Vision Scotland : Everything you need to know

Blepharoplasty surgery

Blepharoplasty (eyelid lift) is an operation used to reshape the eyelids and treat droopy eyes. In the UK, over 8,000 people undergo the procedure each year.

What is the cause of droopy eyelids?

Most patients undergoing blepharoplasty do so to reduce the effects of ageing. As we get older, the skin becomes looser and muscles around the eye relax. These muscles play an important role in containing the fat which cushions the eyes, and the accumulated loose skin collects as folds and creases in the upper and lower lids, often referred to as ‘bags’.

Why have Blepharoplasty?

This procedure is usually carried out for one of the following reasons:

Functional – when the eyelid droops or hoods the eye and obscures your visual field
Cosmetic – to improve the symmetry of the eyes or to improve the appearance of droopy or puffy eyelids which make the eyes look old or tired

How safe is blepharoplasty surgery?

Blepharoplasty is generally a safe and effective aesthetic procedure with high satisfaction levels. It is carried out under local anaesthetic, which reduces the risks compared with a general anaesthetic. Patients often report that friends and family don’t notice that surgery has taken place, instead noticing that the recipient looks fresher and brighter than normal.

Vision Scotland : Eye care specialists

What is involved?

Pre-surgery

Before surgery, you will come to the hospital to meet your surgeon. You will have lots of time to talk about what you hope to achieve. Your surgeon will give your face, and particularly your eyes, a thorough examination and discuss what can be achieved. They will also take a medical history, and it is particularly important to notify them of conditions such as thyroid disease, high blood pressure, diabetes, and glaucoma, as these can affect how treatment is carried out. There is no obligation to go ahead with surgery if you or your doctor decide that it isn’t in your best interests.

Surgery

Your eyelid surgery will be carried out under local anaesthetic. You will come into the hospital and be greeted by one of the Vision Scotland nurses. They will run through your medical details to check there have been no changes since your consultation. You will walk through to the treatment room where your surgeon will make small incisions that follow the natural curvature of the eyelid - in the creases of the upper and lower lids. Small strips of skin are removed and the area re-stitched to reduce to amount of excess skin.

Surgical plan

An upper eyelid blepharoplasty concentrates on the region between the eyebrow and the eyelashes. Lower eyelid blepharoplasty focuses on the area between the eyelashes and the cheek. In lower blepharoplasty, tiny internal incisions are made inside the eyelid. These incisions are used to remove portions of fat in the lower eye to reduce bagging. Residual fat is repositioned and sculpted to the surgical plan you have agreed on. Due to the incisions within the eyelid, this procedure can usually be carried out without any scarring and need for stitches. This surgery reduces or repositions the underlying fat to a more youthful configuration.

Aftercare

Chloramphenicol ointment should be used to keep the treated area well moisturised. This can be used several times a day until the tube runs out or until advised to stop by your clinician. Once this is finished, you can use your own chosen moisturiser several times a day for the next 3 months. Do not use a barrier cream. The aim of regular moisturising is to ensure the skin doesn’t become tight and to minimise any scarring.
For swelling and bruising, cool packs can be used. You may also want to take Ibuprofen, if you can, to minimise swelling and bruising. You can also use Arnica cream and/or Arnica tablets for this purpose.
Try to sleep in a more upright position for the first two nights post surgery, this will also help to reduce any swelling. Regular pain killers can also be taken after surgery to keep you comfortable and reduce post operative pain.