Are you tired from looking tired?
The first facial feature we notice about another person is their eyes. Our eyes are powerful communicators of emotions and thoughts every single day. They speak volumes – both intentionally and unintentionally – about who we are and what we feel. Being a centre of attention, we are able to notice the slightest changes in their appearance. As we age, signs of ageing begin to appear around our eyes first. This is due to the skin around our eyes being the most delicate on our body. The skin that forms your eyelids stretches, muscles underneath weaken, and fat surrounding the eye begins to bulge, causing sagging upper lids and bags under the eyes.
Ageing eyelids can affect a person’s appearance beyond just looking older, because so many emotions are expressed with our eyes, this can give the impression of being tired, sad or angry even when you are happy or feel well-rested. Eyelid surgery, also known as blepharoplasty, improves the appearance of your eyelids achieving a more refreshed and youthful look.
Sometimes, in addition to making you look older, excess skin tissue around your upper eyelids can result in visual disturbance, and removal of this tissue can lead to a significant improvement of your vision problems.
What are the two types of eyelid surgery?
Eyelid surgery, or blepharoplasty, can be subdivided into:
- Upper eyelid surgery (upper blepharoplasty)
- Lower eyelid surgery (lower blepharoplasty)
What are the goals of eyelid surgery?
The goals of upper eyelid surgery are to improve and rejuvenate the contours of the upper eyelid. This can include an improvement of visual impairment, that might be experienced due to excessive, loose skin.
Sagging, “baggy” lower eyelids are likely due to herniated fat that collects beneath the eyes. The goals of lower eyelid surgery are to smoothen puffy lower eyelids by reducing or repositioning the herniated fat, and to remove any excess skin.
What are the benefits of eyelid surgery?
Droopy upper eyelids or puffy lower eyelids can run in your family. You may benefit from blepharoplasty in your early 30s already, treating an anatomical variant rather than signs of aging.
Blepharoplasty is considered to be a rewarding and safe procedure that leads to a refreshed appearance of the area around your eyes. It has a limited postoperative downtime and the results last for several years. It frequently is combined with complimentary procedures.
Before your procedure
Mr. Bran will review your medical history and perform a physical exam of the area of your concern. This will include measurements of your face and eyes with your eyes open and closed, at rest and when smiling. Your personal goals for surgery will always be taken into account throughout your surgical journey. Appreciating your personal aesthetics and managing your expectations is key to any surgical planning by Mr. Bran. Based on the clinical findings and your expectations he will then be able to elaborate realistic goals. During your consultation photographs will be taken for your medical record.
Preparing for your eyelid surgery
Preoperative assessment is critical in order to select appropriate patients for eyelid surgery. Apart from a physical examination you will have a discussion about your current and past medical history, and any medication you are currently taking or have recently taken. You will be asked about allergies, particularly drug allergies. If required, an anaesthetist will see you before your surgery. Depending on your medication, you may be asked to stop or change certain drugs for a duration of time.
You should refrain from taking Aspirin, or non-steroidal anti-inflammatory drugs such as Ibuprofen in the week before your surgery.
In order to optimise your healing, we strongly advise all our patients to stop smoking at a minimum of 2 weeks prior to your surgery and refrain from cigarettes or any other nicotine containing products for 2 weeks after their procedure. Smoking significantly impairs your post-operative recovery and doubles the risk of complications such as delayed wound healing, poor scars or altered results.
RISKS EYELID SURGERY
In accordance with the Montgomery judgement, the following risks and side-effects are associated with eyelid surgery:
|PAIN||Moderate discomfort is expected; suitable pain medication will be provided.|
|BRUISING||Common, may last for 2-3 weeks. Avoid Aspirin / Ibuprofen.|
|SWELLING||Swelling will occur. It can take 3-4 weeks to fully resolve.|
|CHEMOSIS||Occasionally swelling of the conjunctiva (the clear, thin membrane covering your eye) may occur. It can take 2-3 days to resolve.|
|BLEEDING||Rare. Haematoma (blood collection – risk is less than 0.1%) can cause damage to eyesight, may require drainage or return to surgery.|
|INFECTION||Occasionally, mild infection. Rarely serious infection. If required, appropriate antibiotics will be prescribed.|
|SCARRING||With any incision there is a risk of delayed healing and poor scarring, which can lead to hypertrophic scars or keloid formation.|
|Common due to post-operative swelling. Resolves within 3-7 days.|
|Some diminished sensation is expected around the scar and on the eyelids. It can take 6-12 months to return to normal.|
|Common, can take 1-2-weks to resolve.|
|ASYMMETRY||Uncommon, any pre-operative asymmetry will be pointed out and the operation will aim to improve this.|
|DEEP VEIN |
|This is a clot that forms in the deep veins of the lower limbs causing pain, inflammation, and swelling. This will require immediate medical attention.|
|This is a clot which has travelled to the lungs causing chest pain and shortness of breath. This will require immediate medical attention.|
A good candidate for eyelid surgery has one or more of the following:
- realistic goals and expectations
- excess skin that creates folds or disturbs the natural contour of the upper eyelid
- loose tissue that is hooding especially in the periphery and impairing your vision
- fatty deposits in the medial part of your eyelids that appear as puffiness
- you are a non-smoker
- unrealistic expectations
- visual impairment that is caused by droopy eyebrows (these patients will benefit from a > BROWLIFT)
- patients with a dry eye syndrome (xerophthalmia)
- patients with an eyelid ptosis
Upper blepharoplasty can be offered under local anaesthetic, whereas lower eyelid surgery frequently is performed under general anaesthetic. Both procedures can be performed as a day case.
Upper eyelid surgery usually takes less than 1 hour to perform. Lower blepharoplasty requires approximately 1.5 hours. If you combine upper and lower eyelid surgery, or you have additional procedures, operating time will increase accordingly.
Eyelid surgery is offered using a minimally invasive approach. Minimal discomfort is to be expected. This includes swelling and bruising of the operated area which can extend down to your cheeks in the days after surgery. Patients report tightness in their eyelids due to swelling, and some patients experience dry eyes in the first few days post-opreatively. You will be given adequate pain medication and appropriate eyedrops to keep your discomfort at a minimum.
We advise our patients to plan enough time for their recovery. The minimum after an eyelid operation are usually 10-14 days. In this time, you should expect swelling around your eyes and cheeks. Most of the swelling will usually resolve over the first week. Due to the delicate nature of our eyelids, residual swelling can take up to 10 weeks to settle. You may be advised to use specific eye drops to prevent eye dryness in the early post-operative period. Cooling packs may be applied within the first 48 hours and you will be advised to rest with an elevated position of your head. After 6-7 days the sutures used to close the incisions will be removed. Patients can go back to their daily activities approximately 7 to 10 days after surgery. We advise our patients to avoid strenuous activities or exercise completely for 3 weeks after surgery.
Incisions are either placed inside the natural fold of your upper eyelid, few millimetres underneath your lower lid eyelashes or on the inside of your lower eyelid. Eyelid skin is the thinnest in our body, making scarring minimal. As the scars continue to mature they will become barely visible. Mr. Bran wrote his PhD on scars and continuously improved his surgical techniques in order to create the least noticeable scars.
What can complement eyelid surgery?
Other beneficial procedures that can complement eyelid surgery include forehead rejuvenation or brow lift surgery, face lift, or neck lift.
In order to find out more you should book a confidential consultation with Mr. Bran. As an expert in facial plastic surgery, he will be able to answer all of your questions and explain the details of your tailored procedure.