As we get older our skin gradually loses its elasticity throughout our bodies, but often most noticeably in the delicate skin around the eye. This can create the appearance of excess skin, wrinkling and puffiness. In addition, the compartments holding fat pads around the eyes can become stretched and the fat start to push through, creating 'eye-bags' and contributing to a tired appearance. In the upper eyelid, excess skin can cause hooding which may sometimes be bad enough to obscure vision.
I use a variety of techniques depending on the specific problem to be addressed, but most commonly a combination of skin tightening procedures together with a reshaping of the fatty eye bag. This produces a more alert, brighter and younger look, with scars well hidden in the natural creases of the eyelids. Eye ointment is given for a few weeks to prevent dry eyes.
Surgery is carried out either under local or general anaesthesia depending on your individual procedure. Surgery normally takes around 30 minutes per eyelid.
Upper Eyelid Surgery
The incisions are generally made along the natural upper eyelid crease. Excess skin and fatty tissue is then removed together with a thin strip of muscle to improve the eyelid contour. The scar is hidden in the crease of the eyelid and is one of the few scars that even a Plastic Surgeon may have difficulty identifying when it has fully healed.
Lower Eyelid Surgery
Incisions are most commonly made just below the lower eyelashes. The skin and muscle is then lifted allowing access to the fat pads and removal of excess fat. In some cases, it is helpful to re-shape fatty tissue onto the cheek. Skin and muscle are then trimmed as needed.
If you have a lower lid eye bag without substantial droopy skin it is sometimes more appropriate to make your incision inside the eyelid itself, leaving no externally visible scar. The operation can be carried out in exactly the same way except that skin is not trimmed at the end of the procedure.
Any surgery carries potential risks, which you must be aware of before proceeding. Blepharoplasty carries risks of externally visible scars, infection, bleeding, bruising and swelling, asymmetry, pulling or eversion of the lower eyelid (scleral show or ectropion), and of developing dry or itchy eyes. A serious but thankfully rare risk is of bleeding behind the eyeball, called a retrobulbar haematoma, which if not treated rapidly can progress to permanent blindness of the affected eye. Please get in touch prior to surgery if you wish to discuss these or any other risks.
Before surgery you will have a full examination to make sure you do not have dry eye conditions, blepharitis or any other eye problem that could be exacerbated by surgery.
Smokers are urged to stop for 2 weeks before and after surgery. Aspirin should be avoided for 1 week before surgery. If you take other blood thinners we will need to consult with your GP to discuss the advisability of stopping them.
Anaesthetic: General or Local Anaesthetic
Hospital stay: 0-1 Night
Surgery time: 30 minutes per eyelid
Time off work: 2 weeks
Reasonably mobile: Immediately
Washing: Immediately, but without rubbing the eyes for one week
Full recovery: 1-2 weeks
Driving: 1 day, provided your vision is clear
Exercise: 3-4 weeks
Analgesia (pain relief) - Ibuprofen and paracetamol can be taken
Complete rest will be necessary for 48 hours
Daily tepid showers will be possible after 48hours
Surgical skin tapes should be left in place for 2 weeks
The hospital or surgeon should be contacted if you develop a temperature
The hospital or surgeon should also be contacted immediately in rare cases of bleeding or
Patients should take care not to over exert themselves in the first few weeks and to keep
pressure off the wounds
Wounds will be checked and sutures removed normally at 1 week
I will see you routinely at 1, 2 and 6 weeks after surgery
Dressing care nurses may see you more often
Swelling reduces after a few weeks