folds in the skin so that as they heal they become difficult, if not impossible, to see with the passage of time. When performed on the lower eyelids, providing there is not too much excess skin, your doctor will make the incision inside or behind the eyelid. This technique is called a transconjunctival blepharoplasty which allows the removal of fatty deposits while avoiding the need for an external incision. If there is excessive skin or muscle folds below the eye, an incision may also be made just below the base of the eyelashes. As this incision heals it should become barely visible.


After Blepharoplasty

After the procedure, you will need to have someone drive you home. Bruising and swelling are common after the surgery and usually noticeable for a week to a month after the surgery, although longer in some cases. Cold compresses and head elevation will help reduce swelling and bruising and minimize discomfort. Eye ointments and/or eye drops may be given to keep the eye moist and clean. Postoperative discomfort is usually relatively mild, although this will vary from patient to patient. Most patients require little, if any, pain medication. Your eyes may feel sticky, dry, and itchy for a week or so after the procedure. You will need to take special care in cleaning around the eyes for the first week or two. Your surgeon will give you a list of activities and environments to avoid during that time. Stitches are usually removed within five to ten days after surgery. Self-absorbing stitches will dissolve on their own. Make-up can usually be applied to camouflage bruising after the stitches are removed and a good pair of sunglasses may help you feel better when in public for a while. It is important to follow all your postoperative instructions to speed healing and reduce the risks of complications.


What to Expect

Most patients experience a marked improvement in the appearance of their eyes after blepharoplasty.  In addition to improving some patients’ vision, many patients report feeling more alert and energetic. Although the positive effects of having blepharoplasty on your appearance will be immediate, your results will not be considered final for up to a year as the healing process continues.

At Cape Fear Eye Associates, we not only provide blepharoplasty (eyelid surgery), we also provide eyelid ptosis repair, and BOTOX® cosmetic treatments to improve the appearance of the eyes and surrounding facial tissue. Oculoplastic procedures such as eyelid surgery are both cosmetic and reconstructive in nature; they not only improve the appearance of the area around the eyes, but also restore vision for people whose eyelids or tear ducts are impairing proper eye functioning. We also administer BOTOX® cosmetic to treat a number of neuro-ophthalmologic conditions, such as twitching eyelids and misaligned eyes.

Eyelid Ptosis Repair (Correction of Droopy Eyelids)

Eyelid ptosis is characterized by excessive drooping of one or both of the eyelids such that more of the eye is covered than is normal. Often, the drooping extends to the pupil, thereby interfering with vision.

Children can be born with this condition, or it may be acquired later in life. When the condition is congenital, it is usually caused by the abnormal development of muscle tissue, which may cause one of the eyes to become “lazy.” Acquired eyelid ptosis, on the other hand, occurs as the aging tissues of the eyelid loosen over time.

Both congenital and acquired eyelid ptosis can be corrected with eyelid surgery, which is used to restore vision and improve the appearance of the area around the eyes. By making a small incision in the affected eyelid, our surgeons can tighten the appropriate muscle, elevating the upper lid to a normal position that doesn’t interfere with the patient’s vision and often results in a more youthful appearance. The procedure generally requires local anesthesia in adults and general anesthesia in children.

BOTOX® Cosmetic Treatment

BOTOX® Cosmetic is a neurotoxin that blocks the signals from the brain that cause muscle spasms. It therefore relaxes muscles at the site of the injection. At Cape Fear Eye Associates, we use BOTOX® injections both cosmetically and therapeutically, depending on the nature of the patient’s needs. BOTOX® injections are highly effective, minimally invasive, and virtually pain-free. In addition, they are provided on an outpatient basis and require little or no downtime, making them a convenient way to manage certain eye conditions and achieve substantial cosmetic improvements.

BOTOX® Injections to Treat Blepharospasm

Blepharospasm is an uncontrolled muscle spasm that generally causes twitching of the eyelids. It is sometimes associated with other conditions as well, including dry eye syndrome and Tourette’s syndrome, and can adversely affect vision as well as self-confidence. Small injections of BOTOX® Cosmetic administered to the upper and lower lids of the affected eye typically provide a temporary solution to the problem, with results lasting as long as six months. Additional treatments may be necessary every three to six months, depending on the severity of the condition.

BOTOX® Injections to Treat Strabismus

Strabismus typically begins in childhood and is characterized by a misalignment of the eyes. People afflicted with this condition usually have double or blurred vision caused by overactive or under active eye muscles, which make one of the eyes focus poorly. In adults, the onset of strabismus may be stimulated by diabetes, thyroid disease, or a stroke. When strabismus results from an overactive eye muscle, BOTOX® injections can provide an effective solution. By injecting small amounts of BOTOX® Cosmetic into the affected eye muscle, our doctors are able to stabilize its movements, thereby resolving or improving symptoms. Repeat treatment may be necessary for some patients.

Contact Our Fayetteville Area Eye Centers for Eyelid Surgery and More

If you would like to improve the appearance of your eyes, Cape Fear Eye Associates can help. In the Fayetteville areas of North Carolina, we provide eyelid surgery, eyelid ptosis repair, and BOTOX® injection treatments to rejuvenate the appearance of the eyes and surrounding facial tissue. These treatments can also have a therapeutic effect for people with impaired vision or neuro-ophthalmologic conditions. Call to schedule an appointment at 910-484-2284. 

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