• Upper eyelid surgery removes excess fat deposits that appear as swelling in the upper eyelids;
• Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision, and can be treated with upper eyelid surgery;
• Lower eyelid blepharoplasty removes excess skin and fine wrinkles on the lower eyelid;
• Bags under the eyes can be corrected by blepharoplasty;
• Lower eyelid surgery can correct drooping lower eyelids.

Blepharoplasty is usually performed on adult men and women who have healthy facial tissue and muscles, with realistic goals about the surgery.

• Healthy individuals without pathology that could impair healing or increase the risk of surgery;
• Non smokers;
• Individuals with a positive outlook and realistic expectations about surgery;
• Individuals without serious eye conditions.

• Eye diseases such as glaucoma, dry eye or retinal detachment;
• Thyroid disorders, such as Graves' dysfunction and hypo- or hyperthyroidism;
• Cardiovascular diseases, high blood pressure or other circulatory problems or diabetes.

The success and safety of the surgical procedure depend on your sincerity during the consultation. You will be asked about your health, desires and lifestyle.

• The reason why you want to undergo surgery, your expectations and the desired result;
• Medical conditions, previous drug allergies and previous medical treatments;
• Current use of medications, vitamins, natural medicines, tobacco, alcohol and drugs;
• Previous surgeries.

• Assess your general health status and any pre-existing health conditions or risk factors;
• Take photos for medical records;
• Discuss your options and recommend treatment;
• Discuss likely results of surgery and any potential risks or complications .

Before surgery, it may be necessary to:
• Take laboratory tests or medical evaluation;
• Taking certain medications or adjusting your current medications;
• Stop smoking well before surgery;
• Avoid taking aspirin and some anti-inflammatories and natural medicines, as they can increase bleeding.

• What to do the night before and the morning of surgery (fasting time, medications, bath);
• The use of anesthesia during the procedure;
• Post-operative care.

Be sure to ask someone to accompany you and stay with you for at least the first night after surgery.

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. Options include intravenous sedation or general anesthesia. Your doctor will recommend the best option for you.

Step 2 – Incision

The incision lines for eyelid surgery are designed to leave scars well hidden within the natural structures of the eyelid region. Upper eyelid drooping can be corrected through an incision in the fold of the upper eyelid, allowing the repositioning of fat deposits, contraction of muscles and tissues, and/or the removal of excess skin. The lower eyelid can be corrected with an incision just below the lower lash line. Through this incision, excess skin on the lower eyelids is removed. A transconjunctival incision, hidden within the lower eyelid, is an alternative technique to correct lower eyelid imperfections and redistribute or remove excess fat.

Step 3 – Closing the Incisions

Eyelid incisions are typically closed with:

• Removable or absorbable sutures;
• Skin stickers;

The surgeon may use a chemical peel or laser to remove dark color from the lower eyelids.

Step 4 – Results

The results of eyelid surgery will appear gradually as swelling and bruising subsides.

The decision to undergo surgery is a personal one and it is up to you to decide whether the benefits will meet your goals and whether the potential risks and complications of blepharoplasty are acceptable. The plastic surgeon and/or assistants will explain in detail the risks associated with the surgery. You will be asked to sign the consent form to ensure that you fully understand the procedure you will undergo and any potential risks or complications.

• Unfavorable scars;
• Blurred or temporarily impaired vision;
• Dry eyes;
• Difficulty closing your eyes;
• Bleeding (bruise);
• Poor healing;
• Infection;
• Accumulation of fluid (seroma);
• Numbness and other changes in skin sensitivity;
• Anesthetic risks;
• Eyelid dysfunction involving abnormal position of the upper eyelids (palpebral ptosis), loose eyelid skin, or abnormal laxity of the lower eyelid (ectropion), which may coexist with flaccidity of the forehead and eyebrow structures; eyebrow lift surgery will not correct these dysfunctions; additional surgery may be necessary;
• Pain, which may last;
• Skin discoloration and swelling;
• Suture threads may spontaneously emerge from the skin, become visible or produce irritation that requires their removal;
• Deep vein thrombosis, cardiac and pulmonary complications;
• Possibility of revision surgery;
• Loss of vision.

It is very important that you ask all your questions directly to the plastic surgeon about the surgical procedure. It is natural to feel a little anxiety, whether it is anticipation of the result or pre-operative stress. Don't be ashamed to discuss these feelings with your plastic surgeon.

Fibrin glue (made from heat-activated human blood components to inactivate virus transmission) is used to hold tissue layers together at the time of surgery and decrease postoperative bruising after surgery. This product is carefully produced from the plasma of selected blood donors who are free of hepatitis, syphilis and human immunodeficiency virus (HIV). These products have been used safely for many years in cardiovascular surgery and general surgery, helping to reduce the possibility of surgical hemorrhage and serving as an adherent to tissue layers.

If you experience shortness of breath, chest pain, or an abnormal heartbeat, seek medical attention immediately. If any of these complications occur, you may need hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure, requiring a new surgery.

Following your doctor's recommendations is essential for the success of the surgery. It is important that surgical incisions are not subjected to excessive force, abrasion or movement during the healing period.

After the procedure is completed, use a lubricating ointment and apply cold compresses to the area. In some cases, the eyes may be covered with gauze.

How to care for your eyes, medications to apply or take orally to help with healing and reduce the risk of infection, specific care for the surgery site or your health status, and post-operative follow-up with the plastic surgeon. Initial healing after surgery may include swelling, irritation, dry eyes or bruising, and discomfort that can be controlled with medication, cold compresses, and ointment. There may also be irritation at the incision sites.

• Where will I remain in recovery after surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will a dressing be necessary after surgery? When will it be removed?
• Will the stitches be removed? When?
• When will I be able to resume my normal activities and exercise?
• When will the return appointment be?

Important: You must protect yourself from the sun and wear sunglasses until the healing process is completely complete.

The final results of eyelid surgery will appear within a few weeks but it can take up to a year for the incision lines to fully refine. Although eyelid surgery can correct certain conditions permanently, there is natural aging. Throughout life, adequate sun protection is necessary to help maintain results.

Cost is always a consideration in elective surgery. A surgeon's fees may vary depending on their experience and the type of procedure performed.

• Surgeon's fees;
• Hospital or surgical center expenses;
• Anesthetist's fees;
• Spending on medicines;
• Medical exams.

When choosing a plastic surgeon for your eyelid surgery, remember that the surgeon's experience and your good relationship with him or her are just as important as the final cost of the surgery.

• Blepharoplasty: Eyelid surgery to improve the appearance of the upper eyelids, lower eyelids, or both.
• Ectropion: When the lower eyelid turns outward after eyelid surgery, often a temporary condition.
• General anesthesia: Drugs and/or gases used during surgery to relieve pain and reduce consciousness.
• Hematoma: Accumulation of blood beneath the skin.
• Intravenous sedation: Sedatives given by injection into a vein to help you relax.
• Local anesthesia: Drug injected directly into the incision site during surgery to relieve pain.
• Transconjunctival incision: Incision made inside the lower eyelid.
• Skin refinement: Treatment to improve the texture and overall appearance of the skin.
• Sutures: Stitches used by surgeons to hold skin and tissue together.

Use this list as a guide during your consultation:

• Are you a specialist by the Brazilian Society of Plastic Surgery?
• Have you been trained specifically in the field of plastic surgery?
• How many years of plastic surgery training have you had?
• Is the installation of the procedure room in your office authorized by the Health Surveillance of your city?
• Am I a good candidate for this procedure?
• What is expected of me so that the best results are obtained?
• Where and how will the procedure be performed?
• Which surgical technique is recommended for my case?
• How long can I expect to recover, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications treated?
• What will my eyes look like over time?
• What are my options if I am dissatisfied with the aesthetic result of the procedure?