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Eyelid Surgery

Heavy droopy eyelids can make you look much older than you are. In some cases the droopiness becomes severe enough to impair vision. Puffiness or bags under the eyes may can leave you looking tired, even after a good night’s sleep. Eyelid surgery or blepharoplasty can correct all of these problems and help you regain a fresh and youthful look.

Eyelid surgery can be performed on either the upper or lower eyelids, either separately or, as is often the case, together. Quite often both are performed together. These procedures will not, however, remove dark circles or the fine lines and wrinkles around your eyes. Neither does blepharoplasty address the issue of sagging eyebrows. For the latter you need a forehead lift. Although eyelid surgery is quite often performed on its own, sometimes surgeons recommend combining the procedure with a forehead lift, facelift or other non-surgical procedures such as skin resurfacing.

This article provides you with the basic information you need before making a decision to undergo eyelid surgery. It will help you understand how eyelid surgery can improve your appearance, how the surgery is performed and what you can expect from it. This article is neither a comprehensive guide to eyelid surgery, nor an alternative to a thorough and detailed discussion with your chosen facial plastic surgeon.

Successful outcomes in facial plastic surgery are a result of teamwork and rapport between you and your facial plastic surgeon. Only your surgeon can answer specific questions about your blepharoplasty and your particular surgical needs.

Is Eyelid Surgery for You?

It is essential to have realistic expectations before having eyelid surgery.

Blepharoplasty can help you achieve a refreshed and youthful appearance with firmness around the eyes. The procedure removes excess skin, fat and muscle from both the upper and the lower eyelids.

As with all elective surgery you must be in good health at the time of surgery. If you have eye (ophthalmological) problems, circulatory problems or other serious medical conditions, you should discuss these issues with your specialist doctor and surgeon before making the decision to undergo eyelid surgery.

Your facial plastic surgeon will help you decide whether any other procedures can be combined with your eyelid surgery to better improve your appearance. Your surgeon may recommend combining the blepharoplasty with a forehead lift to smooth forehead wrinkles and remove droopy eyelids.

Before You Have Surgery

Choosing a facial plastic surgeon that you can trust is one of your most important decisions. Your trust should be based on the verifiable qualifications and expertise of the surgeon, his or her reputation and past experience with this type of surgery. The rapport you develop with your surgeon during the initial consultation process is also very important.

When you decide to undergo any cosmetic surgery, including blepharoplasty, make a commitment to follow closely the pre- and post-operative instructions issued by your surgeon. Following doctor’s orders will ensure the best possible outcome.

At the initial consultation your surgeon will examine you and ask a number of questions concerning your vision, tear production, use of lenses and expectations from the surgery. Your surgeon will then explain what you can reasonably expect from eyelid surgery, together with a detailed description of the eyelid surgery procedure. The discussion will cover potential risks and complications involved with this type of surgery, taking into account such factors such as your age, skin type, ethnic background and the degree to which your vision is obstructed by your eyelids.

This discussion should be an open and honest exchange of ideas between you and your surgeon. You will be asked to provide a thorough medical history to help your surgeon take into account any conditions that could increase your level of risk during surgery.

As part of the informed consent process, your facial plastic surgeon will also explain alternative non-surgical procedures that can achieve a similar outcome. He or she will also tell you what (if any) additional surgery might be required and discuss potential risks. The surgeon will also tell you about the costs involved.

When you have decided to go ahead with eyelid surgery, your surgeon will describe the technique that will be used, the type of anaesthesia that may be employed and provide you details of the surgical facility where your procedure will take place.

Understanding the Surgery

Before upper eyelid surgery, your surgeon will mark the individual lines and creases on your eyelids so that scars can be placed along natural folds to minimise visible scarring. Then the surgeon will make an incision and remove excess fat, muscle and loose skin from the eyelids. The incisions will be closed using fine sutures, further minimising the chances of visible scars.

During lower eyelid surgery the surgeon will make incisions in an inconspicuous location along your lash line and along the smile creases on the lower eyelid. The surgeon will then remove the excess fat, muscle and skin and close the incision with fine sutures.

When eyelid puffiness is due primarily to excess fat, a method called transconjunctival blepharoplasty may be used. It involves making an incision inside the lower eyelid and removing excess fatty tissue. Sutures used to close this type of incision will be self-dissolving and leave no scar.

Eyelid surgery can take between one and two hours to complete. It is frequently performed under local anaesthesia and IV sedation. In some cases the surgeon may opt for general anaesthesia.

What to Expect After Eyelid Surgery

Immediately after normal eyelid surgery—not including transconjunctival blepharoplasty—your surgeon may apply small sterile bandages to your eyes. It is not essential that your eyes be covered.

It is normal to experience some swelling and bruising after eyelid surgery. Using cold compresses and elevating your head during sleep will relieve discomfort and prevent further swelling. Your surgeon will prescribe medications to ease any discomfort you might have.

Your surgeon will provide you with instructions on how to take care of yourself during the recovery period. You will be told how to clean your eye area for the week after your eyelid surgery. During this period your eyes may itch and feel dry and sticky. You may be given an ointment or eye drops to prevent dryness of the eyes. For a safe and uneventful recovery, follow your surgeon’s instructions on what activities and environments you must avoid for the first few weeks after surgery.

Any permanent stitches will be removed within three to five days. When self-absorbing stitches are used, they will dissolve on their own.

Additional information

Sometimes eyelid surgery is combined with a facelift, forehead lift or some non-surgical cosmetic procedures.

In general, insurance does not reimburse costs of elective cosmetic surgery. However, if droopy eyelids impede your vision, or the surgery is to correct an eye deformity or treat an injury, you may be able to get costs of such correction reimbursed. To be sure, always check with your insurance plan on the specifics of coverage.

You can find accredited facial plastic surgeons who perform eyelid surgery among members of the Australasian Academy of Facial Plastic Surgery.