How is Blepharoplasty done?
Incisions in the upper lids are made in the crease above each eye. Excess muscle, fat and loose skin is removed and fine sutures are used to close the incisions. The resulting scar normally fades to a fine line that virtually disappears into the eyelid creases.
If excess skin or muscle needs to be removed, the incision may be made in a natural smile crease below the lash line. Eyelid surgery is usually performed under general anaesthetic but it can also be performed under local anaesthetic if desired. You may experience some mild swelling or bruising of the eyelids after the surgery, but this usually subsides quickly. Keeping your head elevated when you lie down and a cold compress will help to reduce swelling and speed up healing. If you have any discomfort after surgery, it can be controlled with a mild medication. The eyelids heal remarkably quickly and the scars fade rapidly; the scars can be camouflaged with makeup after one week. If you wear contact lenses you must wait for two to three weeks before you can resume wearing them.
There are various and alternative forms of management for minor skin wrinkles that would significantly improve these wrinkles without having to resort to eyelid surgery. These include chemical peeling and laser resurfacing.
The goal of eyelid surgery, or Blepharoplasty, is to remove excess fatty tissue and skin from the eyelids to correct sagging or baggy eyelids. Blepharoplasty will not remove “crow’s feet”; eliminate dark circles or lift sagging eyebrows. And it will not correct ptosis which is the actual sagging of the upper eyelid margin either. Muscle surgery is required if this condition exists and this can be done. Blepharoplasty will also improve visual field if excess skin is sufficient enough to block part of the visual field at the same setting.
There are limitations to Blepharoplasty and these include excessively dark circles beneath the eyes, the surgery may improve this condition but not remove it, cheek bags and small “fluid” pouches of the cheek area below the eyelids, eyelid asymmetries and wrinkling in the crow’s feet area and fine wrinkles of lower eyelid skin. Sagging of the brow itself is also not improved by Blepharoplasty.
There are expected outcomes post-surgery and these include: swelling, asymmetric bruising, temporary tearing, “dry eye syndrome” due to swelling of lids or conjunctiva and this will require artificial tears, itching and blurring of vision, tightness on eyelid closure, fine scarring of the upper or lower eyelid area, slight scleral show, and possible minor asymmetries in eyelid or incision position. Certain lower eyelid procedures may produce a temporary upward slant at the corner of the eyes. Contact lenses should not be worn for at least 10 days following surgery.
Complications are rare but may include: asymmetry, bleeding, infection, blurriness, double vision, visual loss, upper or lower lid sagging, rounding of the corner of the eye, and/or “dry eye syndrome”. Although these conditions are usually only temporary they can be quite disturbing for patients and may interfere with their anticipated return to work plan. Minor redundancy of eyelid skin or residual/recurrent puffiness may occur and an outward roll of the eyelid may also occur and very uncommonly will require surgical correction.
There are many variable risk conditions and potential surgical complications that may influence the long term result of eyelid surgery. Should any complications occur, other treatments or additional surgery may be necessary and these could attract additional costs.