Blepharoplasty

Also known as – eyelid surgery

Procedures
Face
Breast
Body
Hair
Non Surgical

Indications

- The eyes are the mirror of the mind. Baggy eyes give one a physically and mentally harrowed, sleepy,and tired look or appear prematurely aged. This can be an important aesthetic consideration in people who are tired of fending questions about their health.This can be addressed by a simple yet very gratifying procedure called BLEPHAROPLASTY (surgery for baggy eyelids).

- It is indicated when there is unsightly appearance of bagginess, laxityand excess skinin the lower eyelids. It could also be done for excess skin and a droopy look of the upper eyelids.

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What does the procedure achieve?

The procedure removes any excess loose skin on eyelids, removes or redistributes any excess fat (bulges) and tightens the overall eyelid structure.The procedure gives the area around the eyelids a youthful and rejuvenated look. The effects of the surgery usually last for a few years. Longer lasting effects can be seen in patients who have good skin quality (thin and elastic), younger age and less photodamage on their side. Severe physical and psychological stress, endocrine disorders, changes in visual acuity, chronic alcoholism, chronic smoking can reduce the longevity of the result.

Contra-Indications

Patients with bleeding disorders, on blood thinner medications, uncontrolled thyroid disease, dryness of eyes,glaucoma etc must approach this procedure with caution.

Consultation

At a detailed preoperative consultation, your surgeon will:

- Discuss your surgical goals and expectations

- Evaluate your general health status and risk factors

- Elicit History of previous surgeries and medical conditions

- Elicit History of all current medications

- Ask about Allergies (including drug allergies), addictions if any

- Take Preoperative photographs and plan for your procedure

- Discuss all treatment options

- Explain the possible outcomes

- Potential risks and complications of the surgery

Anaesthesia

Usually general anaesthesia is preferred to avoid discomfort to the patient as the surgery is done close to the eye. However, it can also be done under local anaesthesia with sedation.  This is done as a day care procedure (i.e. the patient can get operated in the morning and return home by evening). So, the patient can return home in a few hours.

Time For Procedure

The procedure may take approximately 1 hour for upper blepharoplasty only and may range from 2 to 4 hours if only both lower eyelids or all 4 eyelids are to be operated.
  • Detailed medical evaluation by Blood tests, Xrays, ECG, Stress Test etc
  • Control of any co-morbid medical conditions such as Diabetes, High Blood pressure, Heart disease, Chronic Asthma
  • Stop smoking at least 48-72 hours prior to surgery, preferably 1 week earlier
  • Stop all blood thinners, Aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding during surgery
  • Evaluation by physician and anaesthesiologist, as necessary
  • Evaluation by ophthalmologist, as necessary

The broad outline of the procedure involves removal of excess skin and fat from the area of the eyelids to tighten the area and give a youthful rejuvenated look. Usually both upper lids or both lower lids or all four can be treated in one session, depending on the patient’s concerns.

In the lower eyelid, a precise incision is made just below the eyelashes or along the area where an eyeliner is usually applied. This gives a hidden and very inconspicuous scar. The bulging fat in the fat compartments of the lower eyelid is either trimmed off and redistributed to give a smooth appearance. The eyelid tone is tightened and the skin closure is done meticulously with fine sutures.

In some cases where there is no excess skin in the lower eyelid, the bagginess can be removed through an internal approach from within the eyelid thus avoiding an external scar. Depending on surgeon preference, stitches can be either absorbable type (does not need removal) or non-absorbable type (removed after 5 days). Dressing is minimal and eyes are not covered after the procedure.

In the upper eyelid, the incision is made along the natural eyelid fold. An ellipse of excess skin and any excess bulging fat is removed. The incision is then closed meticulously keeping it in the eyelid fold.

It may be performed in combination with other rejuvenating procedures of the face like Botox or filler injections in the required areas, autologous fat filling, thread lift and similar minimally invasive face lift procedures.

The surgery has minimal downtime of 5 to 7 days. Some bruising will occur which usually settles down in 2 weeks’ time.

In the first one week after surgery, eye strain of any kind should be strictly avoided. This includes restrictions on reading, watching TV or working on a computer, using a smartphone for reading and browsing. Use of ice packs help in soothing. The surgeon may prescribe some anti-inflammatory medication to reduce swelling. Eye drops may be prescribed to be used frequently for the first 1 week. Application of an antiseptic ointment will be needed on the stitch line. Once stitches are removed a scar reduction cream maysometimes be prescribed for use over the next few months. This is combined with the use of a sunscreen before sun exposure.

Complications

It is a relatively straight-forward surgery with rare complications. However, problems that may occur include, hematoma formation (bleeding within the eyelid), delayed wound healing, scar visibility, excess skin removal causing difficulty of closure or excess show of the whites of the eyeball and dry eye. Most of these complications can be fully corrected when detected early by the surgeon. In some cases, bleeding may lead to increased pressure behind the eyeball, leading to blindness.

Overall blepharoplasty is an extremely gratifying surgery for the patient with quick results and gives the face a rejuvenated and young look. When done by a qualified plastic surgeon, it has predictable results with minimal complications.Please look for this certification before venturing into this delicate surgery which can have disastrous complications if done by untrained “cosmetologists” or non-plastic surgeons.