Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat-usually along with excess skin and muscle from the upper and lower eyelids. Blepharoplasty can be done alone or in conjunction with other facial surgery procedures such as a facelift. The normal ageing process involves the stretching of the eyelid skin resulting in excess folds and wrinkles, and sagging of the fat around the eye itself, and appears as bulges in the upper and lower lids. Heredity is often an important factor when young or middle-aged patients exhibit changes that are usually associated with older age. These patients are fed up of comments from their friends that they constantly look tired, despite having had a good night’s rest.
Although eyelid surgery can correct drooping upper lids and puffy bags below your eyes, it cannot remove crow’s feet lines, or eradicate all eyelid creases. Any attempt to do so would invariably require excessive tensioning of the skin, which would result in a downward pulled or staring appearance of the eyelid. Nor does it improve or lift sagging eyebrows. Procedures such as laser skin resurfacing (for lines and wrinkles) and the Brow lift (for sagging eyebrows) are designed for these purposes. Dark circles under the eyes may improve a bit following blepharoplasty, if this is related to large bags, but most often the dark appearance of the lower eyelid skin remains.
A properly performed blepharoplasty procedure will brighten the face and restore a more youthful appearance. In some patients the procedure might improve vision by removing the excessive skin of the upper eyelids, which can hang down and interfere with peripheral vision.
What does the Operation involve?
On the upper eyelids the incision is carried out in the natural crease line that occurs approximately 1 cm above the eyelashes.  Surgery here is designed to correct both the excess skin and the excess fat. After making the incisions, the excess skin and muscle is trimmed from the upper eyelids together with any fat, which is usually present on the area adjacent to the sides of the nose.  On the lower eyelids, the technique very much depends on the patient’s individual circumstance and requirements. Therefore if the problem is mainly prominent lower bags without excessively loose skin, you may have what is termed as a transconjuctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. Alternatively, when loose skin needs to be trimmed, the incision starts underneath the eyelashes and extends 1 cm or so outwards into the crow’s feet area. The skin is then lifted upwards and outwards, gently tensioning the area and overlapping skin removed.
What type of anesthetic is used?
Eyelid surgery is usually performed using local anesthesia. This is usually accompanied by some intravenous sedation to make you feel relaxed and insensitive to pain. It is most commonly performed as a day case procedure.
How long does it take?
Blepharoplasty usually takes between 45 and 90 minutes depending on the extent of surgery.
What happens After the Surgery?
Following surgery you will have cool compresses applied to the eye region. Sutures are usually removed at around 4 days. In the transconjuctival technique mentioned above there are no sutures in place.
What kind of after effects should I expect?
Following surgery you will experience swelling around the eyes to varying degrees. The majority of the swelling usually subsides after the first 10 days postoperatively.
What are the Scars like?
Overall, blepharoplasty scars heal relatively well. The scars along side the eyelashes almost always heal with a near invisible line after several months have passed.
Is it painful?
There is no pain after this surgery.
What could go wrong?
Complications are rare in a well designed and performed blepharoplasty.
Blepharoplasty is one of the most popular aesthetic surgery procedures. The chances are excellent that you’ll be happy with your surgery, especially if you realize that the results may not be immediately apparent. The positive results of freshening your eyes and reducing a tired appearance will benefit your self-esteem and confidence and should last for years.