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Guide To Cosmetic Surgery - Eyelid Surgery

Eyelid surgery

The medical term for this procedure is ‘blepharoplasty’. This is surgery undertaken to remove those all too familiar bags under the eyes as well as loose folds of skin on the upper and/or lower eyelids.

Excess skin and muscle can cause that puffy eyed look that becomes more noticeable over time. This is one aspect of the ageing process which many people wish to get rid of in order to return to a fresher and youthful looking persona.

This surgery can be undertaken on its own or in conjunction with other procedures such as a facelift. It cannot remove ‘crow’s feet’, forehead lines and wrinkles but a face or brow lift can achieve this.

Suitability for eyelid surgery

The question is, are you suitable for surgery? This can only be answered in the consultation between you and your surgeon. He or she will take a range of factors into account which include your age, physical and mental wellbeing, and, your reasons for surgery.

If you have ‘tired’ or ‘hooded’ eyes; excess folds of skin on either the upper or lower eyelids or wish to remove those bags under the eyes then blepharoplasty is a good option.

It can also remove excessive wrinkling on the upper and lower eyelids.

As this is an age related condition, surgery is usually performed on patients aged 35 and upwards. However, it can be carried out on younger patients, if they are very large bags under the eyes and drooping folds of skin on their eyelids.

If you are in good health, are realistic about your expectations of this surgery and are emotionally stable then you are a very prospect for surgery.

What might rule me out? If you suffer from any eye conditions such as detached retina, glaucoma, dry eye or other such problems with your tear ducts.

Diabetes, heart disease, hyperthyroidism (overactive thyroid), Graves’ disease (thyroid problem) and hypertension (high blood pressure) are other possible exclusions.

You need to be clear about why you want surgery. The results are very good but no cosmetic surgery can guarantee 100% perfection and it is as well to bear that in mind.

Preparing for surgery

Your eye health will be of prime importance. The surgeon will perform a series of tests to check your eyes which will include checking to see if you are able to produce tears.

If you have had an eye test recently then it would help the surgeon if you could bring a copy of the results to your consultation. If you wear glasses then bring these as well. This equally applies to those patients who wear contact lenses.

The surgeon will provide instructions on how to prepare for your operation. This will include what medications you can take (if you are taking prescribed medicines) and which to avoid. Drugs such as aspirin, ibuprofen and vitamin E are not recommended as they thin the blood. Other types of medication can affect wound healing.

Are you a smoker? If so then you will find that the surgeon will not operate unless you stop well in advance of your surgery. He or she would prefer it if you stopped altogether but if not then please ensure that you cease smoking at least 2 weeks beforehand.

And, do not return to this until 2 weeks after your operation.

If you are trying to give up but with little success then the surgeon can advise you about ‘stop smoking’ programmes and other forms of help.

Smoking can delay the healing process which will impact upon your recovery and the results. If you are still smoking up until the day of your surgery then you will find that the surgeon will refuse to operate because of this.

If you enjoy alcohol then you will be asked to have your last drink a week before surgery. The surgeon will advise you further about this.

As well as his/her instructions there are things that you can arrange beforehand that will save you time later on. Making a ‘to do’ list can help as you may find that there are quite a few things to attend to.

This list can include (as a rough guide), ensuring that you have enough painkillers and medicines (if required) to see you through your recovery. Remember: you will not feel up to arranging any of this after your operation so it is a good idea to take care of things in advance.

Other things include buying in any dressings, special bandages, gauze, and anti-bacterial soap; scar reducing creams, petroleum jelly and moisturisers. The last 3 items can help to reduce any scarring.

Prepare ice packs in advance: frozen packs of vegetables can help as they are useful for reducing any swelling. If not, your chemist will stock special gel packs for this purpose.

You are going to be confined to the house for the first week or so. Make sure you have someone who can help you out during that time and is on hand in case you need anything. Ask that person if they can drive you to the hospital and back.

It can help to cook and prepare meals in advance or buy in ready prepared meals. You will want to keep your fluids up so buy bottled water and juices if necessary. As regards food, go for protein rich meals and include plenty of fresh fruit and vegetables as these will boost your recovery.

Keep some extra blankets or the duvet close to hand. You may find that you feel the cold more than usual which is common amongst post-operative patients.

If you have a family then ask your partner or member of your family to help out if possible.

The eye surgery (blepharoplasty) procedure

The surgeon will make an incision in the natural crease, in the upper eyelid (the fold above the eyelashes).

This incision can extend into the ‘crows feet’ around the side of the eyes.

There are two types of procedure:

• Transconjunctival (incision is made inside the lower eyelid)
  Excess fat only is removed from beneath the eye.
  
• Transcutaneous (incision is made through the skin)
  This is performed on both the upper and lower eyelids – if there is excess skin.

The surgeon will remove any excess fat and trim away skin and muscle. The incision is closed with tiny stitches.

If both the upper and lower eyelids are involved then surgery will be carried out under a general anaesthetic. This will also include an overnight stay in hospital.

If the upper eyelids only are operated on then this procedure can be performed as a day case.

This surgery takes around 1 to 2 hours to complete.

The surgeon will lubricate your eyes with an ointment to stop them from drying out and may apply a special bandage.

Recovery

You can expect some bruising and swelling although this will ease after a week or so. It is a good idea to keep your head elevated during this time as this can help to reduce any swelling.

You can expect to feel tired and sore but this is completely normal and will disappear after a short period of time. Your eyes will tire easily during this time so take short naps as and when required.

Avoid any activities which involve heavy eye use such as using a computer, watching television and reading as these can also dry out the eyes. If you wear contact lenses, switch to glasses instead. The surgeon will be able to advise you about when you can return to using contact lenses.

This applies to the first week following surgery.

If you have the traditional non-dissolvable stitches then these will be removed after a week.

You should be able to return to work 10 days after surgery. During this time wear dark glasses (sunglasses are ideal) as these will protect your eyes against the sun and other environmental factors.

Avoid doing anything that is likely to put a strain on your eyes. This means no lifting, bending or stretching. This is why it’s a good idea to have someone who can help you during this time.

Do not undertake any strenuous activities or sports for at least 3 weeks.

The benefits of eyelid surgery

You will notice that your eyes look clearer, brighter and younger looking. That tired, stressed look, caused by those unwelcome bags will have disappeared.

If you previously had ‘hooded’ eyes then this will have been corrected which means better vision and an all round improved appearance.

Generally, you will look and feel better. Your confidence will be increased and this will impact upon your quality of life as a whole.

The risks of eyelid surgery

No surgery can be discussed without mentioning the risks. Every type of surgery, cosmetic or otherwise has a small amount of risk and this must be taken into account.

If any complications arise then they can be treated.

There are side effects to any type of surgery which include feeling sick and dizzy after anaesthesia, scarring, soreness and bruising and tiredness. These will all ease after a few days.

Then there are complications which can occur during any type of surgery. These include:

• Deep vein thrombosis
  
• Pulmonary embolism
  
• Infection
  
• Poor or delayed wound healing
  
• Bleeding
  
• Sudden increase in pain (intense/sharp)

And, then there are complications specific to eyelid surgery. These are:

• Loss of eyelashes
  
• Ptosis (drooping eyelids)
  
• Haematoma (blood clot behind the eyeball)
  
• Eye sight is affected/altered (temporary)
  
• Eyelid skin loss
  

If you notice any of these symptoms then contact your surgeon immediately.