During the aging process, loss of skin elasticity and constant gravitational pull often result in excessive skin folds on the upper and lower eyelids. At the same time, the thin membrane that holds the fat in place also weakens with age causing the fat protrudes forward into the lids like a hernia. For upper eyelids, excessive skin folds and bulges that hang over the eyelashes often resulting in loss of natural fold of the upper eyelids and obstruct peripheral vision. On the other hand, the excess skin and fat on the lower eyelid may make the eyes appear puffy, tired and aged.
Eye lift surgery (blepharoplasty) is a cosmetic surgical procedure that helps to reduce puffiness from lower eyelids and removes redundant skin from the upper eyelids. This surgery is also an effective way to improve sight in older people whose sagging upper eyelids get in the way of their vision. An eye lift surgery will not eliminate dark circles under the eyes, crow’s feet, or other facial wrinkles. It is often done along with other procedures such as laser resurfacing, filler injection, midface lift or forehead lift to achieve desirable aesthetic results.
The selection of the surgery varies individually, depending on the problems presented and individual needs. Some only require surgery for their upper or lower eyelids. Others may need surgery for both or additional procedures. The process involved removal of excess skin, muscles and fat, or repositioning the fat to flatten hollow areas. Upper eyelid blepharoplasty uses incisions to allow for removal of skin, thin strip of muscle and fat. The skin is meticulously closed together to create natural eyelid crease.
Lower eyelid blepharoplasty can be performed either via skin incisions directly below the lash line or an incision on the inside of the eyelid, called a transconjunctival approach. The transconjunctival approach allows for access to the lower eyelid without visible incision, thus making this technique perfect for patients who need fat removed or added. This approach can be combined with laser resurfacing of the eyelid skin to reduce lines and wrinkles.
IDEAL CANDIDATES
The best candidates for an eye lift surgery are people who are in good health and who have realistic expectations. Most are 35 years or older, but if baggy eyelids or droopy eyelids run in the family, the surgery may be required sooner. Eye lift surgery can enhance the appearance and help to build patient’s confidence. Eye lift surgery can make the eyes look more youthful, and it tighten loose skin around the eyes. However, it does not result in alteration of the facial structure or changing the structure of the eyes. The results of eye lift surgery are much more subtle, resulting in more of a refreshed look than a major change. Before deciding on the surgery, think about the goals and discuss them with your surgeon.
PRE-OPERATIVE EVALUATION
Communication is vital in order to achieve the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desirable results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.
- Discussion about patients’ expectations and desired outcome
- Medical conditions, drug allergies and previous medical or surgical treatment
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Discussion of type of anaesthesia
- Examination of the face and periorbital area
- Photography for preoperative and postoperative evaluation
PREPARATION
- Get laboratory testing or a medical evaluation
- Adjust your medications if you have certain medical conditions
- Stop smoking and alcohol well in advance of the scheduled date for surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements before surgery
RISKS AND SAFETY
It is important for patients to understand that every surgical procedure has its own complications and down time. However, if a patient is assessed properly before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced.
Some of the common risks of eye lift surgery:
- Infection
- Bleeding
- Poor wound healing
- Skin discoloration
- Swelling due to blood clot or fluid accumulation
- Scarring
- Temporary numbness at operated sites
- Asymmetry
- Possibility of revision surgery
- Anaesthesia risks
POST-OPERATIVE EXPECTATIONS
After the surgery there will be swelling, bruises, discomfort or irritation at the eyelids. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Placing cold compresses on the eyes and keeping the head elevated as much as possible during the first few days of recovery can help to reduce swelling and bruises. During the first couple of days following the surgery, the incision sites should be treated with antibiotic ointment to keep them clean and lubricated. Occasionally, eye drops are necessary to prevent the eyes from drying out. The stitches will be removed 5-7 days after the surgery. For the first couple of weeks following the surgery, dark sunglasses are recommended to protect the eyes from irritation caused by the sun and dust. Normal and light activities can be resumed after 10 days postoperatively. Throughout the first three to four weeks after the surgery, any strenuous activities (such as heavy weight lifting, sporting activities, and even crying) that increase blood flow to the eyes should be avoided. The final outcome of surgery will appear after several weeks, but it may take up to several months for incision lines to become inconspicuous.
POST-OPERATIVE CARE
- Keep your head elevated especially when sleeping for several days
- Regular application of antibiotic ointment and cold compression around the operated areas
- Avoid strenuous physical activities for two weeks
- Wear sunglasses to protect eyes
- Do not wear contact lenses after surgery unless directed by a physician
