Upper eyelid surgery, or upper blepharoplasty is a procedure which commonly addresses excess skin, lax muscle or fat deposits in the upper eyelid. The signs of ageing patients may find are:
- Fine lines or crepey skin.
- Excessively folded skin, which may encroach into one’s field of view.
- Bulging areas, especially towards the inner edge of the upper eyelid.
What can I expect?
After a careful assessment, Richard can discuss with you which components of the ageing eyelid you have, and how best to address these. An ideal outcome appears awake and engaged, highlighting your natural eye shape and in harmony with the rest of your face and your inner vitality.
Where fine lines or crow’s feet are present, these are better managed using non-surgical means. Excess skin can be carefully excised during surgery, with a fine line scar that sits in a natural crease in the eyelid. In our youth, the normal fat deposits around the eyelids provide a full, smooth and softer appearance. However, as we age, these fat deposits may bulge as their previous constraining tissues become weaker and the shape of the eye socket changes. This fat can be carefully reduced or repositioned, although removing too much can result in a gaunt appearance.
Upper eyelid ageing is also affected by any age-related descent of the brow and forehead, and Richard will assess for this during your consultation.
What happens before surgery?
Upper blepharoplasty is most often performed in a hospital setting. The day of your procedure, you will arrive as planned to the hospital where all the staff will be expecting you. They will check your details and ensure all the preliminary paperwork has been done (there’s lots of this, but it’s really important). Before your procedure, your Anaesthetic Specialist will discuss your anaesthetic plan, including any pain medications you may need during your post-operative recovery phase. The procedure is often carried out under general anaesthetic, although in some cases local anaesthetic with or without sedation is applicable. I will meet you again to make sure everything is taken care of, before drawing my surgical markings and any additional photographs as necessary.
What happens during surgery?
Regardless of the type of anaesthesia you receive, Richard will also inject local anaesthetic solution at the start of surgery. According to your surgical plan, Richard will carefully remove excess eyelid skin, sometimes a small sliver of the underlying muscle and any excess fat can be trimmed. The skin is closed with sutures and light dressings and an ice pack applied. If only the upper eyelid is addressed, this procedure may take up to an hour or so.
What happens after surgery?
You will wake up from anaesthetic in the recovery room with an ice pack over your eyes to help minimise swelling and bruising. The eyelids are delicate, with thin skin, so some bruising and swelling is to be expected. Your vision may be a bit blurry due to ointments or fluid, which should resolve. Pain should be minimal if anything, but if you do experience pain, please ensure you discuss this with the recovery nurses.
Most patients can go home the same day, and once home, it’s important to keep your head elevated by setting up a comfortable chair or extra pillows in your bed to sleep for the first three or four days. Please feel free to move about the house as usual and do your normal activities of daily living. You may experience some dryness or feeling of irritation to the eye, and we will recommend some drops to help with this. Avoid strenuous activity or lifting for around four weeks, as this will prolong swelling.
We will see you in the rooms for removal of sutures a few days after surgery, but expect the majority of swelling to resolve after one or two weeks and result to settle over the coming one to four months.
When you’re comfortable, not taking any strong pain killers, have normal vision and can react to road conditions, you can resume driving. This often takes around a week or so.
Possible complications
The decision to undergo eyelid surgery is a very personal one, and should only be made after considering if the potential benefits can achieve your aims, and whether the risks are acceptable to you. The possible risks/ complications of upper blepharoplasty surgery include (but are not limited to):
- Cardiac problems, including heart attack or arrythmias.
- Venous thromboembolism (including deep vein thrombosis and pulmonary embolism, which may be fatal).
- Blood loss requiring urgent return to the operating theatre.
- Surgical site infection.
- Wound breakdown, delayed healing or protruding sutures.
- Conspicuous scars, including hypertrophic, stretched or migrated scars.
- Numbness (temporary or permanent).
- Fluid accumulation or leak which may require drainage.
- Asymmetry, areas of tightness, pleating or contour irregularities.
- Dry eye or troubles with vision.
- Eye injury, which may require ophthalmologist input, including blindness.
- Lagophthalmos.
- Injury to the muscles that retract the eyelid.
- Injury to lacrimal glands and associated structures
- Possible need for revisional surgery.
- You should understand that other people will probably notice you have had facial surgery, and this may draw attention.