Blepharoplasty
Eye Lid Surgery
Why do eyes start looking tired?
As we all age, the skin loses its elasticity and the muscles of the eye weaken. This results in the brows dropping, in excess skin in the upper eyelid, in weakness of the lower eyelid comparments causing fat to protrude. General face laxity can also impact the way we look.
Eyelid surgery is usually the last resort to many patients, as there are many steps before to help with many of these problems around the eye.
What is blepharoplasty?
The term blepharoplasty can refer to any surgery around the eyes, upper or lower, to reshape the eye. An upper eyelid blepharoplasty removes the excess skin, and can ve combined with a browlift. A lower eyelid blepharoplasty involves working on the fat compartments to reduce the protrusion. The procedure can be combined with tightening the eye (canthopexy).
There are some risk factors to a blepharoplasty. These include:
- Infection
- Bleeding
- Asymmetry
- Over correction
- Unfavrouble scarring
- Dry or watery eyes
- Blindness
Who is a good candidate to have eyelid surgery?
- You do not suffer from dry eyes
- You do not smoke or prepared to stop smoking
- Want wider eyes without hooding
- Do not suffer from seasonal hay fever
What is eyelid surgery
Blepharoplasty, is the operation to correct droopy eyelids and remove excess skin and fat. It can be combined with a canthopexy, a tightening of the lower eyelid, lacrimal gland repositioning and muscle repairs. It also combined with a browlift or a facelift on many occasions. Post surgery addition of anti-wrinkle injections can help give a final touch.
Benefits of eyelid surgery
Blepharoplasty procedures are done for aesthetic or functional reasons. The procedure will remove the excess skin and fat, and if needed the muscle can be tightened to restore the youthful look of the eyes. If there is severe hooding this can result in vision restriction and reduced peripheral vision. Lower blepharoplasty addresses the lower eyelids excess of skin and fat herniation. Patient feedback afterwards that they look fresher and less tired.
blepharoplasty procedure
The procedure is very safe and is done under a local anaesthetic or general anaesthetic. It takes around 45 minutes to do the upper blepharopplasty and around 1 hour to do the lower blepharoplasty. The scars are well placed to be hidden in the long term. Afterwards cool compressions are applied. It can be a daycase procedure. It takes at least a week to recover and 10 days as a hide away period. Final results take up to 4 months to allow all the scars to settle.
Watch how a blepharoplasty is preformed
Potential Patient Benefits of Eyelid Surgery
PSYCHOLOGICAL
- Feeling less tired appearance
- Increase self confidence
- Boost self-esteem
CLINICAL
- Improve symmetry
- Improve peripheral vision
- Assist glasses or contact lenses wear
Start with a virtual consultation
Options with Eyelid Surgery
one of the first things we discuss is the need for a combined browlift and blepharoplasty procedure. The reason being is that is a browlift is needed, it should be done first.
We always examine the whole the face, sometimes a facelift can correct lower eye problem better than a blepharoplasty alone.
The option of having only upper or upper and lower eyelids, depending on patient needs.
After Care after Eyelid Surgery
Upon discharge, it is important to rest after a blepharoplasty procedure and provide straining or stress, This can cause an acute bleed and this can be dangerous. You should keep the area clean and dry until you return for the wound check in 1 week.
The scars normally heal well, but to help them along, using a gentle moisturiser after 2 weeks helps.
Arnica reduces bruising and can be started before the surgery or soon after, either as a tablet or cream.
Reviews
What our patients say
HealthFormation
Dry eyes & blepharoplasty
As part of our clinical history and examination we ask about dry eyes or watery eyes. Existing problems with this matter can be made worse by surgery and needs to be mitigated.
asian vs caucasian eyes
One of the main differences is the position of the fold in the upper eyelid. The creation of the fold is possible in the upper eyelid but requires training.
medications & Vitamins
Some medications and vitamins can increase the risk of bleeding during surgery and so careful consideration needs to be taken if to stop them.
Choose Your treatment
eyelid surgry- what do you need to know
In this section we will tell you all what you need to know about blepharoplasty or eyelid surgery, in concise and easy bites. This includes the consultation, the examination, the pre-operative preparations and the post-operative care. If you have specific questions, please contact us and we can answer you.
Talk to your surgeon to see if you are suitable for these procedures. The procedures maybe appropriate to you if:
- Excess skin in the upper and lower eyelids
- Excess fat in the upper and lower eyelids
- Grooving in the tear trough of the lower eyelid
- Lower eyelid malar bags
Some patients might not be suitable for a blepharoplasty procedure. Your plastic surgeon will be able to advise you if you are not suitable and if anything can be done to change your criteria. Your surgeon might be able to suggest alternative treatments. Some common reasons why a patient might not be suitable are:
- You have medical conditions that might give rise to major complications.
- Dry eyes
- Visual problems
- Need another procedure first or in combination such as a browlift
During the consultation, you will meet your plastic surgeon and the nursing team. After they introduce themselves to you, the team will collect some demographic information and will proceed to take a relevant medical history and a focused clinical examination. Following this process, your surgeon will explain the possible treatment options for you, including the benefits and the potential consequences of the treatment. There will be an opportunity to discuss your financial options as well. Should you wish to proceed with the treatment or come back for another consultation, we will assist you to move along with you to the next step of your treatment.
The physical examination involves examining the excess skin of the eyelids, the fat pads, and the laxity of eyes. We might also need to examine your vision and tear production.
There are some steps that you can take before having the procedure to ensure that you have a better surgical journey.
- Have a gentle and relaxing evening the day before.
- Eat a meal that you enjoy that is high in vitamins and calories, as you might need to fast the day before.
- Have a relaxing shower the night before. Avoid having a bath.
- You might be tense or nervous before your procedure. Set up your environment to relax and do activities that make you relax, such as reading a book or listening to a podcast.
- You might be given some anti-septic wipes to cleans your body, if so please use them as directed.
- Get all your household shopping done before your surgery and stock up for around one week.
- Have enough loose and comfortable, front fastening, garments that would last for one week.
- If you have pets, it is best to avoid close contact with them the day before.
- Ensure the environment that you are going to recover in at home is cleaned before the procedure.
- If you take medications the anesthesiologist will discuss with you which medications you can take on the day of the surgery and which you should not.
- If you take any herbal medications or vitamins, we will advise you what you should stop and which you can continue to take. In general we advise to stop most of these at least 4 weeks before surgery.
- If you have children, arrange for some help. You might it difficult to carry them for example.
- Place items within easy reach, so you don’t have to stretch after your surgery.
- You should stop smoking before surgery.
Blepharoplasty will rejuvenate the areas around the eye, and this will have beneficial effects:
- A greater confidence
- Improved body image perception
- Improved self-esteem
- Improve vision in cases of hooding.
High projection implants are by far the commonest choice along with round implants within our patient groups. This implant will give the maximum side push for the breast and will also give some lift to the nipple improving its position.
Blepharoplasty is a surgical procedure and so should expect some of the following:
- Some pain and discomfort afterwards
- Bruising in the area
Every cosmetic procedure involves a certain amount of risk, and it is important that you understand the risks involved. An individual’s choice to undergo a cosmetic treatment is based on comparison of the risk to potential benefit.
The following are some of the possible complications that may result from this type of treatment, which may be beyond the doctor’s control. Please read and initial each risk that is mentioned. I understand that no guarantee has been made to me as to result. I realize that, as in all medical treatment, complications or delay in recovery may occur which could lead to the need for additional treatment, and could also result in economic loss to me because of my inability to return to activity as soon as anticipated.
_____ BRUISING, SWELLING, INFECTION With any treatment, bruising of the treated area may occur. Additionally, there may be swelling noted. Skin infection is a possibility any time a procedure is performed. Should infection occur further treatment with antibiotics or hospital admission may be required.
_____ BLEEDING, HAEMATOMA It is possible, though unusual, to experience a bleeding episode during or after the treatment. Should post-procedure bleeding occur, it may require treatment to drain accumulated blood (haematoma). Certain medications such as aspirin, warfarin and other anticoagulants may increase the risk of bleeding. Some vitamin and herbal supplements may also increase bleeding risk. It is important that you inform us of all medications and supplements being taken. Accumulation of blood under the eyelids may delay healing.
_____ BLINDNESS Blindness is very rare following blepharoplasty. However, if there is bleeding around the eye and eyeball during and after the procedure (retrobulbar haematoma) this may result in blindness if untreated. If this occurs urgent immediate surgery will be required to stop the bleeding.
_____ ASYMMETRY All patients will have some degree of asymmetry. These asymmetries may be more noticeable following the procedure. There may be asymmetries in scar position, size, and shape between the two sides. Some degree of asymmetry is to be expected but additional surgery may be required to improve more significant asymmetry.
_____ SCARRING All surgical procedures will result in scarring. Scarring and wound healing will vary greatly from patient to patient with some having a greater tendency to develop abnormal scarring such as hypertrophic or keloid scarring. The nature of scarring is unpredictable. Scarring may also occur in deeper tissues that may alter the outcome of the procedure. Scars will initially be red and may be raised. They take time to mature and improve and this may take up to 2 years. Asymmetry of scars may also occur.
_____ PIGMENTATION Changes in pigmentation are usually temporary, but on rare occasions, may be permanent. Appropriate sun protection is very important (SPF 30 or greater). Sun exposure can result in prolonged redness within a scar.
_____ DAMAGE TO DEEPER STRUCTURES Deeper structures such as nerves, tear ducts, blood vessels and muscles may be damaged during the course of the treatment. The potential for this to occur varies according to the location on the body the treatment is being performed. Injury to deeper structures may be temporary or permanent.
_____ DRY EYE PROBLEMS Permanent problems involving decreased tear production may occur after this procedure. Patients with dry eyes prior to treatment should inform Mr Soueid of this. Additional treatments such as lubricants may be required.
_____ EPIPHORIA Excessive tearing may result from damage to the tear duct system. This may require further surgery to correct.
_____ ECTROPION Scarring can result in pulling of the eyelid away from the eyeball. This may result in an inability to close the eye fully, which can result in injury to the eyeball. This is a rare complication that may require additional surgery.
_____ PTOSIS Ptosis is drooping of the eyelid and can happen temporarily following surgery due to swelling. This may however be more long term if there is damage to the levator during the procedure.
_____ CORNEAL PROBLEMS Some patients may experience some inflammation or dryness of the cornea (eyeball surface). Corneal abrasions may also occur if there is any injury to the surface of the eyeball. This will usually resolve but may require additional treatment with eyedrops or ointments.
_____ LOSS OF EYELASHES Some patients may experience temporary or permanent loss of eyelashes in the treated areas. The occurrence of this not predictable.
_____ CHANGE IN SENSATION It is common to experience some reduction or loss of sensation in the area that has been operated. This loss of sensation may be temporary or permanent.
_____ CONTOUR IRREGULARITIES Occasionally there may be bunching up of skin at the ends of a scar, this is called a dog-ear. If small then these will mostly resolve with time however larger ones may require a further procedure to correct. Rarely, small lumps or cysts may occur along the scar or in the treated area. These will mostly resolve without treatment although some may require additional treatment.
_____ CHANGES WITH TIME The results from any procedure will change with time. Alterations in the appearance of the eyelids may occur as a result of ageing, weight loss or gain, sun exposure, pregnancy, menopause or other factors not related to the surgery. Blepharoplasty does not stop the ageing process and is not a permanent procedure. Future treatment may be required to maintain the results of the blepharoplasty.
_____ OVER- OR UNDER-CORRECTION Removal of too much or little skin can result in overcorrection or under-correction, respectively. Under-correction may require further surgery to remove more skin. Over-correction may require further surgery to reconstruct the eyelid.
_____ ALLERGIC REACTIONS In rare cases, local allergies to suture material, or topical preparations have been reported. Allergic reactions may require additional treatment. This should not be used if you have any allergies to the product used.
_____ SURGICAL ANAESTHETIC Local anaesthetic can involve a minor degree of risk. Serious complications such as injury and even death are extremely rare. Numbness and pale patches at the injection sites typically resolve over a few hours. General anaesthetic also carries some risks and potential complications. The anaesthetist will discuss these with you if you are having a general anaesthetic.
_____ THROMBOSIS Surgery, especially longer procedures, may be associated with the formation of, or increase in, blood clots in the venous system. Pulmonary complications may occur secondarily to both blood clots (pulmonary emboli), fat deposits (fat emboli) or partial collapse of the lungs after general anesthesia. Pulmonary and fat emboli can be life-threatening or fatal in some circumstances. Air travel, inactivity and other conditions may increase the incidence of blood clots traveling to the lungs causing a major blood clot that may result in death. It is important to discuss with your physician any past history of blood clots or swollen legs that may contribute to this condition. Cardiac complications are a risk with any surgery and anesthesia, even in patients without symptoms. If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
_____ DISSATISFACTION Although good outcomes are usually expected, there is no guarantee expressed or implied on the results that may be obtained. You may be disappointed with the result of your surgery. Some of the factors contributing to dissatisfaction are not possible to predict prior to surgery. Many of these factors are also beyond the control of the surgeon and will be dependent on patient factors such as healing, compliance with instructions, abstaining from smoking and other activities that may result in poor outcomes.
_____ ADDITIONAL TREATMENT NECESSARY In some situations, it may not be possible to achieve optimal results with a single treatment. Multiple procedures may be necessary. Should complications occur, additional treatments may be necessary. These may incur further charges.
Please follow the aftercare instructions advised to you by your surgeon and nursing team.
- Keep well hydrated and eat healthy food that is high in vitamins and fiber.
- Avoid heavy exercise for around 2 weeks.
- You might find it difficult to drive for one week.
- If you have dressings, leave them intact until your outpatient appointment.
- You can shower after 48 hours, leaving dressings intact. Just let them air dry.
- If you develop bruising, apply Arnica cream to the area. This will help reduce the bruising quicker.
- You might be supplied with an anti-septic body wipe to use after surgery as well. Please use that as directed.
- You can massage around the area of the surgery if it makes you feel comfortable.
- You might have a body garment to wear. Please ensure you wear it as directed. Usually this is continuously for 1 week, then while you are sleeping only for a further 5 weeks.
- You will need to take pre-cautions is you are involved in severe contact sport to avoid undoing the repair. Avoid severe contact sports for 12 weeks.
- Swimming can be resumed once the wounds completely heal. Allow around 2 weeks.
- Pain is well controlled in most people with over the counter medications.
- You should stop smoking for 4 weeks after surgery.
- We will arrange a follow up visit in 48 hours and 7 days to check that you are progressing well.
- We will also arrange a follow up in 8 weeks for a final review.
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BEFORE
AFTER
BEFORE
AFTER
Frequently asked questions
The procedure can be performed under local or general anaesthetic depending on patient preference and complexity. It is usually a day case procedure. You will be given some anaesthetic eye drops as well as an injection under the skin of the upper eyelids. This will make the area feel numb and so the surgery should not cause any pain.
The first step is the pre-operative marking standing up. If you are combining this with a browlift, the browlift is done first. After the administration of anaesthesia, the excess skin is removed and if any fat removal is required then this can also be performed. Sometimes suspension sutures to the skull are needed. The skin is then stitched together and the scar should lie in the natural skin crease of the eyelid.
It is normal to expect some bruising and swelling after a blepharoplasty procedure. This will take about a week or so to settle and improve. The stitches will need to be removed after 5 to 7 days following the procedure.
The blepharoplasty procedure lasts between one to two hours.
Sometimes the procedure can be combined with a browlift, or followed by a fat transfer, skin peel or laser resurfacing.
If you taking any herbal medications or any blood thinning medications you need to tell Dr Soueid, as he might advise you to stop these medications before the operation.
The wound will be checked in one week after the surgery and if everything is healing well you can go back to wearing full make up and use false eyelashes after the procedure.
You will need to avoid wearing contacts lenses for one week to allow the wounds to heal well.
The most common side effects include bruising and swelling. The surface of the eyeball or conjunctiva may also swell, this is called chemosis.
Bleeding
Bleeding may occur after the procedure and it is common to have a few drops from the wound after the procedure. Sometimes the bleeding can be more and result in a collection underneath the skin, this is a haematoma. This may recover further surgery to remove the blood collection.
Blindness
Extremely rarely, a severe bleed may result in blood around or behind the eye that can cause blindness.
Infection
Infection can result in redness and swelling of the eyelids. This may also result in discharge or even wound breakdown.
Under or over-correction
If too much skin is removed this may result in difficulty closing the eye, this is called ectropion. If too little skin is removed then you may have residual skin excess.
Asymmetry
Most patients will have some degree of asymmetry, which is completely normal. This may also occur after surgery or you may become more aware of asymmetries after the procedure.
Scarring
You will have scarring from the blepharoplasty procedure, which will be permanent. The scar is normally in the natural crease of the upper eyelid or just under the eyelashes on the lower eyelid. Occasionally, scars can become raised and thickened, also referred to as hypertrophic or keloid.
Eye related complications
Some patients will experience dry eyes or aggravation of dry eyes following the procedure. This may require some lubricant eye drops to help. Vision may also be blurred for a few days following a blepharoplasty.
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