Blepharoplasty - Eyelid Surgery

Changes in facial skin, downward shifting of the brow and fullness of the upper eyelid skin are the earliest signs of the normal ageing process to become evident. Frequently, swelling of the eyelids, are first present only in the morning, seems to hang on longer each day, and eye shadow makeup becomes smudged at the lid folds. Progressive upper lid fullness over a period of time may produce overhanging skin folds that result in partial visual obstruction. Some conditions leading to rather early ageing changes are repeated swelling due to allergic or related systematic problems, and a variety of anatomical characteristics that are genetic in origin.

In addition to the wrinkling and sagging of the eyelid skin, so-called "bagginess" may become evident under the lower eyelids and at the inner corners of the upper eyelids. This is the result of protrusion or out-pouching of the fatty tissues under the lid. Occasionally, this tendency is strongly familial in origin, becoming noticeable at a relatively early age, sometimes in the mid-20's. More often, however, the fullness is developmental in nature and appears at 35 or 40, becoming even more marked in the 40's or 50's. Dry, thin skin also contributes to an early development of this condition. The preference for the early surgical correction applies here as it does to facial surgery in general.

When the condition of the eyelid has progressed to the point of visual impairment, or to the point where the muscular fibres around the eyelids have become overstretched, repair becomes more difficult. Sagging of the overstretched skin requires removal of the excess in all directions to achieve maximum benefit. Long standing problems therefore require greater surgical change.

Fortunately, the results of early treatment can be highly successful. There may be more wrinkling or fullness in the skin as years go by. However, once fatty tissue "bags" are removed they generally do not return. Correction may be performed along with the face-lift operation or as an entirely separate procedure when this area alone is primarily involved.

Elevating the eyebrow also have a secondary effect upon the upper eyelid. This may be accomplished surgically and employed to advantage under those circumstances where downward displacement contributes fullness to the upper lid. A separate incision will be required that leaves a permanent although limited scar. Sometimes the brow can be elevated in the course of a face-lift procedure without leaving any visible scars.

The following technical details should be noted. Surgical incisions are so placed that they will hardly be visible after several months have elapsed. Initially, they may appear as small red marks just to the side of the eye; as time passes, however, they fade into the normal lines ordinarily found in this area. The excess skin and any overstretched muscle fibres are removed from the upper lids along with the protruding fatty tissue. Similar correction is performed for the lower eyelids; in this area, however, specific attention is directed to the elimination of excess skin without undue tension on the lid margin. During surgery the same meticulous attention is directed toward small bleeding points as in any other procedure, and repair of incisions is performed with very fine suture material.

As noted, this operation involves he eyelid sutures and the surrounding soft tissues alone. Visual impairment following such a procedure is therefore not realistically a potential problem. While downward displacement of the lower eyelid is possible as a result of excess tension at the free margin, early and frequent squeezing exercises (repeated tight closure of the eyelids) can remedy this difficulty. Where the soft tissues show absence of good muscular tone before the operation, as in advanced cases, lower eyelid displacements may be significant enough to warrant secondary corrections, which may be necessary despite careful surgical technique. Finally, additional hazards or risks in this operation involve unfavorable healing-excess scar tissue, surgical wound infection or prolonged post-operative swelling and discolouration. The last can be particularly troublesome when darker pigmentation is present before surgery. Additional post-operative problems (infection, bleeding etc.) are no more frequent than in other types of surgical treatment.

How long does it take?
The procedure itself takes about 2 hours, depending on the individual case. If the procedure is undertake under a general anaesthetic you will spend 1 night in hospital. If it is taken under a local anaesthetic you will require only day care, visiting our rooms or day surgery clinic. Four to five days after the procedure you will return to have the stitches removed.

What will I look like immediately after the procedure?
When will I look good?
The eye area will be swollen and bruised for 10-14 days, gradually subsiding, so that within a month your surgery will be virtually undetectable.

When can I wear makeup?
Two weeks after the operation, after most of the swelling has subsided you may apply eye make up. Of course you may wear lipstick right away.

For further information and an initial complimentary consultation with a counselor, please contact your nearest Australian Aesthetic Surgery Centre.