Blepharoplasty (Eyelid Surgery)

The skin quality and youthful volume of eyelids change over time with aging. If you feel your eyes have a tired look and you have excess upper eyelid skin, or loose and baggy lower eyelids, then this procedure might be beneficial to you. The aim of upper eyelid blepharoplasty is to mainly remove the excess skin, hooding, for a more youthful look. The upper eyelid is the best place in the body to put a scar and consequently it tends to heal extremely well, hidden in your natural eyelid creases. This procedure is performed under local anaesthetic. Lower eyelid blepharoplasty is a more complex procedure performed under general anaesthetic. It aims to address the slight loss of support and structure of the lower eyelid that develops with aging and some of the excess skin. It is used to remove eyelid bags and to soften the effects of aging for a more youthful and less tired look. An incision is made just under your eyelid line, extended to one of your natural, crow’s feet, creases on the side. Through this, the deep tissues are tightened to recreate support, excess bulging fat is removed and finally the excess skin is trimmed.

The continuous effects of aging and gravity cannot unfortunately be stopped, but on the whole, the result should stand the test of time. It is important to consider however, that skin and collagen lose their elasticity the older we get so small changes are inevitable.

Upper blepharoplasty: You may experience some very mild discomfort. Long acting local anaesthetic is used to numb the area before proceeding with surgery and in combination with simple oral analgesia, should provide sufficient post-operative comfort. There might be a sensation of tightness, especially at night when the eyes are closed, but this gradually improves. You may also experience bruising, dryness or watering of the eyes. Lower blepharoplasty: This is similar to upper lid blepharoplasty, although the swelling and bruising can be a little more significant. For both surgeries, sleeping a little propped up on a few pillows and for the first few nights, will improve the comfort and reduce the bruising and swelling.

Recovery is approximately one week for upper and two to three weeks for lower blepharoplasty. The sutures are removed after one week. For the first few days, careful use of ice packs is recommended and sleeping propped up with a few pillows, helps to reduce the swelling and bruising. Surgical tapes, steristrips, are placed over the suture line for the first week and you might become sensitive to sunlight. Sunglasses are advised, until the sutures are removed and antibiotics drops or ointment will be prescribed to prevent the eyes from drying. Protecting the scar from the sun with high SPF factor eye cream is also very important for a year following surgery. During your recovery you should avoid bending over, avoid driving, strenuous activity and heavy lifting for at least two weeks. Contact lenses should be avoided whilst the eyes still feel dry and healing. As a general rule, they can be used again after about three weeks.

Upper blepharoplasty: These include mild discomfort, infection, bleeding, bruising, swelling, asymmetry, dryness, watery eyes, dehiscence and delayed wound healing, need for revision and lagophthalmos (inability to fully close the eyes at night-time, this improves over time). Lower blepharoplasty: The general risks are similar to the above. However, this is a more complex procedure than upper eyelid surgery. On the whole, the recovery is a little longer and the bruising and swelling might take a week or so more to resolve with the final result being evident at about three months. There is a rare risk of ectropion (eyelid being pulled down) and an even rarer risk of experiencing bleeding behind the eye, which if not corrected immediately (usually by going back to surgery), can lead to blindness. However, this is very rare indeed. Dry eyes can also be troublesome and will be treated with moisturising drops until this improves over a course of about six to eight weeks.