Eyelid surgery ("blepharoplasty") is used to treat the upper and/or lower eyelids. Delicate surgery removes excess or overhanging skin, giving a more youthful look to baggy upper eyelids and even improving vision in individuals whose eyelid skin obscures their vision by resting on their upper eyelashes. Asian blepharoplasty eyelid surgery ("double eyelid" surgery) is performed to create a crease in the upper eyelid, giving the appearance of a larger eye and making it easier to apply eye makeup.
Bags and wrinkles under the eyes can also be treated with specialist techniques including facial fat grafting to address the hollowing that occurs around the eyes with ageing.
When you see Dr Tomlinson to discuss eyelid surgery she will assess the function of your eyelid muscles. If you have a weakness of one or both upper eyelids you may require surgery to the muscles. This "ptosis repair" is performed on droopy eyelids, where a muscle in the upper eyelid ("the levator muscle") has stretched or detached from its usual position within the eyelid. Ptosis repair adjusts the resting height of the upper eyelid, whereas blepharoplasty removes excess skin - with or without fat and muscle. It is important to individualise your surgery in order to achieve optimal results; in blepharoplasty surgery there is no "one size fits all" operation.
Eyelid / Blepharoplasty Surgery
Blepharoplasty is performed as day surgery under local anaesthetic, or sedation and local anaesthetic, or general anaesthetic.
You must not take aspirin, warfarin, clopidogrel or any blood thinning medications prior to surgery as this will increase the risks of surgery, especially the amount of bruising after the surgery. You must disclose to Dr Tomlinson if you have existing eye conditions, such as dry eyes, glaucoma or wear contact lenses as these conditions can affect the surgical risks and recovery. The surgery should not be performed if you have uncontrolled blood pressure or uncontrolled thyroid problems, and if you smoke it is recommended that you give up at least 2 weeks prior to surgery.
Asian Eyelid Surgery
Asian blepharoplasty eyelid surgery (also called "double eyelid" surgery) is performed to create a crease in the upper eyelid, giving the appearance of a larger eye. It is the most frequently performed cosmetic surgery in Asia. In this video US surgeon Dr Amiya Prasad shows before and after images, and demonstrates how the surgery is done (note: video contains medical procedures).
Recovery After Blepharoplasty Surgery
After the surgery you will need to spend 2-3 days resting quietly at home to reduce post operative swelling. Cold packs should be applied gently to the eye area in the first 48 hours to minimise swelling and bruising. Do not rub at your eyes. You will be prescribed pain medications and an ointment to apply to the wounds twice a day. You can wash your face and shower on the night of surgery.
You will return to see Dr Tomlinson at approximately 1 week after the surgery to check your wounds and progress. You should plan to take 1-2 weeks off work; over this time the bruising and swelling will gradually resolve. You can apply eye makeup to the wounds and resume exercise after 2 weeks. You should expect to have visible bruising around the eyes for 7-10 days. More severe bruising can take longer to resolve and you should allow at least 6 weeks before any important social events or photographs.
You are able to drive after the surgery providing it is 24 hours after your anaesthetic and your vision is clear. You must not wear contact lenses until the incision lines are completely healed. If you experience a sensation of dry eyes after the surgery you should not wear contact lenses until this has resolved. It often takes until 6 weeks after the surgery until the puffiness around your eyes has fully resolved.
Possible Complications of Blepharoplasty Surgery
Possible complications of blepharoplasty include:
- Risks of anaesthesia
- Temporarily blurred or impaired vision
- Dry or watery eyes
- Difficulty closing your eyes - this can lead to drying of the eye surface and cause corneal scarring, but the risks of this occurring are minimised through careful assessment and measurements
- Asymmetry of the eyelid position or fold
- Ectropion (rolling down of the lower eyelid)
- Unnatural-looking eyes (although great care is taken to ensure that you and Dr Tomlinson are "on the same page" if you desire surgery that may change the shape or appearance of your eyes)
- Inflamed, itchy scars
- Bleeding behind the eye
- Vision loss, including complete blindness; this risk is said to be 1 in 40,000 procedures and you are at greater risk if you smoke, have pre-existing eye disease, if your blood does not clot properly and if you cough, strain or lift excessively soon after surgery
- Further surgery to treat complications.
Blepharoplasty surgery in itself does not remove dark circles from under the eyes, does not lift the eyebrows and does not remove crows feet. If your eyebrows are low Dr Tomlinson will discuss with you the pros and cons of browlift surgery and whether this would be suitable or desirable for you.
What are the costs of Blepharoplasty Surgery?
The surgical quotation that you will be provided at your consultation includes, where applicable:
- the surgeon's fee
- the anaesthetist's fee
- the hospital or day surgery fee
- the cost of your post surgical appointments for one year
A Medicare and/or private health insurance rebate may be applicable for upper eyelid surgery including ptosis surgery - Dr Tomlinson will discuss this with you at your appointment. Medicare and/or private health insurance rebates are generally not available for the parts of the surgery performed on the lower eyelids, or for fat grafting.
Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.