Blepharoplasty of the upper lid is one of the most frequent functional and cosmetic facial surgeries. The reasons for performing this surgery include:
Congenital factors and ageing can lead to excess skin of the upper lids, which can even hang over the lash line. In addition, deep tissue also becomes weaker, and the pads of fat protectively surrounding the eyes protrude becoming sack-like. Both phenomena lead to a tired and sagging facial expression, and can lead to pressure on the eyes
Droopy skin of the eyelids restricting the visual field, in particular when looking sideways
Blepharoplasty of the upper lid is mostly commonly performed under local anesthesia in combination with sedation, or under general anesthesia. This relatively minor intervention may improve field of vision restricted by the eyelid, and rejuvenate ones appearance.
Firstly, the excessive skin is measured and the dissection lines are marked, then varying quantities of skin, soft tissue, muscle and/or fat are removed. The aim is to attain a fresh and youthful appearance of the eyelids, and improve any restriction of the visual field.
I use a electric very fine surgical needle for the lid surgery, resulting in less bleeding and post-operative haematoma. Sutures are removed 7-10 days after the operation. Very occasionally, a small haematoma may occur.
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Blepharoplasty is the surgery to remove excess upper or lower eyelid skin (dermatochalasis). Dermatochalasis is caused by loss of elasticity of the skin, leading to ‘baggy eyes’. The most common form can start from around age 40 and can affect any ethnicity or gender. Dermatochalasis may cause upper lid droopiness, which could then lead to blocking of your visual field and aesthetic impairment.
Your eye will be bruised and inflamed for one to two weeks after surgery. We advise you to rest and keep your head propped up with pillows when you are lying down for the first few days after surgery.
• To decrease swelling during the first two to three days, we suggest using ice packs or a bag of frozen peas hourly for 10-15 minutes on the operated eyelid.
• Do not wear contact lenses for two weeks to avoid irritation of the eye.
• Wearing dark glasses when you are outside may reduce your sensitivity to sunlight, wind, and other irritants.
• You can start driving and go back to work once the swelling has gone down and your vision is clear.
You will be seen two weeks after the surgery for removal of the stitches and if appropriate, advised to continue the chloramphenicol ointment four times a day for a few more days.
Possible minor complications
• Bruising and inflammation are common after the operation, which should clear up one to two weeks after the surgery.
• Rarely, the operated area can become infected. If this happens, you may need further treatment with antibiotics.
• Scarring may occur after surgery, but this will usually be hidden under the crease of your upper eyelid.
• Overall, the results of this type of surgery are usually successful. Nonetheless, with ageing further loss of elasticity may occur and sometimes further surgery may be needed to achieve the best result. However, the skin excess may not be as much as it was before the first surgery.
Serious complications can include orbital haemorrhage (ranging from 1 in 2,000 to 1 in 25,000) and diplopia (double vision). However, it is important to keep in mind that these serious complications are rare.