Lower blepharoplasty
This operation is designed to improve the appearance of the lower eyelids by tightening the loose skin and removing fat bags. Most patients who choose this procedure complain that they look tired when they feel fine. Blepharoplasty can freshen the appearance of the eyes.
The procedure is performed under general anaesthetic and usually followed by a one night stay in hospital. The surgery lasts about 90 minutes. An incision is made just below the eyelashes of the lower eyelid (subciliary) or inside the eyelid (transconjunctival approach). The bulging fat behind the muscles of the lower eyelids is either removed or re-distributed onto the cheek to remove the abrupt contour change that creates the lower lid bag. If necessary, excess skin is removed from the lower eyelid and a tightening stitch (canthopexy) is performed at the same time - this is a procedure that tightens the lower lid and raises it slightly to give a more youthful appearance and supports the healing eyelid.
Upper blepharoplasty
This operation is designed to rejuvenate the upper eyelids by removing the excess skin and can also remove bulges of fat if necessary. The result is a fresher looking eye, less tired-looking and younger appearance. In some cases this procedure can improve vision if the skin excess is so severe that it hangs over the eyelid margin.
There is a Medicare rebate for this procedure if the upper eyelid skin touches the eyelashes when looking straight ahead.
The procedure lasts about 45 minutes and can be performed under local or general anaesthetic, usually as a day case procedure. Incisions are made in the natural lines of the upper eyelid creases. Skin is removed, often with a section of the underlying muscle. Some of the deeper fat may be removed at the same time.
After the operation
The eyes may feel dry and gritty initially, but this usually resolves after a few days. Lubricating eye ointment is prescribed to keep the eyes moist and is especially important at night time.
You will have some bruising and swelling around the eyes which will fade after 1-2 weeks. I like all my patients to return at one week to have sutures removed. Scars on the eyelids usually heal very well leaving an almost invisible scar if looked after well.
Sleeping with your head more elevated than usual will reduce the swelling (extra pillows). Most people are ready to go out and return to work after 7-10 days. Strenuous activity should be avoided for at least 4-weeks.
Contact lenses should be avoided for 2 weeks after surgery, as these will dry the eyes out. Reading, television and computer usage may also dry out the eyes, so should be kept to a minimum. Make-up on the eyelids or eyelashes should not be used until at least 2-weeks after the surgery.
Complications
Occasionally the inside of the eyelids becomes inflammed (chemosis). This may require extra eyedrops or even a temporary stitch to support the eyelids whilst the inflammation is settling.
Small amounts of bleeding may be stopped with pressure on the eyelid. The most serious, but fortunately extremely rare, complication relates to bleeding that occurs behind the eyeball and requires an urgent return to the operating theatre. It may rarely lead to blindness in the affected eye.
Slight asymmetry of the eyelid position may occur despite the utmost attention to symmetry at the time of surgery.
Rarely, a muscle that moves the eyeball may be bruised or damaged leading to double vision (this rare complication usually only causes temporary symptoms).
Pulling down of the lower eyelid (ectropion) may occur in some people following surgery to this region. There are several techniques used to minimise this complication but if it does occur it may require another operation to correct.
Further information about this procedure can be found here
http://www.plasticsurgeryfoundation.org.au/patient-information/procedures/cosmetic-surgery/eyelid-reduction-surgery/
