Patients often seek a blepharoplasty procedure to improve eyelid bags which can make ones eyes look puffy, old and give the appearance of tiredness. A blepharoplasty or eyelid surgery is a surgical operation to remove excess skin from the eyelids. There is also usually excess bulging fat which is either removed or redraped to improve the appearance. An upper blepharoplasty is an operation to the upper eyelids and a lower blepharoplasty, to the lower. Both upper and lower eyelids can be performed at the same time. In an upper blepharoplasty, the incision lies along the natural crease of the lid. In a lower blepharoplasty, the incision lies just below the lower lid margin.
What should I expect ?
An upper blepharoplasty can be done under a local anaesthetic however if you are having both upper and lower blepharoplastys, then a general anaesthetic is recommended. The operation takes between 1-2.5 hours depending on whether only the upper or lower eyelids or both are operated on. If only an upper blepharoplasty is undertaken, then there is no need to stay overnight, but if all 4 lids are operated on, then an overnight stay is recommended. During your operation, the excess skin is carefully measured and removed. Any excess fat will either be removed or redraped to improve the overall contour of the eyelid. The wounds are stitched closed with dissolving sutures and a special super glue is applied which acts as a dressing. After your operation, there will be bruising and swelling around the eyes which is normal. This may last for up to 2 weeks before settling down. Although the improvement in the appearance of the eyelids will be immediate, this will continue to improve over a period of 3 months.
What follow up will I have ?
Your wounds will be checked at 7 days. Following that, you will have a further appointment at 3 months to review the outcome.
What are the risks and complications ?
A blepharoplasty is a routine operation with the vast majority of patients being happy with the results however it is important you understand the potential risks and complications that can occur
Scarring : The incisions around the eyelids may initially be a little red or pink but they settle down very well. Scars generally take 6-12 months to mature and during this time, you will notice that the scars fade and almost become indistinguishable. Rarely, the scars may remain red and lumpy.
Wound breakdown : This is uncommon however if it occurs, it can delay wound healing and result in a worse scar
Wound infection : This is uncommon however if it occurs, you will require a course of antibiotics
Bleeding : Although every effort is taken to control bleeding during the operation, some patients may develop a blood clot beneath the skin. If this occurs, you will need to return to theatre to have it removed
Asymmetry : Although identical operations are performed on both sides, there is a small risk of minor asymmetry or irregularities
Ectropion : Ectropion is when the lower eyelid gets pulled away from the surface of the eyeball and does not rest immediately on it. This can occur if the lower eyelid is lax and weak or if too much skin is excised and the wounds are closed too tightly. This complication is very uncommon as you will be assessed for the risk of this occurring during your consultation and advised about further minor procedures that may be required to avoid it. If ectropion does occur, it may sometimes settle by itself but if it does not, then a further corrective procedure may be required.
Epiphora : This is an uncommon complication and relates to excessive watering of the eye. It is due to an alteration in tear drainage following the operation. It is usually temporary although in rare instances may be permanent
Eye injury : It is exceedingly rare to get any permanent injury to the eye. The commonest injury that can occur is a minor abrasion to the surface of the eye which heals by itself without any lasting problems. There is a theoretical risk of blindness following a lower blepharoplasty and you should be aware of this as it is such a serious complication. It can occur if a collection forms in the lower eyelid that presses on the optic nerve for a prolonged period of time. The risk of this is 1 in a million however you will be monitored for this after your operation.