As one gets older the skin loses its elasticity and the soft tissues, including the muscle, slacken which in the lower eyelids results in bagging, coarse wrinkling and folds.
In the upper eyelids these changes cause an apparent skin excess with wrinkling which can result in the eyelid sitting on the lash margin and sometimes even drooping over the lash margin.
Eyelid corrections (blepharoplasty) aim to reverse these changes and by so doing enhancing the facial appearance and self confidence.
Pre-operative advice
The initial consultation is very important. After a full examination and assessment a long discussion regarding the goals and realistic expectations is undertaken.
The precise details regarding the surgical techniques and anaesthetics required as well as the post-operative recovery and potential risks and complications will be discussed.
Before surgery Aspirin and related anti-inflammatories should be avoided for approximately 2 weeks as they may promote bleeding.
Smokers additionally have a higher risk of developing complications and it is therefore advised that they should refrain or at least reduce their smoking for 2 weeks prior and 2 weeks following surgery.
Operative details
Patients are usually admitted on the day of surgery and are seen by the nursing staff, by the surgeon and when required by the anaesthetist.
Pre-operative photographs will be taken. The surgery itself takes between 1 and 3 hours depending on the extent of the surgery.
The incisions will follow the natural lines of the eyelids, in the lower eyelids being just underneath the lash margin and in the upper eyelids being in the crease approximately 7 mm above the lash margins.
The incision lines are usually extended for a few millimetres into the laughter lines.
Following surgery
There will inevitably be some swelling and bruising which will usually last for between 1 and 2 weeks. The eyes may be sensitive for this period of time and in some cases eye ointment may be necessary. Eyelid closure may feel tight especially at night, this sensation as the swelling subsides in time. Some watering of the eyes especially when exposed to bright sunlight or wind is also common in the first week or two following surgery.
Follow up
An appointment for removal of the stitches is usually made 4 to 7 days postoperatively and most patients are seen and assessed by the surgeon at 1 and 4-6 months postoperatively.
Risks and complications
As with any surgery there are risks of complications. Fortunately in the upper eyelid these are rare. In the lower eyelid patients sometimes experience a pulling sensation which may distort the lower eyelid and pull it in a slightly downwards position. This is usually as a result of swelling and will self-correct with time. Occasionally a further revision procedure is required. Small cysts or white heads can appear in the stitch line and these are usually easily dealt with in an outpatient appointment at the hospital.
Your new look
In most cases these scars fade and become inconspicuous after several months. The result of the eyelid correction which aims to produce a more alert and youthful look with smooth contours and a pleasing appearance will last for years and in many people these results will be permanent.
