Procedure: Correct drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. (Upper-eyelid surgery may be covered by insurance if used to correct visual field defects)
Duration: 1 to 3 hours.
Anaesthesia: Usually locally with sedation
Side Effects: Temporary discomfort, tightness of lids, swelling, bruising. Temporary dryness, burning, itching of eyes. Excessive tearing, sensitivity to light for first few weeks.
Risks: Temporary blurred or double vision. Infection, bleeding. Swelling at the corners of the eyelids. Dry eyes. Formation of whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery). Blindness (extremely rare).
Recovery: Reading: two to three days. Back to work: seven to 10 days. Contact lenses: two weeks or more. Strenuous activities, alcohol: about three weeks. Bruising and swelling gone: several weeks.
Duration of Results: Several years, often permanent.
Eyelid Surgery (Blepharoplasty)
Eyelid surgery (technically called Blepharoplasty) is a procedure to remove fat, usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes, i.e. those features that make you look older and more tired than you feel and may sometimes interfere with your vision. However, it won't remove crow's feet or other wrinkles, eliminate dark circles under your eyes or lift sagging eyebrows. While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage. Blepharoplasty can be done alone or in conjunction with other facial surgery procedures such as a facelift or browlift.
When eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anaesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.
The Best Candidates
To be a good candidate for eyelid surgery, you must have realistic expectations about what the procedure can do for you. It's important to understand that the procedure can enhance your appearance and self confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidates for eyelid surgery should be physically healthy, psychologically stable and realistic in their expectations. Age is not a major consideration however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.
Expectations
You and your surgeon 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.
Your surgeon will explain the techniques and anaesthesia he or she will use and the risks and costs involved.
Types of Anaesthesia
Eyelid surgery is usually performed under local anaesthetic which numbs the area around your eyes along with oral or intravenous sedatives. You'll be awake during the surgery, but relaxed and insensitive to pain.
The Surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go smoothly. While you're making preparations, be sure to arrange for someone to drive you home after your surgery and help for a few days afterwards if needed.
Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, the surgeon will probably work on the upper lids first.
In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids in the creases of your upper lids and just below the lashes in the lower lids. The incisions may extend into the crow's feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.
If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, your surgeon may perform a Transconjunctival Blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.
Most Common Risks
When eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anaesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.
The minor complications that occasionally follow Blepharoplasty include double or blurred vision for a few days, temporary swelling at the corner of the eyelids and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out. Your surgeon can remove these easily with a very fine needle.
Following surgery, some patients may have difficulty closing their eyes when they sleep and in rare cases this condition may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.
Getting back to normal
After surgery, the surgeon will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anaesthesia wears off, but it is possible to control any discomfort with pain medication.
Your surgeon will instruct you to keep your head elevated for several days and to use cold compresses to reduce swelling and bruising. Bruising varies from person to person and reaches its peak during the first week. Bruising 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. Many doctors recommend eye drops, as your eyelids may feel dry, 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.
Your surgeon will follow your progress closely for the few weeks. The stitches will be removed two days to a week after surgery. 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 remaining bruising. You may be sensitive to sunlight, wind, and other irritants for several weeks, so wear sunglasses and a special sun block made for eyelids when you go out.
Your surgeon will probably tell you to keep your activities to a minimum for three to five days and to avoid more strenuous activities for about three weeks. It's especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol, since it causes fluid retention.
Your New Look
Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they'll fade to a thin, nearly invisible white line.
The positive results of your eyelid surgery such as the more alert and youthful look that you’ve gained will last for years. For many people, these results are permanent.
For more information please call us on 1300 138 797 or email info@cosmosclinic.com.au
