Eyelid Surgery for Men: Planning Around a Busy Work Calendar

Eyelid skin is among the thinnest on the body, and it tends to show age before the rest of the face does. Heavy upper lids and puffy lower lids can make a well-rested man look worn out, a problem for anyone whose work puts his face in front of clients and colleagues all day.

Blepharoplasty, the surgical name for eyelid surgery, addresses that tired look. A Houston practice’s overview of eyelid surgery describes how Leo Lapuerta, MD, FACS, a triple board-certified plastic surgeon with more than 30 years of experience, designs each procedure around the patient’s needs, using an upper lid approach, a lower lid approach or both.

His practice’s guidance on facial surgery for men makes a workplace argument of its own: looking younger may help men who are looking for a new job and competing with younger applicants. The same guidance places the typical male candidate for facial procedures in his 50s with mild to moderate signs of aging.

Reading the signs

The practice lists the concerns eyelid surgery can address. Sagging upper lid skin can create a tired look and, in some men, block part of the field of vision. Lower lids can develop puffiness, bags and excess fat that give a heavy appearance, along with dark circles and hollow areas.

A consultation sorts out which of these you have. The practice describes the best candidates as people with drooping or heavy eyelids and puffy bags under the eyes who are in good overall health and hold realistic expectations.

Upper, lower or both

Upper lids. Dr. Lapuerta places the incision along the natural crease of the eyelid and extends it outward to reach skin folds beyond the center of the lid. Through it he removes excess skin and tissue, and sometimes a small segment of the orbicularis oculi muscle that moves the eyelid. The scar heals within the crease.

Lower lids. The usual incision sits just beneath the lash line, where he removes excess fat and tissue. For men with puffy lower lids who still have good skin elasticity, the practice may recommend a transconjunctival approach, with the incision made inside the lower eyelid and no visible external scar.

According to the practice, some patients treat only the upper or lower lids, but most choose both. One set of lids alone generally takes about 60 to 90 minutes; both can take up to two hours. The surgery is an outpatient procedure that must take place in an accredited facility, and patients usually have it at Dr. Lapuerta’s on-site AAAASF accredited surgical facility, where he works with physician anesthesiologists.

Clearing the calendar

For a working man, recovery is a scheduling question. The practice’s recovery guidance breaks down into a sequence you can plan around:

1. Choose the anesthesia. Options include sedation with local anesthesia, deep sedation with local anesthesia, or general anesthesia with local anesthesia. Medical history and preference drive the choice.
2. Plan for the first day. Bruising and swelling around the eyes appear right after surgery, and swelling can make the eyes hard to open or blur vision at first. Dr. Lapuerta provides cooling masks to wear in recovery and at home. If the local anesthetic causes stinging, a sterile saline eye wash from a drugstore can flush it out.
3. Sleep with your head up. He suggests a recliner or several pillows during recovery.
4. Return to the office. Patients are usually able to return to work within a few days.
5. Return to the gym. Exercise can resume around two weeks after the procedure.
6. Keep the sunglasses handy. The practice advises dark sunglasses against wind and sunlight for several months after surgery. Mild irritation or dryness is possible, and drops or ointments can help.

Like any operation, eyelid surgery carries risks, and those belong in the consultation alongside the schedule.

What eyelid surgery won’t do

The practice is plain about the limits. Blepharoplasty is not designed to treat crow’s feet; Botox or a brow lift are the options it recommends for those lines. The practice’s men’s guidance adds that a brow lift can open up the eyes and soften lines and wrinkles.

Dark under-eye circles caused by a lack of fat may respond to injectables that fill the soft-tissue deficit. Many patients pair eyelid surgery with Botox, facial fillers or fat injections in the same session.

Results show once the initial swelling subsides, and the practice says they often last for many years, in particular for patients who keep a healthy lifestyle and protect their skin from the sun. For a man who spends his days outdoors or on the road, that last part means sunscreen and a decent pair of sunglasses become part of the upkeep.

This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.