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As we age, our eyelids stretch and the supporting tissues weaken. As a result, excess skin and fat may gather above or below your eyelids, resulting in heaviness, eyelid drooping, reduced side vision (peripheral vision), wrinkles and grooves. In addition, younger people may be unsatisfied with their eyes due to problems such as puffy eyelids, eye-bags, and asymmetry or absence of their double eyelid fold.
Eyelid surgery, also known as blepharoplasty, is a surgical procedure to improve the appearance of the eyelids, making one’s eyes appear younger and more alert. Blepharoplasty can correct the following problems:
Excess skin on the upper eyelids that reduce your peripheral vision
Baggy or droopy upper eyelids
Asymmetric or absent upper eyelid crease (“double eyelid”)
Excess skin on the lower eyelids
Bags under your eyes
Surgery can be done on the upper eyelid, lower eyelid or both at the same time. If your eyebrows are droopy and you have deep creases in your forehead, your surgeon may also recommend a brow lift in addition to blepharoplasty. The Procedure
Blepharoplasty is usually done in an outpatient setting. Depending on the extent of surgery that you require, this surgery may be performed under local anaesthesia or general anaesthesia.
During your preoperative assessment, your surgeon will decide how much skin, muscle, and/or fat to remove. Markings will be made to indicate the surgical incisions and where tissue is to be removed. Typically, for the upper eyelid, your surgeon will make an incision hidden within the natural fold of the upper eyelid. A new fold (double eyelid crease) will be created if you do not naturally have one. For the lower eyelid, the incision will be placed either just below the lower lashes (subconjunctival incision) or hidden inside the lower eyelid (transconjunctival incision).
Through the marked incisions, excess skin, muscle and possibly fat will be removed. Tissues may redistributed internally to reduce bulges and puffiness. The incisions will be closed with sutures or glue.
After the Surgery
You will be monitored for complications in the recovery room for a period of time, and discharged afterwards to recuperate at home if you feel well.
After the surgery, you may temporarily experience:
Pain or discomfort
Swelling or bruising
Numbness of the eyelids
Blurred vision from lubricating eyedrops or ointment applied to your eyes
Difficulty in closing your eyes
These symptoms usually improve over several days with rest. Painkillers and antibiotics will be prescribed to control the pain and minimize the risk of infection. Cold compresses are usually helpful to reduce the swelling and bruising, as is sleeping with your head raised higher than your chest for a few days. You will be taught how to gently clean your wounds and apply antibiotic ointment and eyedrops regularly. During the first 1 to 2 weeks after surgery, you are advised to avoid strenuous activity, heavy lifting, exercise, swimming, smoking and rubbing your eyes. Avoid activities that may irritate your dry eyes, including reading, watching television, wearing contacts, and using a computer. Use of darkly tinted sunglasses when you go out during the day will help to protect the wounds from the sun and wind. Your surgeon will ask you to return to the clinic for removal of the sutures about 5 to 7 days after the surgery.
The bruising and swelling generally subsides after 14 days of surgery. Redness of the scars is normal after surgery and typically fades over several months. During this time, it is important to avoid excessive sun exposure on your delicate eyelid skin. It will take several months before the optimal result is achieved. Understanding the Risks
Every year, many thousands of people undergo successful eyelid surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks:
Swelling and bruising
Dry, irritated eyes
Difficulty closing your eyes
An outward eversion of the eyelid (scleral show or ectropion)
Injury to the eye muscles
Temporary blurring of vision, or rarely, loss of eyesight
You may need to undergo revision surgery to correct some of these problems. The subject of risks, as well as potential complications of surgery are best discussed on a personal basis between you and your plastic surgeon.