Eyelid Correction

Introduction

At your consultation you will be asked your general medical history with details of any previous eyelid surgery. Slight differences in facial symmetry are normal and are usually pointed out as they are often unnoticed by the patient. Anthony will describe the positioning of the scars and indicate the likely postoperative results.If you have had previous eyelid reduction, upper or lower the results can be more unpredictable due to scarring. Also there may be some droop of the brow (brow ptosis) after upper eyelid reduction due to “decompensation” of the brow muscles. This may give a hooded appearance of the upper eyelids in the post-operative period. This should be born in mind as you may subsequently require a brow lift as a separate procedure, which would incur addition expense.

Procedure Details

Blepharoplasty can be carried out with local anaesthetic and sedation, or under general anaesthetic. Both are usually performed as day case operations (for upper eyelids-overnight stay and general anaesthetic for lower eyelid reduction). This procedure is often carried out at the same time as a facelift giving excellent overall results. The incision for the upper eye is the natural crease line above the eyelashes. The excess skin is trimmed, any fat usually present in the adjacent area to the sides of the nose is removed and the lid is then sutured. The incision for the lower eyelid is just below the eyelashes (subcillary), again, extending out into a natural laughter line. The tissues are then elevated and excess fat removed or redraped. The skin is then lifted upwards and outwards gently tensioning the area and removing the overlapping skin and suturing to close.

Summary

Blepharoplasty is one of the most popular aesthetic plastic surgery procedures. The results can significant and give a freshened appearance to the eyes. Following blepharoplasty, you may not be able to wear contact lenses for some time and should discuss this possibility with your surgeon. However, the limitations of the surgery will be fully discussed with you at the time of your consultation by Anthony and need to be borne in mind before deciding to proceed with upper or lower blepharoplasty. The possible complications of blepharoplasty include: blindness, alteration in visual acuity and vision post-operatively, dry eyes, watering eyes, change in shape of eye aperture or lid position, ectropion (dropping of the lower eyelid position), blepharitis or conjunctivitis, astigmatism.

Aftercare

Sutures will be removed at about 7-10 days post-operatively. It is VERY IMPORTANT not to stoop or carry out vigorous activities for two or three days following surgery, otherwise postoperative bleeding could result which could affect your vision in the longer term. Avoid Aspirin or Neurofen for at least 3 weeks before this surgery, as they increase the chance of bleeding, post-operatively. The eyelids should be gently splashed with water and not rubbed in any way. It is advisable to apply artificial tears as a lubricant (“Visco-Tears”)  for three or 1 week and eye makeup should not be used for the first week or two. Discomfort around the eyelids following surgery may be controlled by mild analgesics such as Paracetamol (Aspirin must be avoided). The scars may be helped by gentle massage, starting 2weeks post operatively.

General Advice

You should arrange for someone to drive you home from hospital.

You will experience mild discomfort after your surgery and it is recommended that you take one or two pain relieving tablets (such as Paracetamol) on a regular basis for the first week or so. DO NOT TAKE ASPIRIN OR ANY PRODUCTS CONTAINING ASPIRIN as this may prolong or cause bleeding in the early post operative period.

Swelling and bruising

There maybe some swelling and bruising following surgery, though this should settle over the first two weeks. To minimise swelling and bruising around your eyelids you are advised to sit up right throughout the day and prop yourself up with an extra pillow at night for the first two weeks post operatively.

It is important to rest as much as possible for the first 48 hours after surgery, after which you can recommence gentle activities and household chores, but should refrain from exercising for at least two weeks. You should move around the home as much as possible and not lie in bed for protracted periods.

We recommend eye lubricants in the weeks following surgery to avoid any irritation of the eye itself. Advice on this will be given at the time of surgery.

Post operation meeting

You should avoid getting the incisions or dressings wet for the first week.

You will have stitches to be removed by the nurse about 5 days post operatively. This is painless.

Once the incisions have healed and they have been inspected by the nurse you will be advised that you may recommence showering the eyelids. Until this point, you should avoid getting your wounds wet. You should avoid using make up for at least one week post operatively.

Provided that your eyes are fully open and your vision is not impaired you may recommence driving when you feel it safe to do so.

Smoking

I would have advised that it is important to stop smoking prior to your operation in order to reduce the risks of complications. You should avoid smoking for the first two weeks post operatively.

Back to work

Following surgery, the type of job that you do determines when you can return to work. If you mainly confined to deskwork, you may feel able to return to work after one week

Skin care

The scar will pretty much look after itself. By week two you should commence moisturising and gentle massage of the scar, with a good quality moisturiser for five minutes morning and evening for the first three months the aim being to soften the scar and speed up final scar maturation. The delicate scar tissue is at greater risk of sunburn if exposed to the sun, therefore, you are advised to avoid sun exposure to any scar tissue for the first six weeks of healing, after this if the area is to be exposed to sunlight you should apply sun protection factor 50 or greater sun block to exposed scar tissue.

Complications

Though most people experience uneventful post operative recovery, if you develop any of the following you should contact Mr armstrong’s nursing team:

  • Temperature greater than 38.5°
  • Severe pain not alleviated by simple painkillers
  • Fresh bleeding from the wound, other than a minor ooze Any disturbance of vision
  • Excessive swelling, particularly of the lower eyelids
  • Any irritation of the eyeball where it feels uncomfortable

Patient Journeys

  • I feel completely refreshed and although some people did not see why I wanted to have it done I did and it has made me feel renewed. Well done to Anthony and his team for their support and care. So recommended.

  • I feel so appreciative of my surgery and I would like to highly recommend the expertise of Mr. Armstrong and his professional and caring team.

  • Once the bandages came off my ears, I was able to see just what a fantastic job Mr Armstrong had done.