Blepharoplasty - Eyelid Surgery

About

With the progression of years; age, heredity and sun combine to damage your skin and create unwanted folds of skin, manifest as loose skin over the top of the upper eyelid, creating a hood look, and bags of skin that contain fat under the lower eyelid.  Sagging or drooping upper eyelids tend to make us look and feel older or more tired than we are.  Blepharoplasty is an operation where we remove excess skin and remove fatty tissue to eliminate the tired, puffy look around your eyes which, in turn, restores a more youthful appearance to your eyes, creating more self-confidence.  The results can be a refreshened appearance, with a firmer, younger eye region.  Under certain conditions, upper eyelid surgery will be fully reimbursed by medical insurance companies.

Benefits

• Helps refreshen and revitalize your face
• Reduces excessive and sagging eyelid skin
• Reduces puffiness from eyelid fat pads
• Can improve visual acuity (visual fields increased)

Alternatives

Laser skin resurfacing

How Does it Work?

The most common procedure which patients undertake is an upper lid blepharoplasty, removing the loose hood of redundant skin from the upper eyelid.  With upper eyelid surgery the surgeon marks out the lines and creases of the lid in order to hide the incision in one of these natural folds.  Excess skin, muscle and fat are then removed and very fine sutures are used to close the skin.  The procedure takes about one hour and can be performed under local or general anaesthesia, depending on the patient's request.

For lower eyelid surgery, the bagginess here is caused not by fluid, but rather by fat pads.  There are three fat pads in each lower eyelid.  If bagginess is a problem then these fat pads will need to be removed.  For the lower eyelid, we use the transconjunctival approach, by which fat is removed from inside the eyelid, resulting in no visible scarring.

Who is a Candidate?

Any patient with sagging skin or prominent bulges (fat pads) would be a candidate.  The procedure can be performed under local or general anaesthesia, depending upon the patient's request.

What Can I Expect?

Improved visual fields and a more rested and younger appearance.

Safety and Side-Effects

As with any operation there are always risks.  We believe every patient should be aware of them.  The likelihood of these problems occurring is no greater than with any other surgical procedure. 

Scarring - as eyelid skin is thinnest, the skin normally heals very well.  When we perform lower eyelid surgery, this procedure is performed through the transconjunctival method, hence there is no external incision at all.

Infection - most unlikely as the procedure is performed under strict sterile conditions and we also commence patients on antibiocs one day prior to surgery.

Bleeding - great care is taken to seal all blood vessels at the time of surgery.  Very rarely, bleeding may occur in the orbit and as the blood pressure is on the optic nerve this can cause loss of vision.  This rare possibility is always checked before you leave our centre.

Recovery Time

Following surgery, an ice-pack will be placed over your eyelids to reduce swelling and bruising.  The amount of bruising that patients get is variable.  In some people it is hardly noticeable and others can have a black eye.  Following your discharge, you should go home to rest.  Sutures with upper eyelid surgery are dissolveable.

Does it Hurt?

If patients require local anaesthesia, once this has been achieved no pain is felt during the surgery.  If patients require general anaesthesia, they will require the services of a specialist anaesthetist.  A mild sedative (Hypnovel) is offered for relaxation on the operation day.

Before Treatment Instructions

Avoid any medication which will thin your blood.  Patients on Warfarin must completely discontinue this medication five days prior to surgery.  Patients taking Aspirin, anti-inflammatory pills, ginseng, Vitamin E and garlic must discontinue this medication two weeks prior to surgery.  Paracetamol can be taken at any time before surgery and is recommended for pain relief after surgery, if required.

After Treatment Instructions

Patients are commenced on antibiotics for one week following surgery, and are given an ample supply of topical antibiotic ointment to apply to the eyelids three to four times a day.   Sterile eyelid bandages are used at night for the first ten days.  Patients must avoid bending over, exercise and heavy lifting for ten days, and continue to avoid blood thinners for at least ten days after the procedure.  Ice packs are suggested for the first 48 hours, and head elevation should be continued for at least two to three days.  Pain medication is rare, but Paracetamol is suggested if there is any problem with pain.   

Who Performs the Treatment?

Dr McKerrow.