Eyelid Surgery (Blepharoplasty)

What is Blepharoplasty or eyelid surgery?

Blepharoplasty is a surgical procedure to correct premature ageing of the eyelids by removing fat or excess skin of heavy hooded eyelids or droopy eye bags.

The eyes are the most important feature on the face as they are always the first feature looked at by others. Their beauty can be obscured by excess skin causing hoods over the upper lids or prominent folds in the lower lids. Excess fat can also give the appearance of puffiness and bags.

When these problems are corrected by eyelid surgery it is usual for others not to notice that you have had an operation; more commonly they will comment how well you look.

The normal ageing process includes stretching of the eyelid skin which in this area is especially thin. Fine lines and creases develop due to the activity of facial muscles in smiling and squinting. Exposure to sunlight and smoking are other factors in premature ageing and some people have an inherited tendency for their skin to age more quickly than others. Excess fat deposits around the eyes are another inherited characteristic and with age these become more obvious with loosening of the soft tissues.

At the consultation you will be asked about your general medical history and any medical problems relating to your eyes. The features of your eyes which are correctable will be pointed out as well as any features which will remain unchanged. Slight differences in facial symmetry such as the height of the eyebrow, lid fold or eyelid itself may be pointed out as they are often unnoticed by the patient. Mr Chana will describe the positioning of any scars, the recovery period and indicate the likely post­operative results from the eyelid surgery.

It is important to realise that fine eyelid creases will not be eradicated. To try to do so would produce an over­correction, a staring appearance and potentially a change in shape of the eye. The crow’s feet cannot be eradicated either.

Often eyelid surgery is carried out together with a brow lift or facelift to enhance the overall rejuvenative effect. These procedures complement each other.

What happens during the eyelift operation?

Blepharoplasty can be carried out under general anaesthetic or under a local anaesthetic. Usually this involves a day case procedure.

The incision for the upper eyelid is in the natural crease line approximately 1 cm above the eyelashes and extends out into the ‘crow’s foot’ area. Excess skin forming the hood is trimmed away, any excess fat (usually present in the area adjacent to the sides of the nose) is removed and the eyelid is sutured using one continuous stitch.

The incision for the lower eye is just below the eyelashes again extending out into a natural ‘laughter line’. The tissues are hinged forward and the excess fat removed or re-­positioned. The skin is then lifted upwards and any overlapping skin excess is removed. Stitches are used to close the wound.

What is the recovery?

The stitches will be removed at between 3 to 5 days post­operatively. You will need to sleep upright for a few nights and it is important not to stoop or carry out vigorous activities for a few says, otherwise post­operative bleeding could result. The eyelids should not be rubbed in any way.

Antibiotic eye ointment is sometimes prescribed for three or four days and eye make­up should not be used for the first week or two. You may also be more comfortable using artificial tears for the first few days. Discomfort around the eyelids following surgery may be controlled by mild analgesics which will be prescribed. Aspirin or aspirin like medication (non-­steroidal anti­inflammatory tablets) must not be taken.

The eyelids will be swollen in the first week and assume that bruising will last two weeks.

Following eyelift surgery you may not be able to wear contact lenses for some time. Do bear this in mind since you will require glasses of a suitable prescription during the early post-operative stage of your treatment.

The scars will appear pink for some weeks, although they are easily disguised with make­up. The scars in the ‘crows feet’ area may become lumpy for a period but these invariably flatten with the passage of time. This may be helped by gentle massage as advised during your recovery period.

What are the risks?

Complications after blepharoplasty are rare. Bleeding might require a return to the operating theatre whilst an infection is usually readily treated with antibiotics. Most are temporary i.e. excessive tears or abnormal pigmentation of the eyelid skin.

Occasionally, what appears to be a transparent sack of fluid develops in the outer corner and covers part of the eye. This looks quite frightening but you should not be alarmed as this will settle on its own or sometimes steroid eye drops are required.

A scratch on the cornea (surface of the eyeball) while not serious can be irritating and may take some days to heal. Damage to the nerves of the eyelid or eye have been reported during blepharoplasty but this is extremely rare.

Very rarely, patients may require a secondary tightening of the eyelid skin at approximately the six month stage.

Mr Chana will provide you with a comprehensive information leaflet on Blepharoplasty following consultation.

© Jag Chana 2014