Blepharoplasty (Eyelid Surgery)

Blepharoplasty is surgery on the eyelids. It removes loose skin, wrinkles and the puffy bags that make a face look tired. Patients have it to look younger, and also to see better.

The skin of the eyelid is the thinnest skin on the body. It ages before the rest of the face. As the thin skin and the muscle under it loosen, they no longer hold back the fat that sits deeper. The fat slides forward and down, and an eye bag forms. Heredity, tiredness, lack of sleep, alcohol and allergy all make the bags worse.

Why the operation is done

The operation has an aesthetic reason and a medical one.

Loose skin on the upper lid can hang over the lashes and cut into the field of vision. Removing it restores the field. Loose skin on the lower lid can pull the lid away from the eye, which dries the eye and leads to redness and infection.

Aesthetically, the operation lifts a drooping upper lid and reduces the bag under the eye. The look around the eye becomes rested and the gaze becomes sharper.

Before the operation

The doctor takes your full medical history. Tell the doctor about high blood pressure, diabetes, bleeding disorders and any problem you have had with wound healing. The doctor also asks about your field of vision, dry eye and tear problems, and whether you wear contact lenses. If you have had an eyelid operation before, say so, because it raises the risk of complications.

• Stop smoking and alcohol in the weeks before surgery.
• Avoid aspirin and aspirin-like medicines, ibuprofen and other non-steroidal anti-inflammatory drugs, ginkgo biloba, herbal preparations and vitamin E.
• Continue your daily medicines if the surgeon approves them.
• Eat and drink nothing after midnight before the operation, unless you are told otherwise.
• Wear no make-up. Leave false lashes, contact lenses and jewellery at home.

How the operation is done

The surgeon uses local anaesthesia, local anaesthesia with light sedation, or general anaesthesia. It is day surgery, done in the clinic or in hospital. The procedure is not painful, though you may feel mild discomfort. Under general anaesthesia you sleep through it.

Two lids take 40 to 60 minutes. All four lids take about two hours.

On the upper lid the surgeon cuts along the natural crease, so the scar hides in the fold. The cut runs from the inner corner to the wrinkle at the outer corner. The surgeon removes the excess skin, muscle and fat. The cut is closed with fine stitches that dissolve or are removed within a week.

On the lower lid, when no skin has to be removed, the surgeon can work through a small cut inside the lid. This is called transconjunctival blepharoplasty and it leaves no scar on the skin.

If the brow has also dropped, a brow lift raises it and is often combined with eyelid surgery. The operation can also be combined with a face lift.

After the operation

You go home the same day. Hospital stay is usually not needed. Healing differs from person to person. Redness fades and swelling settles within about ten days.

• Use a cold compress on the first day to reduce the swelling.
• Keep your head raised. This reduces swelling and bruising.
• Use the eye drops and the ointment the doctor gives you, to stop the eye drying.
• Avoid reading, screens and television in the first week, because they dry the eye.

Stitches come out after 5 to 7 days. Around the tenth day most patients feel well enough to return to normal activity. Avoid heavy activity for three weeks.