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Blepharoplasty (Cosmetic Eyelid Surgery): The eyes are probably the most noticed and expressive of our facial features. They are framed and highlighted by the eyelids. The effects of aging and hereditary features can cause looseness, wrinkling and folding of the skin along with heaviness, fullness and "bagging" of the eyelids. The result can be a aged, tired, heavy, or sad appearance. The surgical correction of this is called a blepharoplasty. How is it done? There are four components that can contribute to the appearance of the eyelids. They are, the skin, the muscle, the fat, and the supporting structures (ligaments). Any or all of these can be involved. A blepharoplasty is personally customized to deal with the important components for each patient.  The operation can be done under local or general anaesthetic as a day care procedure.For the upper eyelid an incision is made in the fold of the eyelid. Extra over folding skin is measured out and removed. If there is bulging fat it is trimmed. Sometimes the muscle is trimmed to refine the fold. The incision is then sutured to give a scar that is disguised as part of the eyelid fold.  The lower eyelid is done through an incision just below the eyelashes and the carried out to a "crow's foot" wrinkle. The skin and muscle are then trimmed. Bulging fat is reduced or repositioned and, if necessary, the ligament is tightened. The layers are then sutured, giving a scar that lies disguised by the shadow of the lower eyelashes and the "crow's foot" wrinkles.Recovery: Most patients find that this is not a painful operation, but pain medications are prescribed if necessary. The incisions heal very quickly (five days is average). Swelling is very noticeable for the first week and then subsides. Bruises take two to three weeks to resolve, but can be disguised with makeup after the first week. Scars take one to three months on average to soften and lose their color and can be covered with makeup after the first week. There may be some blurring of vision due to swelling or tearing for the first week. Possible Complications: The rate of serious complications with blepharoplasty is quite low, however with any surgery they are possible and must be considered. Hematoma is a blood collection behind the incision. If this is large it may cause wound healing problems or pressure on the globe of the eye which could effect vision. If this happens the hematoma is removed. Infections are rare and usually respond well to antibiotics. They do have the potential to effect healing and vision. Dry eye syndrome is a condition that causes a dry, scratchy sensation on the surface of the eye and is related to altered tear production. It is quite common in the un-operated middle aged and older population. It is sometimes first noticed after surgery around the eye region. The problem usually resolves over the course of a few months, but occasionally can be a long term problem. It is treated with artificial tears. Eyelid retraction can occur after surgery and can be related to overly tight skin, scar tightening under the skin or looseness of the ligament of the lower eyelid. It is sometimes seen early after the operation and usually corrects itself. If it does not, a touch up procedure may be needed. Minor eyelid asymmetry is normal in un-operated patients. Attempts are made to minimize this at the time of surgery, however some asymmetry may persist and may not be correctable. Extremely rarely alteration in vision and even visual loss has been reported after surgery on the eyelids. The reasons for this are often not well established and may be due to conditions not directly related to the surgery. |
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