Upper Blepharoplasty

Your eyes can make you look much older and more tired than you actually feel. The skin around your eyes is much thinner than the rest of your face and is often the first place to show signs of aging. As you age, the eyelid muscles weaken, the skin sags and fat accumulates around the eyes creating bags. Heredity, sun damage, smoking, stress and fatigue are factors that affect the appearance of your eyes.

Eyelid surgery can remove excess skin and fat from the upper and lower eyelids. Both men and women, young and old, can benefit from this cosmetic surgery procedure. It can make a big difference in how you look and feel about yourself.

While eyelid surgery can correct those drooping tired eyes and puffy bags, it can’t eliminate dark circles under your eyes, remove crow’s feet, or lift sagging eyebrows. A forehead lift, another procedure that often accompanies eyelid surgery, can lessen wrinkles and creases, and raise sagging eyebrows.

The best candidates are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, although you may require surgery earlier if you have strong family history of baggy eyelids.

  • Very little preparation is necessary for surgery. If you are well informed and know what to expect, if you are fit and healthy, if your reasons for surgery are good and your expectations realistic, you should get through the procedure with the minimum of problems.
  • Smoking is generally unhealthy, but in particular it interferes with normal blood flow and wound healing. I would therefore recommend that for any surgery, blepharoplasty in particular, you stop smoking a week or two before hand and you refrain from smoking for about three weeks afterwards. Although nicotine replacement products such as the spray, patch or gum are of great assistance, these products also adversely affect wound healing and should be avoided for the same period.
  • You should arrange for someone to bring and collect you from the clinic and there should be a responsible adult to look after you on the night of surgery. Hospital admission can be arranged for this or domicillary nursing care if you require it.
  • Do not apply make up on the day of surgery. On the day of surgery, you should be healthy and not suffering from flu or any other illness. All cosmetic surgery is elective and it is better to delay surgery than to tempt problems. If you want to be done under general anesthesia you should arrive at the clinic on the morning of surgery having fasted and being nil by mouth for six hours.
  • Your eyelids will be bruised and swollen after surgery and you might find that your eyes are sensitive to light. It is a good idea, therefore to bring a pair of good quality sunglasses to wear afterwards.
  • At the first consultation, we like you to tell us in your own words what it is that worries you about your eyelids and to define the problem(s) as you see them. It is important to be honest and forthright as surgery is tailored around the problem(s).
  • Your eyes and lids will be carefully examined to assess the quantity of excess skin and fat, the quality of the muscle and the bony relations to the eyeball. Your suitability and fitness for surgery will be evaluated. Routine pre-operative photographs will be taken which form part of the medical record.
  • Following assessment, we will discuss all available options and formulate an operative plan, including type of surgery and anesthesia to be used, venue for surgery and costs. In consultation, we will decide whether all four lids require surgery or just upper or lower. Other facial procedures may in addition be advisable for a harmonious result. Risks and complications will also be discussed.

The upper eyelid incision is made in the natural skin fold. Excess skin and fatty tissue is removed, the muscles and orbital septum (a thin connective tissue membrane) may be tightened, and the incisions are carefully closed. The external incisions are hidden within the natural fold of the upper eyelids. Much of the operation is done with a very fine electrocautery, which controls any bleeding. The skin is then closed with very fine sutures.

Information
AnesthesiaUsually locally with sedation or general.
Surgery Length1hour
Side EffectsTemporary discomfort, tightness of lids, swelling, bruising, temporary dryness, burning, itching of eyes. Excessive tearing, sensitivity to light for first few weeks.
Recovery PeriodReading: 2 or 3 days. Back to work: 7 to 10 days. Contact lenses: two weeks or more. Strenuous activities, alcohol: about 3 weeks. Bruising and swelling gone: several weeks.
Stay in Hospital7 days
Stay in Thailand

After surgery, the surgeon will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication prescribed by your surgeon. If you feel any severe pain, call our surgeon immediately.

We will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. (Bruising varies from person to person: it reaches its peak during the first week, and generally lasts anywhere from two weeks to a month.) You’ll be shown how to clean your eyes, which may be gummy for a week or so. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

The surgeon will follow your progress very closely for the first week or two. The stitches will be removed five days to a week after surgery. Once they’re out, the swelling and discoloration around your eyes will gradually subside, and you’ll start to look and feel much better.

 Recovery

You should be able to read or watch television after two or three days. However, you will not be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while.
Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing, you will probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a sun-block when you go out.

Try to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. Your body needs to heal! It is especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. Try and avoid alcohol since it causes fluid retention.