Eyelid Surgery Overview
Blepharoplasty is a type of surgery that repairs droopy eyelids and may involve removing excess skin, muscle and fat. As you age, your eyelids stretch, and the muscles supporting them weaken. As a result, excess fat may gather above and below your eyelids, causing sagging eyebrows, droopy upper lids and bags under your eyes.
Our eyes often dictate whether we look awake and alert, or tired, angry or unhappy. Issues such as lower eyelid puffiness, dark circles or drooping upper eyelids can misrepresent our true mood and temperament. For some clients, these features do not improve, even with plenty of sleep and living a healthy lifestyle. If you are unhappy with the appearance of your eyelids, cosmetic eyelid surgery can help women and men look and feel younger and refreshed.
Clients who can consider eyelid contouring are men or women who demonstrate:
- Bags or puffy bulges under the eyes (fatty deposits)
- Fullness of the upper eyelids (fatty deposits)
- Excess skin diminishing the natural fold of the upper eyelids
- Excess skin and wrinkling of the eyelids
- Impaired vision due to hanging skin on the upper eyelid
What to Expect
Blepharoplasty may either be performed on the upper eyelid only or the lower lid, or both. The most common problem with the upper eyelid is drooping excess skin. Not only does this look unappealing, but it can also obstruct vision for a client. This is corrected with an incision that is placed along the natural fold of the eyelid and extracting any excess fat and skin. For the lower eyelid, treatment will improve any appearance of bulging and sagging below the eye. Incisions may be made just slightly below the lash line, or a transconjunctival incision may be a better option as the cut is made inside the lower eyelid, which eliminates scarring. Through incision, fatty tissue and excess skin is removed. A lower lid lift does not necessarily improve the dark circles that may occur under the eyes. In this situation, we may recommend a skin rejuvenation procedure such as laser treatment or a chemical peel to assist with discoloration.
Eyelid Surgery Recovery Time
Eyelid surgery is performed under general anesthesia or IV sedation. Clients will be sent home and will be advised to keep their heads elevated for the first several days. Bruising and swelling will occur and may last for several weeks. It takes approximately 3-4 weeks for the results to appear. This surgery leads to very minimal scarring due to the location of the incisions. Not only will clients look rejuvenated and refreshed, but also many will have improved vision due to the skin imperfection being removed.
Eyelid Surgery FAQ's
1) What is blepharoplasty?
Blepharoplasty (also known as eyelid reduction, eye lift or eye bag removal), refers to the surgical rejuvenation of the eyelid which is often used in conjunction with non-surgical procedures. It applies to both the upper and the lower eyelids but is commonly used to counteract the effects of ageing on the skin muscle and fat around the eyes.
Young people, however, can also require eyelid surgery either because patients wish to lessen the oriental features or to remove bulging pockets of fat (eyebags). There are also some children born with drooping upper eyelids called Ptosis, who also require surgical assistance.
Blepharoplasty surgery is customised to every patient and no two are the same. It can be performed alone, involving the upper, lower or both eyelids or in conjunction with other surgical procedures of the face, brow or nose. The most common supplementary procedure would be fat grafting for the ageing face and is now included in most cases to achieve youthful vitality.
2) What side effects does blepharoplasty surgery have?
It is very common after surgery to have puffy eyelids for a while, but significant complications are rare. You might have more trouble in the evening when trying to shut your eyes to sleep the first few nights. Your eyes may be irritated or watery for several weeks following the surgery, but this will return rapidly to normal. You may also have bruising resembling a black eye, and some light pink scarring that will fade over time.
Blurred vision immediately after surgery due to persisting local anaesthetic and ointment applied to the eye at the end of the procedure.
Our surgeons will explain all the risks, the likeliness of them occurring and any possibilities of complications upon consultation.
3) How effective is blepharoplasty in treating drooping eyelids?
Blepharoplasty or eyelid reduction is highly effective and is the one lifting procedure which rarely needs to be repeated. There may be non-surgical touch-ups in the future but having another skin excision is less likely.
The skin of the eyelids is excellent at hiding scars, and any scars will be hidden in the fold of the upper eyelid. Making them nearly invisible on most people. The only way the scars would potentially be visible, is when there is a hood of skin to be removed which extends beyond the eyelid, however, again for most people this scar becomes invisible. The scar of the lower eyelid will heal very well, and it is disguised under the eyelashes and in the crow’s feet.
The folds of skin beyond the lower eyelid overlying the cheekbone are often called Festoons and are more difficult to eliminate. There are a few different ways we will work at removing Festoons, either through skin removal, excision, fat or filler, liposuction and steroid injection.
4) What does blepharoplasty surgery involve?
Your surgeon will need to be aware of any medical eye conditions you may suffer from as there are some occasions when surgery is contraindicated. In particular, dry eye can appear worse after surgery. Your experienced surgeon will also need to ascertain whether it is just the eyelids, which are of concern, or whether the surrounding brow, temple, cheekbones and tear trough are also requiring treatment.
All surgery can be carried out as a day case. Usually under Total Intravenous Anaesthesia (TIVA) with the patient only lightly anaesthetised. Smaller procedures can be carried out under local anaesthetic. Your eyes will not be bandaged at the end of the procedure and although vision may be slightly reduced because of the local anaesthesia used, this is only temporary. You should not drive a car for 24 hours. The eyelid skin heals very quickly and in a few days any stitches can be removed. Bruising varies but like all bruises settles, and will become less visible over 10 days. Swelling accompanies all surgery and on the eyelid, this may give a watery look to the eye (chemosis) which can be annoying and last a few weeks. If patients have festoons or swelling over the cheekbones, then this can remain swollen for a month or two. Patients should be reassured that all this swelling does eventually settle.
Finally, the surgery itself is not painful and the only restrictions are intended to reduce temporary swelling. Wearing a cold compress immediately after surgery and sitting propped up in bed for the first night are useful, but probably do not affect the final result. The eye is also watery because the swelling around the tear ducts which naturally drain tears into the nose, swell up and become blocked, again this is only temporary and usually lasts a day or so. You will probably not wish to go to work the next day because of the appearance of dressings, swelling and bruising, but working from home is reasonable for many.
5) What risks are associated with blepharoplasty surgery?
Blepharoplasty or eyelid surgery is safe in expert hands; however, every surgical procedure involves a certain amount of risk and it is important that you understand the risk before proceeding. You should discuss any existing medical problems with your surgeon, for instance, patients taking blood thinning agents are at risk of bruising which in certain types of lower eyelid surgery could cause bleeding behind the eye and in the exceptionally rare occasion, blindness. It is wise to avoid any aspirin or anti-inflammatory medications for 10 days before surgery as this too can increase the risk of bleeding.
Dry Irritated Eyes - Individuals who normally have dry eyes, may be advised to use special caution in considering Blepharoplasty surgery. If patients do use eye drops before surgery, they are quite likely to be using more afterwards.
Infection – Infection is rare and can be treated with antibiotic eye drops and ointment.
Watery Eye (Epiphora)- the tear ducts normally draining into the nose will temporarily block due to swelling. In addition, the swelling may give a watery appearance to the eye due to fluid under the conjunctiva. This is called Chemosis and may last a week or two.
Ectropion – Swelling after surgery can cause drooping of the lower eyelid and push the eyelid away from the eyeball. This usually settles as the swelling goes down and will be helped by massaging the swelling away from the eye and taping the eyelid upwards onto the eyeball. This can be a problem in the older patient and may be pre-existing to any surgery. There are operative procedures to correct it.
6) How should I prepare for the blepharoplasty treatment?
Your surgeon will give you all your pre-operative advice at your consultation. This may include having an eye test, if you have eye health issues, as well as a physical examination and eyelid photography from all angles.
You will need to stop taking blood thinning medication such as warfarin, aspirin, ibuprofen, naproxen, and any other medication or herbal supplement associated with increased bleeding. Your surgeon will advise how long before surgery you need to stop taking these medicines.
You are advised to stop smoking for at least two weeks before your surgery. Smoking reduces healing and increases the risk of complications. Arrange for someone to drive you to and from surgery on the day.
7) Is blepharoplasty surgery painful?
Blepharoplasty is basically skin deep and there is little pain in the post-operative recovery phase. Any discomfort is minor and can be controlled with simple pain relief and eye ointments provided by your surgeon.
8) Will my eyes look natural after blepharoplasty?
Blepharoplasty surgery can give life-changing results and an experienced expert surgeon will not change the shape of the eyes, unless this is the aim. Surgery has evolved in recent years and less muscle fat and skin are being removed.
Fat may be repositioned rather than removed. There will be no tell-tale signs that it has been removed, you will have a natural, face new look to your face. In addition, we aim for an extra youthful vitality which is achieved by fat grafting of the brow, temple, cheekbones, lower eyelids that surround the eye. Fat grafts include stem cells, which improve skin quality as well as contours This is a very specialised technique which makes all the difference in achieving incredible results you’ll be happy with.