It’s surprising what a difference your eyelids can make to the youthfulness of your face. Puffy eyelids and under-eye bags are an inevitable part of the ageing process and can cause you to look older than you are and constantly tired. While many female patients try to counteract the effects with make-up before finally deciding to have surgery, for men the options are even more limited.
Eyelid surgery, also known as blepharoplasty, can correct the problem, making you look fresher and more energised, ensuring your face is more reflective of your actual age and the way you feel on the inside.
The treatment can be carried out alone or in conjunction with other facial surgery such as a facelift or brow lift.
During this consultation, we will assess your eyes and face and seek to understand what you want to achieve from surgery. It’s only through this full and frank discussion that we can determine whether surgery will give you the results you are after.
You’ll need to be physically fit and psychologically stable, with realistic expectations. Most blepharoplasty patients are 35+ but if droopy, baggy eyelids run in your family you may decide to have eyelid surgery at a younger age.
While eyelid surgery can help you to look younger and fresher, there are several problems which can’t be solved by this type of surgery. Eyelid surgery won’t lift sagging eyebrows, remove crow’s feet or other wrinkles, or eliminate dark circles under your eyes.
A general anaesthetic will be required for lower lid surgery while a local anaesthetic is usually appropriate if you are having only the upper lids operated on. A local anaesthetic will numb the area around your eyes as well as oral or intravenous sedatives. You’ll be awake during the surgery, which usually takes one to three hours, but you’ll feel relaxed and insensitive to pain. Expect to feel some tugging or occasional discomfort.
If you’re having your eyelids and your undereye area operated on it’s likely that we will work on the upper lids first. Typically, incisions are made in the creases of your upper lids and just below the lashes on the lower lids. The incisions may extend to the crow’s feet or laugh lines at the outer corners of your eyes. The skin is separated from underlying fatty tissue and muscle, excess fat removed and sagging skin and muscle trimmed. The incisions are then closed with very fine sutures.
Underlying fat, along with excess skin and muscle, can be removed during the operation. If you have a pocket of fat beneath your lower eyelids but don’t need to have any skin removed, we may recommend a transconjunctival blepharoplasty. In this procedure, the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin, and requires a general anaesthetic. Sometimes this procedure is accompanied by laser treatment to the skin to reduce wrinkles.
In a transconjunctival blepharoplasty, a tiny incision is made inside the lower eyelid and fat is removed with fine forceps. No skin is removed and the incision is closed with dissolving sutures.
Minor complications that sometimes follow blepharoplasty can include blurred vision for a few days; temporary swelling at the corner of the eyelids and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out but we can remove these with a very fine needle, if required.
After surgery, some patients may have difficult closing their eyes when they sleep; in rare cases this condition may be permanent. Another infrequent complication is ectropion, a pulling down of the lower lids. This is usually temporary but further surgery may occasionally be required. Blindness has occurred on very rare occasions.
A few medical conditions make blepharoplasty riskier. These include thyroid problems such as hypothyroidism and Graves’ disease, dry eyes of lack of sufficient tears. A detached retina or glaucoma is also reason for caution; in such cases, you may require an examination by an ophthalmologist before going ahead with surgery.
At this session we will need to review your complete medical history, including details of any allergies or if you’re taking any vitamins, medications (prescribed or over-the-counter) and if you smoke. You should also provide any relevant information from your ophthalmologist or a copy of your most recent eye scan results.
We will assess your eyelids and understand what you would like to achieve through surgery. It would then be possible to decide whether you need to have surgery on your upper or lower eyelids or both areas to get the results you would like.
During this session we will discuss the techniques and anaesthesia we will need to use and it’s an opportunity for you to ask any questions which may help you in deciding whether or not eyelid surgery is the right step for you to take.
If you do decide to go ahead, we will provide you with specific instruction on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications – these will help your surgery go more smoothly.
We always recommend that patients ask someone else to drive them home after surgery, and help out for a few days to enable you to rest properly. The less you do in the immediate aftermath of surgery, the better your chances of a fast and trouble-free recovery.
You should be able to read or watch TV after a couple of days but you won’t be able to wear contact lenses for about two weeks, and they may feel uncomfortable for a while.
Expect to be able to return to work after about ten days (women may be able to cover most of any remaining bruising with make-up). You may be sensitive to sunlight, wind and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.
It’s best to keep activities to a minimum for five days and to avoid more strenuous activities for about three weeks, especially those which raise your blood pressure such as vigorous sports. You may also be advised to avoid alcohol, since it causes fluid retention.
After surgery, your eyes will be lubricated with ointment. Your lids may feel tight and sore as the anaesthesia wears off, but you can control any discomfort with pain relief which we will prescribe.
You will be instructed to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. A five-day course of Arnica tablets before surgery may be helpful. We’ll show you how to clean your eyes, which may be sticky for a week or so. Sometimes eyedrops will be useful, since your eyelids may feel dry at first and your eyes may be irritated.
For a few weeks after surgery you may experience excessive tearing, sensitivity to light and temporary changes in your eyesight, such as blurring.
Stitches will be removed after four days – once they’re out, the swelling and discolouration around your eyes will gradually subside.
No, we can help to rejuvenate the appearance of your eyes but it’s not possible to completely remove under eye bags. We will be able to discuss what results can be achieved when you attend your initial consultation.
There are risks with all surgery and it’s important to know what they are so that you can make an informed decision. To minimise risks it’s important to work with experienced plastic surgeons.
No, once your scars have healed there should be no visible signs of eyelid surgery. The shape of your eyes usually do not change and so people will not notice that you have had anything done.
Every patient is different. By understanding the results you would like to achieve we can give you appropriate advice and guidance.
Yes, we always seek a natural look so that patients can rest assured that they will simply be a rejuvenated version of themselves.