Eye Lift (Blepharoplasty)

WHAT IS BLEPHAROPLASTY

Blepharoplasty (also known as eyelid rejuvenation) removes fat and if required excess skin and muscle from the upper and/or lower eyelids. It can be used to correct drooping upper lids and puffy bags beneath your eyes and can be combined with other procedures such as a browlift and ptosis surgery. However, blephar oplasty will not remove crow’s feet or other wrinkles, dark circles or lift sagging eyebrows.

WHAT ARE THE RISKS

Not everyone is suitable for blepharoplasty; pre-existing medical conditions which can make the procedure more risky include hypothyroidism and Graves’ disease, dry eye, high blood pressure or other circulatory disorders, cardiovascular disease, diabetes, detached retina and glaucoma. If you suffer from any of these conditions an assessment of your suitability will be made after having taken a complete medical history.

Complications with this procedure, assuming surgery is carried out by an appropriately qualified oculoplastic surgeon and the patient has followed the medical advice given are infrequent and usually minor. However, all surgery carries a risk, the minor complications that can occur include double or blurred vision for a few days, temporary swelling at the corner of the eyelids; a sight asymmetry in healing or scarring. Incision scars in this region generally heal well and are frequently not visible some months after surgery. Some patients, however, do 'scar' worse than others and this is often outside the control of the surgeon. The upper lid scars are mostly hidden in the upper lid skin crease but may be visible (and occasionally unslightly) at the inner and outer ends of the incision where this extends out of the skin crease. The lower lid incision is close to the eyelashes which disguises it presence to some extent but again is often visible at the outer aspect of the incision. This tends to be less of an issue in middle aged and elderly patients when any visible scars are often hidden in wrinkle lines around the eyes (as younger patients do not have any wrinkles the prsence of a scar may be more noticable). Tiny whiteheads may appear after stitches are taken out but these can be removed with a fine needle. Dry eye symptoms may be made worse by upper lid blepharoplasty. Some patients may have more serious complications such as difficulty closing their eyes when they sleep, in rare cases this may be permanent. Another rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.

WHAT CAN YOU EXPECT

Your complete medical history will be required, so check your own records ahead of time and be ready to provide this information. Be sure to inform us if you have any allergies; if you're taking any vitamins, medications (prescription or over-the-counter), or other drugs; and if you smoke.

In this consultation, your vision will be tested and tear production assessed. You should also provide any relevant information from your optician or the record of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along.

You should carefully discuss your goals and expectations for this surgery. You'll need to discuss whether to do all four eyelids or just the upper or lower ones, whether skin as well as fat will be removed, and whether any additional procedures are appropriate.

You will need to follow any guidelines on how to prepare for surgery, including eating, drinking, smoking and taking or avoiding certain vitamins and medications. You may need to arrange for someone to drive you home after surgery and be around to help you out at home if needed for a few days.

Blepharoplasty will take around two and half hours for all four lids. In a typical procedure, the incisions follow the natural lines of your eyelids, in the creases of the upper eyelids and just below the lashes in the lower lids. Skin is separated from the underlying fatty tissue and muscle, fat is remodelled and any excess removed, sagging skin and muscle trimmed if necessary and the incisions are then closed with very fine sutures. Younger patients with more elastic skin may have a transconjunctival blepharoplasty performed with the incision made inside the lower eyelid which leaves no visible scar.

AFTERCARE

After surgery, your eyes are lubricated with ointment and a bandage applied. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication prescribed. If you feel any severe pain, call the hospital immediately.

You should keep your head elevated for several days, and use cold compresses to reduce swelling and bruising. (Bruising varies from person to person: it reaches its peak during the first week, and generally lasts anywhere from two weeks to a month.) You'll be shown how to clean your eyes, which may be gummy for a week or so. You will be prescribed eyedrops or ointment, since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

The stitches will be removed 1-2 weeks after surgery. Once they're out, the swelling and discoloration around your eyes will gradually subside, and you'll start to look and feel much better.

You should be able to read or watch television after two or three days. However, you won't be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while.

Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor's instructions, you'll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.