Breast Enlargement Breast Reduction Breast Lift
Face Lift Thread Lift Eyelid Rhinoplasty Prominent Ears
Tummy Tuck Liposuction Thigh Reduction Arm Reduction Scars Hand Surgery

Eyelid

Blepharoplasty is an operation that removes excess skin or fat or muscle or a combination of this from around the eyes to correct droopy eyelids & bagginess under the eyes. It is called upper or lower blepharoplasty depending on whether it is performed in the upper or lower eyelids.

Anaesthetic: These can be done either under a local anaesthetic or general anaesthetic. A local anaesthetic means the patient is awake during the procedure. The area is made numb by injecting a local anaesthetic under the skin or the lids. When a general anaesthetic is given the patient will be asleep throughout the procedure. For a general anaesthetic people are usually not required to eat or drink for about 6 hours before the operation.

Duration of admission: These operations can be performed as a day case with no need for an overnight stay in hospital. After a general anaesthetic you may need to spend one night in hospital.

Technique: The incisions are usually made into the natural lines & creases either in the upper lid or the lower lid, extending for a very short distance into the laughter lines (crow’s feet) at the corner of the eye. The excess tissue is removed. If there is no excess skin, the excess fat can be removed through an incision on the inside of the lower eyelid (transconjuctival approach). The wound is usually closed with very fine stitches. The eyes are then covered with pads. The patient is then taken back to rest in the ward for an hour or two before discharge when it is done as a day case, or for an overnight stay.

Duration of operation:

upper blepharoplasty 1 hour
lower blepharoplasty 1 hour

Post-Op Care: On discharge patients are usually given painkillers & sometimes a short course of antibiotics & an eye ointment for use at home is usually provided. It is good to arrange for a friend or family relative to take the person back home after the operation especially if it has been done under general anaesthetic. Advice about how to care for the eye area & a follow up appointment is made before discharge. Application of a cold compress such as a bag of frozen peas wrapped in a towel can help to reduce the swelling & bruising. The frozen peas should not be placed directly onto the skin. When at home, lying propped on pillows with the head higher than the body can reduce the swelling & bruising further. It is important to contact the hospital or your own GP immediately if the eyeball feels painful or if there is blurring of vision. Avoid wearing contact lenses for about 10 days as the eyes may feel uncomfortable for a while.

Avoid driving until the eyes have stopped watering when exposed to air or bright light. The stitches are usually removed in 4 - 7 days.

Cautions: There are certain things that can happen following an operation around the eyes which are not complications but are a usual accompaniment in some people. There may be some mild soreness around the eyes, the eyes may be watery for a few weeks, there may be sensitivity to light for a few weeks especially if done during the summer. It would not be a bad idea to wear sunshades for few weeks following this operation. Bruising & swelling may occur for a variable period of a week to three weeks. Even though the scars are pink & noticeable on closer inspection in the early period, they rapidly become barely noticeable as the swelling subsides.

Time off work: This will depend on the job but usually one to two weeks when the bruising is more settled.

Risks/Complications: There are general complications that can occur with any operation including bleeding during or shortly after the procedure, infection, wound breakdown, a bad reaction to the anaesthetic or a blood clot in the veins in the leg. Precautions are taken to prevent the latter, mainly by asking the patient to wear compression stockings while in hospital.

The problems that are specific to blepharoplasty include in the short period following the operation there may be bleeding within the tissues with a collection of blood. This is a condition called haematoma. This may require a visit back to the theatre for evacuation. Other complications, which are also rare, which has been recorded include:

the lower eyelid pulling away from the eye, but this is usually as the swelling subsides.
problem closing the eyes when sleeping usually settles & is very rarely permanent.
Minute scratches or damage to the eyeball during the operation which can give a gritty feeling (this usually settles after a few weeks),
Increased pressure within the eye (glaucoma) which may require an ophthalmologist or eye specialist opinion & a raised scar. There is a potential risk, though very rare (0.04%) of blindness. This can be caused by bleeding & requires immediate surgical decompression & referral to ophthalmologist.