Upper Eyelid Surgery
What Is Blepharoplasty?
Blepharoplasty is a surgery performed on the eyelids. It’s done to remove excess skin from the upper eyelids and reduce bagginess from the lower eyelids. It’s also called an eye lift.
The skin loses its elasticity, and our muscles slacken with age. For the eyelids this results in an accumulation of loose skin which collects as folds in the upper lids and forms deepening creases in the lower lids. At the same time there is slackening of the muscle beneath the skin allowing the fat, which cushions the eyes in their sockets, to protrude forward to give the appearance of bagginess. In some families there is an inherited tendency for bags to develop during early adulthood before any skin changes.
Why Is Blepharoplasty Done?
This surgery is usually done for cosmetic reasons. It's also an effective way to improve sight in older people whose sagging upper eyelids get in the way of their vision.
An eye lift won’t get rid of dark circles under the eyes, crow's feet, or other facial wrinkles. It’s often done along with other procedures such as laser resurfacing, filler injections, or forehead lift.
Is there an alternative to Blepharoplasty?
Sometimes, a sagging forehead and eyebrow can make the eyelid look like it is sagging. Your surgeon may recommend an eyebrow lift instead of, or at the same time as, an eyelid reduction. Only wrinkles in the skin which is cut away by the surgery will be improved. Folds of skin extending on to the cheek will not normally be improved. If you have wrinkles and saggy skin elsewhere on your face and neck, it may be useful to have a facelift or neck lift (or both) at the same time as the eyelid reduction. A facelift can be used to not only lift the eyebrow and the upper eyelid, but also to lift and open the outer corner of the eye.
Although an eyelid reduction is the best way to reduce sagging of the eyelid, a laser can sometimes be used to burn the surface of your skin in a controlled way. This is called laser resurfacing and it can be carried out at the same time as the eyelid reduction to improve any remaining wrinkles. After laser resurfacing, the skin heals to be softer and less wrinkled. This improvement is not permanent, and the procedure does not work well on dark skin.
It has no effect at all on dark circles under the eye. Botox (injections of the botulinum toxin) can also be used to smooth out fine wrinkles.
Be as healthy as possible. It is important to keep your weight steady with a good diet and regular exercise. Your GP can give you advice on this. If you smoke, stopping at least six weeks before the operation will help to reduce the risk of complications. Do not worry about removing hair near where cuts will be made, but do have a bath or shower during the 24 hours before your operation to make sure that the area is as clean as possible.
You’ll need to arrange for another person to drive you home after your surgery. You should also have someone stay with you the night of the procedure. You are very welcome to a sedation drug to help you relax, providing the surgeon agrees you’re fit and well to receive the sedation. It is a small tablet, and you are prohibited to drive for 24 hours following the administration of the drug.
Expect and plan to stay home from work and limit your activities for several days after surgery while your eyelids heal. Some people have dry eyes after surgery, but that rarely lasts more than 2 weeks. If you have dry eyes lasting more than 2 weeks, contact your doctor.
You will meet your surgeon to talk about why you want surgery and what you want. The surgeon will make a note of any illnesses you have or have had in the past. You should tell him if you have ever had any thyroid disease, high blood pressure, diabetes or eye disorder (such as a detached retina or glaucoma). The surgeon will also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor.
Your surgeon will examine your eyes, face, and skin, and will take some photographs for your medical records. They will ask you to sign a consent form for taking, storing, and using the photographs.
The surgeon will make sure that it is safe to do an operation. If you are overweight, pregnant or planning to become pregnant, your surgeon may suggest delaying your operation.
At home, you should have the following items ready:
- Ice cubes
- Ice pack (or you can use freezer bags filled with ice, frozen corn, or peas)
- Small gauze pads
- Eye drops ask your doctor to recommend the proper type to meet your particular needs)
- Clean washcloths and towels
- Over-the-counter painkillers (which your doctor can recommend)
An eyelift usually takes about 2 hours if both upper and lower eyelids are done together. Your doctor will most likely use local anesthesia (a painkiller injected around the eye) with oral sedation.
At this clinic we only provide an upper eye lid surgery.
The surgeon will usually cut along the natural lines of your eyelids. Through these cuts, your surgeon will separate the skin from the underlying tissue and remove the excess fat and skin (and muscle if indicated). Next, the surgeon will close those cuts with very small stitches. The stitches in the upper lids will stay for 3-6 days. You will need to return to the clinic to have the sutures removed.
After either of these procedures, your surgeon may recommend laser resurfacing.
After the surgery:
Your doctor will probably put ointment in your eyes to keep them moist and cover them with cold compresses while you’re in the recovery room. Right after surgery, you may have blurry vision from the ointment and be sensitive to light. Your eyes may feel dry or watery.
It will help to put ice packs on your eyes and sleep with your head raised the first night after surgery.
Upper eyelid surgery is good for at least 5-7 years. Lower eyelid surgery rarely needs to be repeated. Of course, your eyes will still age after the procedure.
If your lids sag again, a forehead lift rather than another eye lift may be the preferred procedure.
Blepharoplasty Recovery and aftercare:
You may have a little bleeding from your eyelids for the first day or two after your operation. Dab this away gently with gauze squares or a clean handkerchief. Activities that increase the blood flow in your face (for example, bending over, straining, lifting or taking a hot bath) may increase the chance of bleeding, so avoid these for the first week.
Sleep with extra pillows to keep your head raised and be gentle with your eyelids for at least another month. You can gently clean your eyes with wet gauze.
You will be able to do light activities after one or two weeks. Most patients take at least two weeks off work after the operation, depending on their job. Do not lift heavy things for several weeks and avoid sex for at least two weeks. With all activities, start gently. Do not drive until you feel safe and are comfortable wearing a seatbelt. Check your insurance documents if you are not sure.
After eyelid surgery, you’ll have stitches in both lids that will remain for as long as a week. It is common to have swelling and, occasionally, bruising, but your eyelids should look normal within a week or two. To aid recovery and to assist the operation look it’s best for a longer period of time you should:
- Protect your body, and get the best result, look after yourself.
- Avoid vigorous activities after your operation.
- Protect your wounds as you are told to.
- Putting on weight will affect the results. Maintain a healthy weight and level of exercise.
Complications and risks of the surgery:
- Scars: There will be scars from the surgery. These will usually be red at first, then purple, and then fade to become paler over 12 to 18 months. Occasionally, scars may become wider, thicker, red or painful, and you may need to have surgery to correct them.
- Bleeding: Bleeding into the wound or the eye socket is unusual but possible, and you may need a blood transfusion or another operation (or both) to stop the bleeding. If there is bleeding into the eye socket, this is an emergency as increased pressure in the eye socket can cause permanent blindness. The risk of bleeding into the eye socket is higher if your surgeon needed to remove fat. It usually happens immediately after, or soon after, surgery. A build-up of clotted blood underneath the wound can delay healing or cause scarring, and you may need another operation to remove it. Before the surgery your surgeon will discuss any medicines that increase your risk of bleeding, and it is important to control high blood pressure.
- Infection: If you get an infection of the wound you may need antibiotics or another operation. This can affect the result of the surgery.
- Swelling, bruising and pain: There will be some swelling and bruising around the eyes after the operation, and this can take weeks to settle. There may be long-term pain, but this is uncommon. The result can take many months to appear, once the swelling has completely gone down.
- Healing problems: Sometimes, wounds take longer than expected to heal. This problem is usually put right by dressing the wounds, but you may need an operation to remove the tissue that has not healed. Smokers are more likely to have healing problems.
- Sometimes, tiny white cysts can appear along the stitch line. These are nothing to be concerned about and your practice nurse can pick them out with a needle. If you tend to suffer from dry eyes or watering eyes, the surgery will temporarily make this worse. However, it should settle within six weeks.
- Extrusion: This is where deep stitches poke out through the skin. These can easily be removed.
- Increased or reduced sensation After the surgery, the skin near the scar can be sensitive. In rare cases, the change in sensation may be permanent.
- Asymmetry: This is where the eyes are not symmetrical. Almost everyone has a mild degree of asymmetry, and eyelid surgery may make you much more aware of this.
- Eyelid position: For the first day or two after the surgery it is quite common for the eyelash line of the lower lid to be slightly pushed away from the eye due to swelling. This will usually settle on its own or with simple dressings, but you may need another operation. If too much skin is removed, it can cause your eyelid to be so tight that you cannot close it properly. This can lead to the surface of the eye getting dry. If this is severe, you may need a small skin graft.
- Damage to deeper structures: Although rare, the surgery can damage deeper structures, including the eyes, nerves, blood vessels and muscles. This damage may be temporary or permanent. Blindness is an exceptionally rare complication. However, temporary changes in the film of moisture over the eyeball or pressure on the eye itself can affect your eyesight and may make you more aware of age-related deterioration in vision. Any temporary effect from the surgery will disappear within six months. Rarely, the surface of the eye can be scratched during the operation or by a stitch. If this happens you may need to use an antibiotic ointment for a few days. If the operation involved removing fat from a lower eyelid, there can be damage to eye muscle within the fat, which can cause double vision. This may be permanent and you would need to have a second operation.
- Unsatisfactory result: Sometimes, patients are not satisfied with the result of their eyelid reduction. This may be to do with the look or feel of the eyelids, or the shape of the eyelids not meeting expectations. It is very important that you talk to your surgeon, before you have the surgery, about the outcome you want, and whether this can be safely achieved with a good outcome. A very small number of patients need another operation to get the result they want.
- Change over time: The result of an eyelid reduction usually lasts for five to 10 years and can sometimes be permanent. The appearance of your eyelids will change as a result of ageing, sun exposure or other circumstances not related to your surgery. You may need more surgery or other treatments in the future to maintain the results of the eyelid reduction.
- Allergic reaction: Rarely, allergic reactions to tape, stitches or solutions have been reported. If you have an allergic reaction, you may need extra treatment.
Disclaimer: This website is designed to supply useful information but is not to be regarded as advice specific to any case. It does not replace the need for a thorough consultation and all prospective patients should seek the advice of a suitably qualified medical practitioner.
- Upper Eye Lid Surgery – 1950.00