Eyelid Surgery (Blepharoplasty)

In Toronto and Oshawa, women and men come to Dr. Derek Ford for eyelid surgery (blepharoplasty) when they want smoother, uplifted, younger-looking eyelids. He is 1 of only 2 plastic surgeons in Canada who is formally trained and certified in oculoplastic surgery, making him an exceptional choice for your procedure. Dr. Ford uses his advanced skill to correct sagging skin, loose muscle and ligaments, as well as bulging fat and hollowing around the eyes.

Who Is a Good Candidate for Eyelid Surgery?

Most patients seeking eyelid surgery are 35 years of age or older, although puffy eyes — which are often hereditary — may prompt some younger people to inquire about this procedure. The goal of eyelid rejuvenation is to make the eyes look cleaner and more youthful without changing the shape of the eyelids that frame the eye.

In some patients, the position of the eyebrow may contribute to the appearance of heavy upper eyelids. In these situations, it’s important to consider a brow lift procedure instead of or in addition to eyelid surgery to satisfactorily rejuvenate the upper face.

Your Eyelid Surgery Consultation

Your health and safety are Dr. Ford’s top priorities. During your in-office consultation, he will gather the following information:

• Pre-existing eye conditions, such as dry eye or glaucoma
• Previous eye surgery, including LASIK or laser vision correction
• The date of your last eye exam

A recent examination by an optometrist prior to your consultation is important to evaluate eye function. Dr. Ford takes his patients’ wellness and safety very seriously, and he only performs surgery on qualified candidates.

While serious complications are extremely uncommon, Dr. Ford will discuss the potential risks of blepharoplasty during your consultation. This is simply to be transparent through all phases of the surgical process and make sure you have all the information you need to make a decision about the procedure.

Your health and safety are Dr. Ford’s top priorities.

How Much Does Blepharoplasty Cost in the Toronto Area?

The cost for eyelid surgery procedures by Toronto oculoplastic surgeon Dr. Ford is as follows:

• Lower eyelid surgery:  $7,330
• Upper eyelid surgery:  $5,515/span>
• Upper & lower eyelid surgery:  $10,990
• Upper eyelid surgery with endoscopic brow lift:  $12,890
• Upper & lower eyelid surgery with endoscopic brow lift:  $18,190

*Prices exclude taxes

Does Insurance Pay for Upper Eyelid Surgery?

If you are getting upper eyelid surgery to improve your field of vision, the Ministry of Health in Ontario will cover the cost, provided that an optometrist documents at least a 50% reduction in your visual field.

Your Upper Eyelid Surgery

Men and women seek eyelid surgery for the upper lids to correct age-related changes, including:

• Forehead and glabellar creases
• Droop (ptosis) in the lateral eyebrow
• Excessive upper eyelid skin and muscle
• Hollowing of the area between the lid and the brow
• Loss of the upper eyelid fold

Additionally, Dr. Ford specializes in Asian eyelid surgery for individuals who want a double eyelid (single crease) instead of a single eyelid (absent crease).

Assessment

It is important for Dr. Ford to perform an organized, sequential assessment of your upper eyelid and brow during the consultation process. He carefully evaluates your brow for droopiness (ptosis) and symmetry. In women, it is desirable for the brows to arch laterally. Most men, however, request a straighter, more horizontal position. If brow laxity is not corrected, or if the brow is not properly stabilized, it can contribute to further sagging after surgery.

A gland in the outer area of the upper eyelid may also drop with age, creating a sad or tired appearance. This gland may need to be re-suspended at the time of upper eyelid surgery in order to ensure a clean-looking upper eyelid contour.

When examining the upper eyelid, Dr. Ford looks for the presence of upper eyelid sagging. This looks like a droopy upper eyelid without a crease, and Dr. Ford can correct this with eyelid surgery. He also evaluates any asymmetries and the amount of fat framing the upper eyelid. With age, the upper eyelid becomes hollow-looking, and it is important not to remove upper eyelid fat during surgery. In some cases, Dr. Ford even adds fat to this area or uses an injectable hyaluronic acid filler, such as Restylane®.

Bulging or prominent eyes may appear as the result of a thyroid condition and require medical evaluation prior to surgery.

How Is Upper Eyelid Surgery Done?

Dr. Ford typically performs upper eyelid surgery with the patient under local anesthesia, but he may use general anesthesia if the surgery is combined with other procedures. Most eyelid surgery procedures take about 1 hour to perform.

During surgery, Dr. Ford makes an incision along the upper eyelid crease — the point where the upper eyelid skin transitions from being fixed to being loose on the lid. He removes a crescent-shaped piece of excess skin and muscle in a conservative fashion, especially since it’s vital to leave enough tissue to allow for full eyelid closure. Since this area can become hollow with age, Dr. Ford takes great care not to remove upper eyelid fat during surgery. In some cases, he even adds fat to this area or uses an injectable hyaluronic acid filler, such as Restylane®. By allowing the upper eyelid fat to fall down to the crease, a symmetrical, gentle arch above the upper eyelid fold is created.

Dr. Ford closes the incision using non-absorbable sutures. He uses meticulous techniques to reduce tension on the incision for a superior, discreet scar.

Your Lower Eyelid Surgery

Men and women seek eyelid surgery for the lower lids to correct age-related changes that include:

• Skin and muscle laxity that may result in wrinkles
• Ligament laxity and rounding of the lower eyelid shape
• Bulging fat beneath the eyes
• A deepening groove between the lower eyelid and cheek

Assessment

Before surgery, Dr. Ford evaluates both the lower eyelid and cheek. He also assesses the shape and canthal tilt of the lids. A negative canthal tilt occurs when the outer eyes appear lower than the inner eyes. This may indicate lower lid laxity as the result of aging or the presence of a prominent eye. People with prominent or bulging eyes are often at a higher risk of complications. For these patients, Dr. Ford tailors his technique to make the surgery as safe as possible.

Dr. Ford also examines the lower eyelid for laxity. He notes the presence of “scleral show” (visible white below the iris), excess skin and muscle, and protruding fat bags, and deep tear troughs.

How Is Lower Eyelid Surgery Done?

Dr. Ford prefers to perform lower eyelid surgery using general anesthesia. Because the procedure typically takes 2 hours to perform, general anesthesia is a good way to ensure patient comfort and safety. Dr. Ford makes a long, thin incision just below the lower lash line. He manipulates the underlying muscle, raising it to create a cleaner and more alert appearance. Often, he also raises the cheek tissue, blending the lower eyelid with the cheek for a more natural-looking delineation. He removes any excess skin and closes the incision with sutures. He also uses sutures to splint the outer upper and lower lids together. All of these sutures are removed 7 days after surgery.

What Can I Expect After Eyelid Surgery?

For the first 72 hours after your surgery, Dr. Ford recommends keeping your head elevated and applying clean, cool compresses to your eyes. He suggests the application of ophthalmic antibiotic ointment to the incisions and into the eye to reduce the loss of the protective tear film. Patients who do not have a history of glaucoma may use a fluorometholone 0.1% ophthalmic suspension to minimize early inflammation.

Eyelid Surgery Recovery

Swelling and bruising around your eyes are common after blepharoplasty. Dr. Ford recommends keeping your activity level minimal for the first 2 weeks after surgery, although you are encouraged to take short walks around your house to reduce the risk of blood clots. Typically, the recovery process involves the following:

Bruising and swelling: These issues usually peak 2 to 3 days after surgery, but nearly all bruising and swelling subside about 3 weeks after the procedure.

Sutures: Your stitches will be removed at your first follow-up visit, about 7 to 10 days after your surgery.

Bathing: You may shower and shampoo your hair daily while at home.

Makeup: Applying foundation and other makeup is allowed once your sutures are removed.

Activity: You can resume normal activities after 2 weeks and exercise after 4 to 6 weeks.

Travel: Delay any travel for at least 2 weeks after surgery.

Scars: Protecting your eyelid skin from sunlight is important during recovery and beyond. Beginning 6 weeks after surgery, massage your scars and apply a silicone scar cream twice a day. Continue this regimen for 3 to 6 months to minimize your scars.

Is It OK To Combine Eyelid Surgery With Other Procedures?

Although it can produce beautiful results on its own, blepharoplasty is often performed in conjunction with other procedures for a more profound result. Typical pairings include endoscopic brow lift, facelift and neck lift, and micro fat grafting.

When Should You Consider a Nonsurgical Solution?

For patients interested in lower eyelid rejuvenation without surgery, Dr. Ford often recommends treatment with an injectable hyaluronic acid filler such as Restylane. These products can fill in the tear trough, which is the depressed groove between the puffy lower eyelid and cheek. Although this option doesn’t replace the results that can be achieved with formal eyelid surgery, it does offer an in-office nonsurgical alternative that reduces the appearance of lower eyelid aging. Glabellar furrows (between the eyebrows) and crow’s feet at the outer corner of the eyes are best addressed with the use of injectable neuromodulators such as BOTOX® Cosmetic.

Eyelid Surgery FAQ

If you think your eyelids need a lift, request a consultation online with Dr. Ford, or call our Toronto office at  (416) 925-7337 or our Oshawa office at  (905) 743-9888 to schedule your appointment.