Purpose: To remove excess upper and lower eyelid skin and give the eyes with the face a more youthful appearance.
Length of operation: 1-2 hours
Anaesthesia: General anaesthetic or local anaesthetic (if only upper eyelids)
Inpatient stay: 1 day
Followup: 1 week, 3 months, 6 months, 1 year
Time off work: 1-2 weeks
Recovery: 2-3 weeks
Risks: swelling, bruising, asymmetry
This is a common plastic surgery operation for an aging eye. The operation can be done for the upper eyelid, lower eyelid or both simultaneously. The operation involves removing excess skin and bulging fat from the eyelid. The end result which we aim for, is a fresh, rejuvenated look to the eyes and the midface region. This operation can be usefully combined with a facelift and chemical peel procedure to give a harmonious appearance to the face.
The results are generally excellent with high satisfaction rates. In this description I shall take you through the operation, hospital stay, recovery and the complications. Once you have met me for the initial consultation, I would be quite happy to see you again for a second consultation, so that you can clarify any of your doubts.
Procedure / Hospital Stay
It is advisable to stop smoking for 4 weeks and stop contraceptive pill and hormone replacement therapy for 4weeks prior to the procedure. Aspirin needs to be stopped for at least 10 days before the procedure, as it thins the blood out and can make for more bruising. If you are hypertensive then it is particularly important that this is well controlled prior to the procedure. On the day of the operation Dr Sanjay Azad with do skin markings over the face. Photographs for documentation and teaching purposes are standard and will be discussed. The procedure is done under local anaesthetic for just upper blepharoplasty. However general anaesthesia is used if you undergo an upper and lower blepharoplasty. The duration of operation will vary depending on the mix of procedures you undergo.
The procedure for the upper eyelid is done using an incision which typically runs along a skin crease, and get masked when healed. The operation of the lower eyelid is done through an incision which is just below the lash line. Excess skin and obvious bulging fat is removed before closing the wound.
The stitches are not dissolving in nature. At the end there is a paper tape dressing on the upper eyelid. You will feel quite bruised and swollen after the operation and this settles in due course. We advice on using cold packs for the first few hours as this helps to reduce swelling. The hospital stay is conventionally overnight, but depends on your recovery.
Recovery After Surgery
You will need to attend the dressing clinic in one weeks time. Simple pain killers like paracetamol are adequate, and undue pain after the procedure can signify a complication. Keep an additional pillow under your head for a few days, as this helps to reduce swelling. Further dressings may or may not be required depending on the wound. The bruising typically takes 2-3 weeks to disappear. Initially the bruise becomes tan coloured and this fades in due course. You will be seen again in 3 months time. Photographs will be taken at this stage.
You should avoid smoking for 4 weeks after the procedure. Recovery is individual, but most patients get back to work and driving in 3-4 weeks time. It is important in the healing phase to apply a sunscreen cream otherwise the scars can become pigmented. This should be used for at least 1 year after the procedure.
Overall results are excellent but there are some well known limitations, risks and complications which you should be aware about. Scars, infection and blood clots are risks of any procedure. Bruising and swelling are common and take about 2-3 weeks to settle.
Eyes will feel gritty after the procedure, but this settles in due course. Eyelid surgery does not treat the droopy forehead which will require a browlift procedure. I shall discuss with you about this in details. The eyes and face are rarely symmetrical on both sides. It is common to notice some difference in the symmetry of both eyes especially on the sides. Under correction or over correction of the eyelids can also rarely occur and may necessitate a small additional procedure.
- Mr Sanjay Azad advices his patients to take Tablet Arnica (30 strength) once a day prior to surgery. This is a homeopathic remedy which has been found to reduce bleeding and bruising after surgery.
- No make up should be applied on face prior to the operation.
- Do not cut your hair prior to surgery so that the incision can be well hidden.
- Do get a scarf and sunglasses which will be useful after surgery.
- Continue taking Arnica tablet once a day for 2 weeks after surgery.
- Pain killers after surgery are typically a combination of codeine and paracetamol. Avoid any tablets like ibuprofen or diclofenac which can potentially thin the blood and cause more bleeding or bruising. If you have any allergies please highlight this to Mr Sanjay Azad.
- If there is any bleeding through the bandage, please contact the team.
- Do not consume alcohol for 2 days after surgery.
- It is useful to apply ice compresses to the exposed area of the face during the first 2 days to reduce swelling.
- You can wash your hair 3 days after surgery.
- Try not to do too much after surgery and take a soft diet for the first three days. Limit activities such as bending, straining and lifting. Avoid excess neck movements and heavy exertion for the first month. Aerobics should only be done 3 months after surgery.
- While sleeping keep your head elevated (to 45 degrees) by using an additional pillow. This should be used for the first week after surgery.
- Do not go into direct sunlight for first 6-8 weeks after surgery. Also use sunblock daily.
- It is common to have swelling of the face and sometimes bruising of the neck and chest. Bruising typically settles down in 2-3 weeks time. It is safe to apply makeup after the first week to mask the bruising.
- It is useful to massage the face with moisturizing cream after surgery which helps in the settling down process.