Eyelid surgery (upper and/or lower blepharoplasty)
Length of operation: from 1 hr 30 min to 3 hours
Type of Anaesthesia: Local/ General
Length of stay in hospital: day case/ one night hospital stay
Recovery time: 10 to 14 days for the bruising and swelling to subside. Full recovery is between 3 to 5 months
Time off work: 1.5 to 2 weeks after operation
About blepharoplasty: With the passage of time the skin stretches and becomes less elastic and wrinkly and the normal fat which is present underneath the eyeball bulges forward causing eye bags to become prominent. Blepharoplasty consists of the conservative removal of fat, excess skin and muscle from the upper and lower eyelids. You can have this procedure done alone or have it done in combination with other facial cosmetic surgery procedures like a forehead lift or a facelift.
Suitable candidate: If any one or a combination of the following conditions trouble you – puffy eye bags below your eyes, drooping upper lids, excess skin obscuring the natural fold of the upper eyelids or droopiness of the lower eyelids, showing white below the iris – then you would be a good candidate for eyelid surgery.
Reasons not to go ahead: patients on blood thinning medicine, active smoking, overweight patients, problem with tear ducts leading to dry eyes, glaucoma, detached retina, ectropion (downward pulling of the lower lid, which would anyway require additional surgical procedures).
Pre op: The consultation with your surgeon will be your opportunity to discuss your expectations, learn about the surgery and ask queries or clarify any doubts you might have. The surgeon will perform an examination in order to be able to assess your individual needs and discuss the results in length with you.
On the day: If you decide to go ahead with the procedure, you will receive advice about what to do and what to avoid, prior to surgery. Following the operation, the surgeon will lubricate your eyes with an ointment right after the surgery. Most patients are discharged either the same day or the following morning from the hospital.
Post op: An appointment will be made for a wound check and removal of sutures seven days following the operation ( usually the sutures are dissolving). The patient will receive a complete list of postoperative care instructions before leaving the hospital including how to care for the surgical site including application of ointment and gentle massage to help the swelling and the bruising to settle, medications to take, specific concerns to look for at the surgical site or in overall health. A review appointment is arranged with the surgeon a week or so after the operation.
Following the operation the area around the eye will be bruised and swollen. The bruising and swelling normally settles within one to two weeks following surgery. There may be times where your eyes will feel extra dry. You can treat this by applying drops or an eye ointment and avoiding activities such as reading, watching TV, wearing contact lenses and spending time on the computer. The sutures are normally removed after five to seven days. There will be scars just like any other surgery, and these scars will heal depending on each individual patient. It is going to be hard to close your eyes for the first few days but this is only temporary. There will also be temporary blurred vision for the first few days but this will eventually clear out. You may have to wear dark sunglasses after the surgery which will prevent the eyes from getting irritated by the elements like dust, bright light, the sun, and wind. It is recommended that you take a lot of naps because your eyes will likely tire easily and avoid crying and activities that involve increasing the blood flows to the eyes like sport, bending and heavy lifting.
Convalescence: Keep your head elevated for the first few days after surgery. Most of the bruising and swelling will be experienced during the first two weeks. It will begin to subside after the first ten days. Scars from bletharoplasty are usually small, tend to settle well and not very noticeable.
Risks and complications: A small percentage of patients can have complications just like for any surgical procedure.
Infection: can be usually readily treated with an antibiotic.
Haematoma (blood clot under the skin) or bleeding: a re-visit to the operating theatre may be necessary.
Delayed healing of the wound: particularly true in case of diabetic patients or those who smoke. This needs to be discussed with the surgeon during the consultation stage.
Asymmetry and scars: usually scarring will normally heal well, but will differ from patient to patient.
Eye closure: temporary and should only last for only a few days; in rare cases, it can be permanent and could lead to sleeping disorders.
Ectropion (tightness of the eyelid) and epiphora (watering of the eye); very rare; less than 5 per cent may require a secondary revision procedure.
Effects of the procedure: Patients are usually happy with their appearance for many years following eyelid surgery as the results are generally long-lasting. Removal of fat from eyelids, which usually causes puffiness and bags, is permanent and therefore these conditions will usually not recur. However, as the skin continues to age, skin laxity along the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows which mimics a recurrence of drooping upper eyelids. if this happens, correction may require a forehead lift or a secondary eyelid procedure.
All results will be affected by your heredity, skin type and lifestyle factors.