Blepharoplasty
Definition
Blepharoplasty - or eyelid surgery - is an operation
to remove excess skin, fat and muscle from around the eyes to
improve droopy eyelids and bagginess under the eyes. The surgery
can be performed on the upper lids and lower lids at the same
time or can be done on separate occasions. Frequently, the surgery
is done to improve vision problems. In other cases the surgery
is performed as a cosmetic operation to improve the appearance
of the eyes.
The Operation
The operation is performed as inpatient surgery
lasting approximately two hours or less. Blepharoplasty can be
carried out under a local anesthetic, in which case the area
around the eyes will be numb but the person will be awake during
the surgery. In other cases, a general anesthetic may be administered,
which means the person will be asleep throughout the procedure.
Patients are required not to eat or drink six hours prior to
the procedure if the decision to use a general anesthesia has
been made.
Lower Eyelids
For surgery on the lower eyelids, an incision is
usually made just below the eyelash line. This means the scars
run along the eye's natural fold, concealing it as much as possible.
Excess fat, muscle and loose skin are removed and the incision
is closed using fine sutures. If only fat, not skin, is being
removed, the incision can be made from inside of the lower eyelid
leaving no visible scar.
Upper Eyelids
For surgery on the upper eyelids, an incision is
made in the natural crease of the lid.
After the Surgery
The eyes may be covered with gauze pads, sterile
tape may be used to support the operation sites and an ointment
may be applied to the eye to prevent dryness. Pain medication
may be prescribed to help with any discomfort immediately following
surgery and in first few hours post surgery as the anesthesia
wears off.
Following a local anesthesia, people usually feel
ready to go home after a short rest in a chair or on a bed. If
the procedure is performed under a general anesthesia, a Longer
rest will be needed.
Patients need to have a friend or relative drive
them home from the surgery and those who have had a general anesthesia
are advised to avoid driving, drinking alcohol and making any
vital decisions in the first 24 hours after surgery.
Before discharge a staff member will provide advice
about caring for the eye area and arrange a follow-up appointment
with the surgeon.
Once the patient is home, pain medication may be
taken as needed. Applying a cold compress, such as ice or a bag
of frozen peas can reduce the swelling.
Recovery
- Keep the head higher than the body by lying propped up on pillows and avoid bending over for a few days, this will reduce bruising and swelling.
- Avoid eye make-up until a couple of days after the stitches have been
removed.
- Keep the eye area clean and use any ointment provided as instructed.
- Do not put contact lenses in or out for two weeks.
- Avoid driving until vision has returned to normal. There may be tearing and slightly blurred vision for a few days after the procedure.
Most people are able to watch TV or read within
a few days. The stitches will be removed after 5-10 days. People
usually feel like returning to work after a week to ten days.
Deciding to have the operation
Blepharoplasty is a commonly performed and generally
safe operation. For most people, the benefits in terms of relief
of their symptoms or improved appearance are much greater than
any disadvantages. However, in order to give informed consent,
anyone deciding whether to have this procedure needs to be aware
of the possible side-effects and the risks of the complications.
Side Effects
- Bruising and swelling for up to three weeks after the
operation, which might make the eyes feel tight and difficult
while trying to sleep.
- The eyes may become watery for a few weeks.
- Some sensitivity to light may increase for a few weeks.
- Soreness around the eyes, which can be helped by taking pain
medication.
- Eyes may feel itchy and dry for a few weeks.
- Tiny whiteheads may appear along the line where the stitches
were - these can be removed at a subsequent follow-up visit.
- The scars, pink and noticeable at first, should become fine
and less noticeable after a few weeks.
In addition, the following are the main complications
specific to blepharoplasty:
- A pool of blood collecting under the skin around the eye, may
need to be drained in a second operation if it doesn't disappear on
its own.
- Problems closing the eyes when sleeping, which can be permanent,
but is rare.
- Possibility that swelling will cause the lower lid to be pulled
away from the eye - this usually settles on its own after
a couple of days, but occasionally another operation will
be needed.
- Damage to the surface of the eyeball or the surrounding muscles.
- The chance of developing glaucoma.
- Some people have an inherited tendency to form unusually red
or raised scars such as hypertrophic or keloid scars.
The Chance of complications depends on the exact
type of procedure being performed and other factors such as an
individual's general health. The surgeon will be able to explain
how the risks apply to each person.
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Quick Links
Click the links below to learn more about some of the conditions
Green Bay Eye Clinic physicians specialize in.
Cataracts
Blepharoplasty
Glaucoma
Extraocular Muscles
Retinopathy of Prematurity (ROP)
Retinal Detachment
Ocular Histoplasmosis
If there is a condition not listed here that you would like to be consulted about, contact
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