Eyelid surgery, called blepharoplasty, is a surgical procedure to improve the appearance of the upper eyelids, lower eyelids, or both, and give a rejuvenated appearance to the surrounding area of your eyes, making you look more alert taking away the tired and sleepy appearance. Our clinic only provides surgical procedures for the upper eyelid. Eyelid Surgery can treat:
- Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
- Excess fatty deposits that appear as puffiness in the upper eyelids
- Excess skin and fine wrinkles of the upper eyelid
Eyelid surgery may not correct the feeling and appearance of tiredness in some people because their symptoms may be due to a sagging brow rather than excess puffy skin on the upper eyelid. Your surgeon will assess both your brows and your eyelids during your consultation so that the best treatment options can be discussed with you.
Eyelid problems may present as a cosmetic problem; however, it may also be the manifestation of an underlying medical condition. After your consultation and examination, you may be asked to go and see another specialist (e.g. an eye specialist) to exclude these conditions.
You must also inform your surgeon if you have any of these conditions:
- Eye disease such as glaucoma, dry eye or a detached retina
- Thyroid disorders such as Graves' disease and under or overactive thyroid
- Cardiovascular disease, high blood pressure or other circulatory disorders
- Previous trauma to the eye
Eyelid surgery can be done in conjunction with:
- Brow lift, to correct sagging eyebrows, giving the appearance and feeling of tiredness in the upper eyelids (Click Here to find out more about this procedure)
- Facelift, to correct sagging mid face, cheeks and correct heavy nasojugal or mid-lid crease below the lower eyelid. It can also correct sagging of the lower face.
Procedural Steps - What happens during eyelid surgery?
Choices of anaesthesia for eyelid surgery are:
- Local anaesthesia alone
- Local anaesthesia with IV sedation
- Full general anaesthetic
Your surgeon will recommend the best choice for you.
The incisions Upper Eyelid
The incision lines for eyelid surgery are designed for scars to be well concealed within the natural structures of the eyelid region. Droopy conditions of the upper eyelid can be corrected through an incision within the natural crease of the upper eyelid allowing repositioning of fat deposits, tightening of muscles and tissue, and/or removal of excess skin.
Removing Fat Pockets
Through the incisions, fat pockets may be removed to decrease puffiness of the eyelids. This can also enhance the contour of the eye socket. It is done judiciously however, as over-correction can result in a deep set and sunken socket appearance.
Closing the incisions
Eyelid incisions typically are closed with:
- Removable or absorbable sutures
- Surgical tape
Specific risks of eyelid surgery
The decision to have eyelid surgery is extremely personal and you'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your surgeon will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
Possible risks of eyelid surgery include:
- Unfavourable scarring
- Temporarily blurred or impaired vision
- Dry eyes
- Difficulty closing your eyes
- Lid lag, a pulling down of the upper eyelid may occur and is often temporary
- Bleeding (hematoma)
- Poor wound healing
- Numbness and other changes in skin sensation of the eyelids
- Asymmetry of eyelids
- Anaesthesia risks
- Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; additional surgery may be required
- Pain, which may persist
- Skin discoloration and swelling
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Deep vein thrombosis, cardiac and pulmonary complications
- Possibility of revision surgery
- Loss of eyesight - blindness
Most of the above-mentioned risks are very uncommon, and some people (with particular health problems or skin types), may be at higher risk for specific complications. Your surgeon will discuss this with you during your consultation if any of these risks are specifically pertinent to you.
Although eyelid surgery is an effective procedure where the benefits significantly outweigh the risks, the degree of surgical success can be altered by how each individual's body responds to surgery and healing. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure; revision surgery may be necessary.
Be sure to ask questions: It's very important to ask questions about your eyelid procedure. It's natural to feel some anxiety so don't be shy about discussing these feelings or concerns with your surgeon or any of our staff members.
After your procedure is completed, cold compresses may be applied to your eyes, and in some cases your eyes may be loosely covered with eye-pads. You will be sent home with the appropriate instructions, pain killer tablets, antibiotics and an information brochure. You may also need eyedrops.
Most eyelid surgery is performed on an outpatient or day-surgery basis, be sure to arrange for someone to drive you to and from surgery. If you have had IV sedation or a general anaesthetic, you will also need to arrange for someone to stay with you for at least the first night following surgery.
Initial healing may include some swelling, bruising, irritation or dry eyes and discomfort that can be controlled with medication, and cold compresses. Irritation at the incision sites is also possible. Sutures are often removed at your first postoperative nursing appointment at 5-7 days. Ointment or tapes may be reapplied onto the wound as required.
A special note: It is recommended to practice diligent sun protection and use darkly tinted sunglasses until the healing process is fully complete.
For more information on postoperative instructions, please click here.
Results and expectations
The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and surrounding region, and an alert and rejuvenated appearance. Bruising around the eye will take 1-2 weeks to settle with some persistent minor swelling. Your final results will appear within 2-3 months, but it may take up to a year for incision lines to fully refine.
While eyelid surgery can be expected to correct certain conditions permanently, you will continue to age naturally. Good skin care and life-long sun protection will help to maintain your results.
Costs associated with Eyelid Surgery
Most health insurance does not cover cosmetic surgery or its complications. When eyelid surgery is performed to eliminate the redundant skin covering the eyelashes, it may be covered by insurance. Dr Vrtik will assess your eligibility during your consultation. Sometimes, you may be referred onto your local optometrist to have a visual field test (perimetry) done to determine whether you qualify for a rebate. It is also recommended that you carefully review your health insurance policy prior to booking your surgery.
To find out more about the costs, please visit our Fee Guidelines page.
Vocabulary to Know
- Blepharoplasty: Eyelid surgery to improve the appearance of upper eyelids, lower eyelids or both.
- General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
- Haematoma: Blood pooling beneath the skin.
- Intravenous sedation: Sedatives administered by injection into a vein to help you relax during the injection of local anaesthetic.
- Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
- Skin resurfacing: Treatment to improve the texture, clarity and overall appearance of your skin.
- Sutures: Stitches used by surgeons to hold skin and tissue together.
(Some Information & Illustrations are courtesy of the American Society of Plastic Surgeons).