Blepharoplasty

What is Blepharoplasty?

Blepharoplasty is an operation to remove excess skin and at times very small amount of muscle and/or fat from the upper or lower lids.

What causes excess upper lid skin?

Excess upper lid skin (dermatochlasis) is often due to advancing age. Previous episodes of upper lid swelling due to allergy or infection could also cause stretching of the skin resulting in dermatochlasis.

Excess upper eyelid skin can make the eyelids heavy and affect the field of vision. There may also be associated fat prolapse or ptosis. Lower lid eye bags may give a tired look affecting self confidence and may be cosmetically unsightly.

How is blepharoplasty performed?

Blepharoplasty is usually performed under local anaesthetics with or without sedation. It involves excision of excess upper lid skin and, if present, correcting the droopy eyelids (ptosis) at the same time.

Your face is cleaned with antiseptic solution and the amount of excess skin to be excised is marked. The local anaesthetic injection is gently given to the eyelid. This causes an initial short lasting stinging for a few seconds. The eyelid will be numb and there will be no pain involved during the operation. Appropriate amount of skin is excised and if indicated a conservative amount of orbital fat may also need removal. The skin is sutured with very fine absorbable sutures. The resultant scar will be hidden away in the natural crease of the eyelid. Antibiotic ointment is put on the eye and the wound and the eye will be padded for approximately 2 hours.

What happens following surgery and what are possible problems?

Eye pads are removed after approximately 2 hours. Do not worry if there is some blood on the eye pads. Cool bags are placed on the eye to help reduce swelling and bruising.  There shouldn’t be any pain at this stage and any mild discomfort can be treated with simple painkillers like paracetamol. If you experience severe and increasing pain not relieved by simple painkillers you should contact the hospital where you had your surgery for urgent advice. It is extremely rare to have loss of vision as a result of a bleed around or behind the eyeball.

It is common to have some bruising and swelling of eyelids. There may also be some swelling of the eyeball too. These changes will all settle down within a few weeks.

Dry and gritty sensation may also occur. This is treated with lubricating eye drops and eye ointments. This again, will settle down after a few weeks. The vision may be blurred for a few days.

Any bleeding following surgery is usually slight and stops within a short time. In case of continuous bleeding you should seek urgent advice from the hospital.

Wound infection causes swelling and tenderness of the wound with poor healing. Antibiotics tablets are required to treat this and re-suturing of the wound may be necessary once the infection has settled.

Problem with complete eyelid closure will occur if too much skin is removed and in extreme cases skin graft may be necessary.

Sometimes some loose skin may persist, often at the outer corner, requiring further surgery.

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