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Eyelid surgery frequently asked questions

Aesthetic eyelid surgery is performed on adults of all ages.  Some people have eyelid surgery to correct problems that are as a result of ageing, whilst others have inherited traits that cause them to seek treatment as early as their 20s or 30s.

Q. Am I a good candidate for eyelid surgery?

A. Any one or a combination of the following conditions may indicate that you are a good candidate for eyelid surgery:

  • Excess skin hanging down to obscure the natural fold of the upper eyelids or perhaps impair vision.
  • Puffy appearance of the upper eyelids making the eyes look tired]
  • Excess skin and fine wrinkles of the lower eyelids often with a depression on the bony border of the lower eyelid
  • Droopiness of the lower eyelids showing while below the iris (the coloured portion of the eye)

Eyelid surgery can usually correct these problems though other treatments may also be discussed at your consultation.

If your upper eyelid condition is accompanied by saggy eyebrows, then an eyebrow or forehead lift may be recommended.  Smoothing of deep creases on the outside of your eyes may require skin resurfacing techniques or injectables.

Treating the dark circles beneath the eyes is difficult but some bleaching  solutions can work.

These are all things you can discuss at your consultation.

Q. What is blepharoplasty?

A. Blepharoplasty is an aesthetic (cosmetic) surgical procedure on the upper or lower eyelids designed to remove excess skin folds and bulging fat bags.  Blepharoplasty will improve the bags and wrinkles around the eyes but will not improve the wrinkles on the cheeks, temples or forehead.

Q. How could this procedure help me?

A. If your eyelids have changed over the years and these changes are due to ageing, then blepharoplasty can restore a more youthful and less tired look to your eyes.  You should frankly discuss your goals and expectations with your surgeon and you should always bear in mind that the desired result is improvement not perfection. 

Q. Will I be hospitalised for the procedure?

A. Blepharoplasty may be done under a local or general anaesthetic and is either an inpatient with an overnight stay in hospital or a day case.  This may depend on your own preferences, but also on whether it is being combined with any other surgery, such as face lift.  You will be asked to attend hospital on the day of surgery when you will have a further opportunity to meet with your surgeon.  If you are having only eyelid surgery, it is normally possible for you to return home the same day.

Q. How is blepharoplasty performed and where will my scars be?

A. The procedure will vary depending on your physical features and your personal preferences.  The amount of skin and/or fat to be removed will dictate the technique used to restore your eyelids.  Usually upper and lower eyelid incisions are made along the natural lines and may sometimes extend into the crow’s feet on the outer aspects of your eyes.  It is sometimes possible to do the operation through an incision placed on the inside of your eyelid so that there are no exterior scars.  You will be able to discuss this further at your consultation.

Q. What results can I expect?

A. The operation will aim to give you a more youthful and rested appearance.  Skin folds and fat bulges will be removed and eyelid creases improved.  To correct drooping eyebrows or creases of the forehead, temple or cheeks, other procedures such as face lift or brow lift should also be considered.  Most people’s faces are not absolutely symmetrical and therefore perfect symmetry cannot be guaranteed but is one of the aspired goals.

Q. How will my plastic surgeon evaluate me for aesthetic surgery?

A. At the consultation you will be asked to look in a mirror and point out exactly what you would like to see improved.  This will help your plastic surgeons understand your expectations as to whether they can realistically be achieved.  The surgeon will carefully evaluate the amount of excess fat and skin in your eyelid areas and the position of your eyebrows.  The tone (tension) of your eyelids and the condition of the muscles around your eyelids may also determine the surgical technique used.  Your past history of surgery, present or past medical conditions and current regular medication may be important.  Some conditions may increase the risks of eyelid surgery, such as high blood pressure, thyroid disease, diabetes or dry eyes. If you have ever had problems wearing contact lenses you should let your surgeon know.

Q. How should I prepare for eyelid surgery?

A. The goal of your plastic surgeon and the entire staff is to make your surgical experience as easy and comfortable for you as possible.

If you are a smoker, it is very helpful if you stop smoking well in advance of surgery.  Aspirin and other certain anti-inflammatory drugs can cause increased bleeding so you should avoid taking these medications for two weeks prior to surgery.  Aspirin and other certain anti-inflammatory drugs and blood thinners (e.g. Warfarin) can cause increased bleeding and an increased operative risk.  You should avoid taking these medications for a period of time prior to surgery.  You can discuss this further at your consultation.

Aesthetic eyelid surgery is usually performed on an outpatient basis.  It is important that you arrange for somebody to drive you home after surgery and to stay with you at least the first night following surgery.

Q. How will I look and feel initially?

A. It is important to realise the amount of time it takes to recover following eyelid surgery.  It greatly varies among individuals.  The first evening after surgery you will not feel like doing very much.  You should rest quietly with your head elevated and put cold compresses on your eyelids.  This helps to prevent bruising and swelling.  You will also be instructed not to take any aspirin or anti-inflammatory medication for 48 hours.  In the first few days your eyelids may feel tight around the eyes and there may be some mild discomfort which can be controlled with paracetamol first. 

The length of time to recovery is quite an individual thing following eyelid surgery.  Some people find swelling persists for some weeks while others may see swelling resolve in as little as one week.  Bruising typically disappears within seven to 10 days.  Once your sutures are removed at about one week, you will be allowed to wear make-up.  Your eyesight may be blurred for a few days or even longer and your eyes will temporarily be sensitive to light.  Excessive production of tears or a feeling of dryness is also not uncommon.  If you have a feeling of dry eyes, then eye drops can help.  You will find wearing dark glasses is very comfortable and you may wish to persist with this for a couple of weeks.  It is not a bad idea, since they also offer protection from wind and sun irritation in the summer.


Q.When can I resume my normal activities?

A. Straining, bending and lifting should be avoided during the first five days but in most instances you will be able to resume your normal activities in 10 days or less.  Although you might feel like going back to work sooner than this, your vision might still be slightly blurry which may make reading and other paperwork difficult.  You should not wear contact lenses for two weeks.

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