What is blepharoplasty?
Blepharoplasty corrects hooded upper eyelids and puffy bags from the lower eyelids. It may be carried out for functional reasons, to enable you to see better once the upper lid hooded skin folds are removed or for cosmetic reasons for both upper and lower eyelids to restore a more youthful appearance.
How do these changes happen around the eyes ?
- Excess upper eyelid skin : The skin and muscles of the upper eyelids stretch with time, sun damage and effect of gravity. Excess skin often may form a hood over the upper eyelid interfering with your vision.
- Sagging and bulging lower eyelids : Almost everyone develops a certain degree of bagginess under the eyes with time for the same reasons as for the upper eyelids. In the lower eyelids, additionally, the fat that normally surrounds the eyeball tends to bulge forward causing the lower eyelid bags.
How is Blepharoplasty performed ?
Upper eyelids : Excess skin and muscles from the upper eyelids are usually removed through an incision made in the natural skin crease of the upper eyelid.
Lower eyelids : Protruding fat and excess skin from the lower eyelids are usually removed through an incision in the skin just underneath the lower eyelid lashes ( subciliary incision ). Fat from the lower eyelids without excess skin can be removed via an incision through the inside of the lower eyelids ( trans-conjunctival ). The scars that result from these incisions are usually inconspicuous once healed.
Is the operation always done under general anaesthesia ?
Blepharoplasty is usually done under a local anaesthetic ( to numb the eyelids ) with or without sedation, as a day case. General anaesthesia may be required in some situations and your doctor will be able to advise you on that.
What to expect after the operation
Usually the eyes are not patched after the operation. Sometimes, the oculoplastic surgeon may cover one of the eyes to reduce bruising and swelling. The eyelids will be usually swollen and you will be unable to close them fully for several days after the operation. You will be given some antibiotic ointments/drops along with some lubricating artificial tears/ointment to prevent eyes from getting gritty due to dryness. Pain is usually not a significant problem but you may use paracetamol as you would following a headache. Aspirin based compounds may be avoided. Keeping upright after surgery will prevent excessive swelling around the eyelids ( sleep propped up if possible )
Most forms of light exercise and normal work patterns may be resumed 2 days after the operation. Eye makeup can be worn 1 week after the operation.
Are there any risks or side effects ?
- Bruising is common and is often unpredictable.
- Bleeding is rare but is potentially the most serious complication following upper or lower eyelid blepharoplasty, especially where fat is removed in an uncontrolled fashion. If recognised early, it can be successfully treated . If not, it may result in loss of vision.
- Excess skin removal from the upper eyelids may result in poor blinking and inability to close the eyes completely. This may cause eye surface problems and may aggravate a pre-existing dry eye problem. It can be managed mostly using artificial tears but occasionally may require further surgery.
- Excess skin removal from the lower eyelids may result in lid malpositions which may result in further surgery. Similarly, excess fat removal during the lower eyelid blepharoplasty may result in a ‘hollowed look’. Both are unusual and a conservative removal of tissues reduces the risk of this nature.
- Infection is unusual and can be successfully treated if recognised early.