By Dr. Drispiotis, Ophthalmologist.
Blepharoplasty is a surgery to remove excess skin and fat from your eyelids and tighten skin and soft tissues around your eyes. Your specialist surgeon will evaluate and let you know if a blepharoplasty is right for you. However, it is up to you to decide whether or not to intervene.
Home take message!
A blepharoplasty is an aesthetic act that makes your eyelids look younger and in some cases improves your eyesight. However, it is not suitable for all people. You should carefully consider the options suggested by your specialist eye surgeon and have realistic expectations about the results.
Is blepharoplasty suitable for me?
As you grow older, your skin loses its elasticity and gravity pulls down on the soft tissues of your eyelids resulting in an under-eye bag. The small fat pads behind the diaphragm project through the weakened muscles, making your eyes look tired and swollen.
Excess skin on the upper eyelid can sometimes be so intense that it interferes with your vision. An upper eyelid blepharoplasty can be an effective treatment in making you look younger and at the same time improve your eyesight.
The skin in the lower eyelid may lose its tone, hang, wrinkle and appear swollen due to the fat pads that protrude through the loose tissues. A lower eyelid blepharoplasty can help reduce excess skin and swelling.
In any case, your surgeon will make a detailed evaluation before deciding if the surgery is right for you. This may include taking photos for your medical records as well as questions about your medical history. Your surgeon will examine your face and the quality of your skin. They may also ask you if you are planning to lose a lot of weight as it is preferable to lose weight before having the surgery.
What can I expect from Blepharoplasty Surgery?
If the procedure is successful, your face will look younger and brighter. If your upper eyelid interferes with your vision, your vision will improve.
It has been found that most people who have a successful blepharoplasty feel more comfortable with their appearance and this is transmitted to all areas of their daily lives.
Are there any alternative therapies to blepharoplasty?
Blepharoplasty is the only and most effective way to reduce bags on your upper and lower eyelids.
Laser skin regeneration as well as Botox infusion for fine wrinkles are co-ancillary therapies that optimize the surgical outcome but do not replace blepharoplasty. If you have signs of aging in other parts of your face or neck, you may want to consider having a face lift, mid-face lifting or eyebrow lifting at the same time as an eyelid surgery.
What does the blepharoplasty surgery include?
An upper or lower eyelid blepharoplasty is usually performed using a local anesthetic that is injected into the eyelid in combination with mild intoxication. The duration of the operation varies greatly depending on the number and size of the problems that need to be addressed in the upper or lower eyelids.
No hospital stay beyond 2-3 hours after surgery is required.
- Upper Eyelidoplasty – Your surgeon will make an incision in the natural aspect of the upper eyelid skin. Any excess skin and / or fat will be removed in combination with some internal sutures to correct the eyebrow.
- Lower Eyelidoplasty – Your surgeon will make a cut along the lower eyelid below your eyelashes to the outer edge of your eye. Any excess skin will be removed and any fat projecting through the muscle will be removed or redistributed.
In some patients where the problem does not involve excess skin, your surgeon may choose to access the conjunctiva without external incisions in the lower eyelid.
At the end of the procedure, your surgeon will close the incisions with non-absorbable sutures that will be removed in the surgery after a few days.
What should I do if I take medication?
You should tell your doctor about all the medicines you are using and follow their advice. This includes herbs and medicines to control diabetes and blood pressure. If you are on beta-blockers, you should continue to take them regularly. You may need to stop taking warfarin, clopidogrel, aspirin or other anti-inflammatory drugs before your surgery, as these are more likely to cause you to bleed during and after surgery.
What can I do to help my blepharoplasty succeed?
- If you smoke, stopping smoking a few weeks or more before an operation can reduce the chance of complications and improve your long-term health.
- Try to maintain a healthy weight. You are more likely to develop complications if you are overweight.
- Regular exercise will help you prepare for surgery and speed up your post-surgical recovery.
What are the possible complications?
The complications of the blepharoplasty surgery range from mild to severe but are largely fully manageable and may include:
- Pain. However, the pain after a blepharoplasty is mild and is usually easily treated with simple painkillers such as paracetamol. If you have severe pain, you should inform your surgeon as this is unusual.
- Bleeding during or after surgery. The bleeding is usually mild. Extracts and eyelid swelling are to be expected in the first few weeks and will completely recede within the next few weeks.
- Surgical trauma infection. If your eyelid swells and hurts for a few days after surgery, you should tell your doctor. Usually an eyelid infection is completely treated with oral antibiotics.
- Removing too much skin can cause a tight eyelid that you cannot close properly. The surface of the eye can be very dry. In extremely rare cases, a small skin graft is required to correct the problem.
- Bleeding inside the conch (risk: 1 in 2,000). This can even lead to reduced vision (risk: 1 in 10,000). The risk is greater if your surgeon needs to remove the endoconchial fat but virtually resolves it with the proper technique.
- Corneal skins. If this happens, you may need antibiotic ointment for a few days.
- Diplopia, caused by damage to the ocular muscle surrounding the lower eyelid fat. This can happen if the procedure involves removing fat from the lower eyelid. Dual vision is usually transient and recedes after a short time.
- Hypertrophic scars. It is difficult to accurately predict how the incisions will heal. They will usually fade after three to six months.
What are the post-operative instructions?
It is recommended to use ice on your eyelids for the first couple of days to reduce any bruising or edema. It is common to feel your eyes dry for the first 1-2 days. Your surgeon will give you special drops of lubricant to ease the discomfort. You can gently cleanse your eyes with wet gauze.
You must not drive, operate machinery (this includes cooking) or perform any potentially hazardous activities for at least 24 hours and not until movement and coordination is fully restored.
For the first week, you should avoid any intense activity and try to keep your head elevated by sleeping on extra pillows. You should not wear makeup for at least 2 weeks and you should wear sunglasses for better healing of the incision.
Regular exercise will help you get back to normal activities as soon as possible. Before you begin the exercise, you should seek the advice of your doctor as each patient is unique and have their own timetable for recovery.
What is postoperative monitoring?
Your surgeon will arrange follow-up visits to check on your progress. It usually takes 3-4 weeks for complete edema to recede and the result to be restored. The effects of a blepharoplasty can last up to ten years and can sometimes be permanent. Your face will continue to grow, but it will always look younger.