Eyelid surgery (medical term is blepharoplasty) is usually performed to remove excess skin and/or fat from the upper and the lower eyelids. It can help to freshen up the look of tired baggy looking eyes. Patients who asked for eyelid surgery are usually in their late thirties to seventies but younger patients sometimes require them as well. Older patients who have difficulty with vision due to sagging upper eyelid skin is also a candidate for this procedure.
A double eyelid surgery or Asian Blepharoplasty as it is widely known is a procedure to create an upper eyelid skin crease in patients who are born without any. The surgical steps are similar to a conventional blepharoplasty with a few technical differences. Depending on the technique, sutures might be used to create the upper eyelid crease.
During the initial consultation, patients will have the opportunity to discuss their goals and desirable results with the plastic surgeon. Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.
Blepharoplasty cannot :
- Remove dark circles around the eyes.
- Correct congenital droopiness of the eyelids (ptosis) but ptosis repair can be done in conjunction with blepharoplasty.
- Correct droopiness of the upper eyelids caused by a lower positioned eyebrows. In these patients a brow lift procedure is required.
- Remove “crow’s feet” or other wrinkles around the eyes.
PROCEDURE
The procedure is usually performed under local anaesthesia. Some patients who are unable to tolerate the procedure under local anaesthesia might opt for general anaesthesia or if the eyelid surgery is performed with other procedures as well. The surgery takes about an hour to one and a half hours for either pair of eyelids.
The surgeon makes incisions following the natural lines of your eyelids; in the crease of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the “crow’s feet” or “laugh lines” at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.
For creation of a upper eyelid crease (double eyelid), fine sutures are used to stitch the skin down to the deep tissues to create the fold.
Once the procedure is completed, a light dressing and antibiotic ointment will be applied to the incision site. A cold compress will be applied while you are waiting in the recovery room. You are advice not to drive yourself back as the swelling from the surgery might limit your field of vision. The surgeon will advice you on how to take care of the wounds at home and you will be given a follow-up appointment.
IDEAL CANDIDATES
- Generally healthy individuals with well controlled medical conditions such as hypertension or diabetes (if they have any).
- Individuals without any serious eye conditions.
- Individuals with a clear and realistic expectations of their desire result.
RISK
Although serious complications from eyelid surgery is uncommon, potential candidates should understand that every procedure comes with it a certain risk for possible complications and has a recovery period (down time). Preoperative preparation and postoperative care will minimize their incidence.
The more common complications from eyelid surgery are :
- Bleeding (primary or secondary).
- Swelling.
- Bruising.
- Infection.
- Asymmetry.
- Skin discolouration.
- Poor wound healing (especially in smokers).
- Scarring.
- Risk of anaesthesia.
- Revision surgery.
- Dry or excessive watery eyes.
PRE-OPERATIVE PREPARATION
- Stop all non medical supplements for at least one week before surgery.
- Stop taking any anti inflammatory pain medications, aspirin, blood thinning medications (anti platelets, anticoagulant) one week before the procedure.
- All medical conditions (hypertension, diabetes etc.) needs to be optimized prior to surgery.
- Smokers need to stop smoking well in advance.
- Some individuals might require prior blood investigation or further medical assessment.
POST-OPERATIVE
After the surgery there will be some swelling, bruising, discomfort, irritation or dry eyes for several days that can be controlled with oral medications, cold compression, eye drops and ointment. The swelling and bruising usually last between 2-3 weeks but in some patients can last longer.
Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Stitches will be removed about 7 days after the surgery. The final result of surgery will appear within several weeks, but it may take up to a year for the scar to fully mature.
CARE
- Cold compression with an ice pack the first day and night after surgery.
- Sleep with the head elevated with two pillows to decrease swelling for several days.
- Avoid strenuous activities and swimming for 2 weeks.
- Wear sunglasses until redness and bruising subsides.
- Regular antibiotic ointment on the surgical wounds.
