Dear Dr. Winder:
Q. I have a question about eyelid surgery . . . I thought it was part of a facelift, but then I read in a magazine about someone who had their "eyes done"?

A. Eyelid surgery is indeed a distinct surgical procedure and is technically referred to as "blepharoplasty". Surgery of the eyelids was really the original "cosmetic" procedure, and is today, still, the most common cosmetic procedure with well over 50,000 people in the country choosing to have it done each year.

Excess, baggy eyelid skin or puffy fat in the eyelids are conditions that contribute to a person looking more tired, and older, than they really are; these conditions can be easily corrected with blepharoplasty. Since this can develop at a much earlier age than a saggy, wrinkled face, it is very common that many who elect to have eyelid surgery do so many, many years before they need a facelift; it is not uncommon for patients to need this surgery as early as their 20's. With conventional lower eyelid blepharoplasty, an incision is made just below the lashline, which heals beautifully. Through this incision, the excess skin and fat are removed, and, as needed, the eyelid is tightened as well. An alternative is what's called a "transconjunctival lower eyelid blepharoplasty"; with this procedure, the incision is made on the inside of the lower eyelid with a laser, through which the excess fat is removed. Then, the settings on the laser are adjusted, and the external skin of the lower eyelid is "resurfaced". Conventional lower eyelid blepharoplasty can be done with as little as local anesthetic (the patient is awake, but the eyelids are numb), and takes between 45-90 minutes. With transconjunctival lower eyelid blepharoplasty, the patient is sedated. The cost ranges from $1500-3000 if done in a hospital setting; however, we routinely do this surgery in our ambulatory surgical center, on an out-patient basis, and ranges in cost from $1,000 -1500.