Eyelid Surgery (Blepharoplasty)
If you are considering eyelid surgery there may be some questions you would like answered. Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat, usually along with excess skin and muscle, from the upper and lower eyelids.
You may wish to consider eyelid surgery to:
- Correct drooping upper lids
- Eliminate puffy bags below your eyes
- Improve features around the eyes which may interfere with vision
What eyelid surgery won't do is remove crow's feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. Eyelid surgery can be done alone, or in conjunction with other facial surgery procedures such as a face lift or brow lift. LPSA offer eyelid surgery from our centrally based London practice.
The following frequently asked questions (FAQ's) and answers will give you a basic understanding of the procedure - when it can help, how it is performed, and what results you can expect. They may not answer all of your questions, since a lot depends on your individual circumstances. However, your surgeon at the LPSA will help answer any further concerns you may have.
What should I consider before having eyelid surgery?
Before you decide to have surgery, think carefully about your expectations and discuss them with your LPSA surgeon. Blepharoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently.
A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution, so check with your ophthalmologist before you have surgery.
If you are physically healthy and realistic in your expectations, aiming for improvement rather than perfection, you may be a good candidate. Most patients are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.
How do I plan my eyelid surgery?
At your initial consultation at LPSA your surgeon will need your complete medical history, so check your own records ahead of time and be ready to provide this information. Be sure to inform your surgeon if you have any allergies, if you are taking any vitamins, medications (prescription or over-the-counter), and if you smoke.
You and your surgeon should carefully discuss your goals and expectations for this surgery. You'll need to discuss whether to do all four eyelids or just the upper or lower ones, whether skin as well as fat will be removed, and whether any additional procedures are appropriate.
Your LPSA surgeon will also provide explanations about general anaesthesia and the hospital where the surgery will be performed, and the Practice manager will go over the costs involved. Most insurance policies don't cover eyelid surgery unless you can prove that drooping upper lids interfere with your vision, so you may be advised to check with your insurer. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
How do I prepare for surgery?
Your surgeon will give you instructions to help you prepare for surgery. These may include guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.
Where will my eyelid surgery be performed?
The surgery is performed at one of several of London's best private hospitals, according to your preference and the availability of operating time. You will usually be admitted on the day of surgery, and stay until the early evening. Occasionally, an overnight stay will be indicated. You will need a friend or relative to accompany you home after your stay in the hospital.
What type of anaesthetic will be used?
Eyelid surgery at LPSA is usually performed under a general anaesthetic, so you'll sleep through the entire operation. Occasionally, local anaesthetic with sedation is used for upper lid blepharoplasty.
What takes place during the surgery?
In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids, that is, in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow's feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures. If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.
How long will the surgery take?
Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you are having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.
What can I expect after the surgery?
Your eyelids may feel tight and sore as the anaesthetic wears off, but any discomfort will be controlled with the pain medication prescribed by your doctor. Your doctor will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. Bruising varies from person to person but usually reaches its peak during the first week, and generally lasts anywhere from two weeks to a month. You will be shown how to clean your eyes, which may be gummy for a week or so. Many doctors recommend eye drops during the day and ointment at night, since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks you may also experience excessive tear production, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision. Your doctor will follow your progress very closely for the first week or two. The stitches will be removed two days to a week after surgery. Once they're out, the swelling and discoloration around your eyes will gradually subside, and you'll start to look and feel much better. Massage of the lower eyelids is frequently advisable after surgery to help them regain their tone and soften the scarring. Your LPSA surgeon will advise you on how to do this.
How long will it take for life to return to normal?
You should be able to read or watch television after two or three days. However, you won't be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while. Most people feel ready to go out in public, and back to work, in a week to ten days. By then, depending on your rate of healing and your doctor's instructions, you'll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a special sun block made for eyelids when you go out. Your doctor will probably tell you to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. It's especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. It is also wise to avoid alcohol, since it causes fluid retention.
How will I feel about my new look?
Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they'll fade to a thin, almost invisible white line. However, you are likely to be pleased with the results of your eyelid surgery - a more alert and youthful look - that will last for years. For many people, results are permanent in the lower lid, while the upper lids may need doing again at some stage.
Does eyelid surgery carry any risk?
Eyelid surgery complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anaesthesia. You can reduce your risk by closely following your surgeon's instructions both before and after surgery. The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out; your surgeon can remove them easily with a very fine needle. Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent. Another rare complication is lower lid malposition, a pulling down of the lower lids. In this case, further surgery may be required.