Surgery to reduce the amount of excess tissue around the eyes (blepharoplasty) may be performed in conjunction with laser resurfacing, a face-lift operation, or often, as a separate procedure. When a patient wants both laser skin rejuvenation, or a face-lift, these can be combined with a blepharoplasty, or may be performed in stages, according to the patient’s personal preferences or financial considerations. Some patients have droopy lids from a weak eyelid muscle (with or without excess eyelid skin and fat). If this problem, which is called blepharoptosis is diagnosed, it too is often amenable to surgical correction.

In most cases the right and lift eyelids are operated on at the same time. However, it is not uncommon to do only the upper eyelids or the lower eyelids as the patient wishes.

Upper eyelid

To remove excess skin and other tissue from the upper eyelids incisions are made in the eyelid fold and extended laterally toward the smile lines. Fatty deposits can be seen, and removed, and in some cases, where the brow itself has dropped, this can be repositioned at a higher level. Lasers or electronic scalpel’s ensure accuracy and minimize any bleeding.

Lower Eyelid

Fatty tissue from the lower eyelids may be removed either through an incision in the skin (just below the eyelashes) or more commonly now, through a laser incision in the inside surface of the eyelid (the transconjunctival approach). Usually no sutures are required with this approach. This is often followed by a chemical peel to smooth and tighten the lower eyelid skin, avoiding the need for surgical skin removal.

The operations take from 30 minutes to two hours and are performed using anaesthetic.

Sutures typically are removed four to seven days after surgery. Although discolouration around the eyes usually resolves in one to two weeks, swelling (oedema) may persist for several weeks longer. The skin scars heal as inconspicuous thin lines in nearly all patients within a few weeks to months. Patients can expect to return to work and normal activities after 7-10 days.

Some patients may experience dryness of the eyes after surgery. This symptom may be caused by imcomplete closure of the eyelids during the healing phase and usually resolves within a few weeks. In the interim, the eyes may be soothed by using artificial tear drops and ointments. Because people who have dry eyes before surgery have a greater chance of experiencing this problem post-operatively, we may recommend an examination by an ophthalmologist before blepharoplasty is performed.

Rarely, there may be other problems after surgery such as persistent drooping or retraction of the eyelids or darkening of the lids because of retention of blood pigments in the skin. These undesirable side effects frequently can be treated satisfactorily. Temporary visual blurriness occasionally may occur after surgery because of alteration of the tears, but the problem typically is short-lived. Complete loss of vision in an eye is an extremely rare complication of blepharoplasty. Symmetry is rarely exact, even in young people, and after upper lid blepharoplasty, about 1mm of variation is regarded as acceptable.

Every year, thousands of patients undergo successful eyelid surgery, with very pleasing results. If you consider that your appearance can be improved with this type of surgery, arrange a consultation with Dr Rosenbaum. He can show you what a real difference this procedure can make to your appearance and self-image.