BLEPHAROPLASTY (Eyelid Surgery)

Eyes being a primary way of facial expression are the central focus of gauging a person’s beauty always. Beautiful eyes are ever desirable and brighten up the face.

Blepharoplasty or eyelid surgery can remove excess eyelid skin, correct bagginess and puffiness and alter eyelid position to create and restore a more youthful, rested and alert appearance.

If the upper lid is too droopy, covering a disproportionate amount of iris (darkened part of the eye), it creates a tired or a sad appearance.

Eyelid laxity can cause lower lids to droop, allowing white of the eye to be seen between the iris and lower lid (scleral show).

Upper and lower eyelid surgery can correct bagginess caused by excess of skin or skin laxity as well as due to herniated fat pads. However, other causes of eyelid oedema or fluid retention should be ruled out.

There are many approaches to the eyelid surgery which are decided by the skeletal structure of the eye, fat distribution, presence of dark circles, etc.

If lateral hooding is present, that is when a fold of skin appears between the eyebrow and the outside corner of the eye, this may require a browlift/forehead lift.

THE CONSULTATION:

The surgeon often makes the patient look in the mirror and point out the actual area or reason of concern.

The facial anatomy is studied whether eyelid surgery alone or in conjunction with some other procedure will help.

The surgery can be combined with browlift, facelift, botox, fillers,etc.

The patient’s entire medical history is reviewed including medications being taken, allergies, medical condition of the eyes like dry eyes, thyroid disorders, high blood pressure, diabetes, etc. If glasses or contact lenses are being used, they should be brought at the initial consultation.

PREPARATION:

The surgeon will give you guidelines on eating, drinking, medications like aspirin and anti inflammatory drugs to be avoided.
The patient should arrange somebody to drive back home and assist for a day or two.

THE SURGERY:

The operation is designed to suit individual patient’s objectives.

Some patients require surgery of the upper lid or lower lid or both, fat or skin removal or both, fat repositioning, tightening of lower lids, raising of the upper lids or both.

The trend today is to preserve enough fat to provide fullness to the adjacent areas.

UPPER EYELID SURGERY:

The incision for upper eyelid surgery is well hidden in the natural crease of the lid and extends usually till laugh lines at the corner of the eye.

Skin excess removal, fat repositioning or removal where the surgeon separates underlying fatty tissue from the muscle and skin can usually be accomplished through this incision.

Treatment of true droopiness due to aging, etc requires tightening of the part of the muscle can also be addressed through the same incision.

LOWER EYELID SURGERY:

There are two different that can be used. The traditional incision just below the eyelashes extending to the corner of the eye if both skin excess and fat is to be removed.

The other is transconjuctival approach when only fat pads are to be removed or muscle is to be tightened.

A canthopexy which is performed at the outer corner of the eye to tighten the lid and improve the lower lid tone.

POST OP:

Eyelid surgery is an outpatient procedure taking between 30-90 minutes and is usually done under local anaesthesia with or without sedation ( twilight anaesthesia).

There may be mild discomfort in the form of tightness and soarness in your lids, which can be controlled by oral medication. Aspirin and ant inflammatory medications are to be avoided.

The head is to be kept elevated for several days while sleeping..

The degree of swelling and bruising varies between patients, cold compresses are advised for 1-2 days.

Most of the swelling/bruising disappears within 10-14 days.

The patient may also experience blurry or double vision, watering of eye and light sensitivity.

The patient is advised to keep activities to a minimum for about 10 days.

Contact lenses should not be worn for about two weeks.

RISKS/COMPLICATIONS:

In addition to the usual risks of anaesthesia, following risks are there:

  • Infection
  • Poor healing of incisions
  • Dry eye syndrome – Usually temporary
  • Inability to close eyes- Usually temporary
  • Ectropion
  • Blindness- Extremely rare.

The results of the procedure are generally long lasting, although it depends on heredity and lifestyle factors.
Eyes are the windows to the world and they appear much refreshed and youthful after the procedure.