Eyelid Surgery (Blepharoplasty)
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The eyes are the first thing we notice when we look at someone's face. It's often said that you can tell a lot about a person's personality by looking into their eyes and they have been evocatively named the “windows to the soul”. This might just be a romantic notion but one thing is true; you can see evidence of a person's lifestyle and habits just by taking one good look at their peepers.
Everyday actions such as blinking and squinting have an unavoidable long term effect on the eye area not to mention the effect of sunbathing, smoking, wearing contact lenses, pollution and crying. While we can prevent the toll that some of these everyday activities take on our face by wearing sunglasses, making sure we remove make-up before we go to bed and wearing a good quality eye cream, the natural ageing process catches up with us all eventually.
But don't despair, there are a range of procedures designed to make the eyes look fresh and wide awake which can take years off of your face. Dreaded crows feet and wrinkles can be remedied effectively with Botox and fillers. Make-up techniques such as eyelash tinting and semi permanent make-up can also be used to great effect to brighten, widen and lift the eyes. For the more serious effects that occur due to tissue loss and sagging skin that comes with the natural ageing process, eyelift surgery (or blepharoplasty) can be a long term solution.
What is blepharoplasty?
Blepharoplasty comes from the Greek words 'blepahron' (meaning eyelid) and 'plasty' (meaning to form). This procedure involves repositioning and removing the fatty tissue muscle and skin that drops as the face ages and can remedy most problems associated with the ageing of the eye area. Such problems commonly include the formation of bags under the eyes, caused by fat under the eye socket sinking into the cheeks, and the wrinkling and sagging that happens when the lid above the eye begins to drop and look hooded. The procedure used to correct the problem with the lower eye area is know as a Lower Lid Blepharoplasty and the procedure for the top lid is termed an Upper Lid Blepharoplasty. These are basic procedures but your surgeon may use a slightly different procedure depending on your exact problem.
The procedure
Like most cosmetic surgery, eyelid surgery will involve a consultation to ensure that procedure is right for you and that you have no medical complaints that might cause complications with the operation. Your surgeon will discuss exactly what process they will use to achieve the effects you desire and advise you of any pre and post operative preparations you should make. The surgery is usually done under local anaesthetic so you can leave hospital the same day but if the surgeon and patient prefer, light general anaesthetic will be used. The procedure is commonly undertaken at the same time as a brow lift or face lift to achieve a more complete result. In this case general anaesthetic will probably be used. The operation will last for approximately two hours where treatment is on the upper and lower lids of both eyes.
Basic upper lid blepharoplasty
This is the basic procedure to correct hooded eyelids. The surgeon will make an incision in the natural crease of the upper eyelid to avoid visible scarring and will then remove any excess muscle fat and skin from the area and sew the incision with tiny stitches (probably dissolvable ones). This procedure is often carried out alongside a brow lift to really open up the eyes and both surgeries can be completed at once.
Lower eyelid blepharoplasty
An incision is made just below the lash line so scarring is almost unnoticeable. The surgeon will lift any muscle tissue fat or skin that has become loose and remove the excess before stitching the wound. As well as improving the look of eye bags, wrinkles will also be diminished and your eye might appear to be a more youthful shape as the excess weight is removed to prevent the skin dragging.
Transconjunctival lower lid blepharoplasty
This is like the above procedure but here the surgeon will make the incision inside the lower lid. This means that no scaring will be visible. This procedure is common when there is only a little fat to be removed rather than a complete lifting process. It is preferred for younger patients whose muscle and skin is still elastic as this procedure will not correct under eye wrinkles.
After care and recovery
There will be bruising and some light scabbing around the incision so about two weeks off work after the surgery will be necessary. If non dissolvable stitches were used, patients will be required to visit the surgeon about seven days after surgery to have them removed. The surgeon will also want to check that the incisions are healing well and the eye is looking how it should. Eyelids will feel tight and sore for a few days after the procedure and the patient may even experience some stinging sensations. Swelling may continue for two weeks but ice packs can be used to alleviate this.
The surgeon should recommend some cleansing products and eye drops or lubricant to keep the eyes moist and patients should avoid alcohol while their eyes recover as this can have a drying effect on the eyes. Patients should also purchase a pair of large sunglasses to wear for some weeks after the operation, not only to disguise bruising and soreness but to protect the healing skin from sunlight and other abrasions.
Risks
The risks associated with eyelid surgery are the usual ones entailed in any surgery carried out under anaesthetic including reactions to the anaesthetic and the risk of infection. Additional side effects of the procedure are usually temporary and include dry eyes or stinging and watery eyes, blurred vision and numbness. Some of these can be treated by medication but usually disappear in a few weeks. In very rare instances they can be long term.
More permanent but very rare side effects include dropping lids where too much tissue has been removed and the remaining tissue is weak. This can occur to both upper and lower lids. It can correct itself on its own but may require extra surgery. The lower eyelid might also appear sunken if too much tissue is removed leaving the patient looking drawn. This can be corrected by fat injections, fillers and further surgery. Blindness is an extremely rare but possible side effect of the operation.