Eyelid Lift (Blepharoplasty)
A blepharoplasty or “eyelift” is a surgical procedure which addresses excess tissue in the upper or lower eyelids. This tissue may be excess skin, muscle or fat or occasionally fluid. The anatomy of the upper and lower eyelids although similar is actually quite different and the upper and lower eyelid blepharoplasty procedures are also different. Like the face, the way the eyelids age is often hereditary. You may have noticed your parents’ eyes changing as they aged. You may see some early signs of their eyes in your own.
Upper eyelid blepharoplasty
In the upper eyelids this excess tissue can cause hooding over the eyelids which can eventually interfere with vision. In some instances it is actually the eyebrow or forehead skin which is drooping down into the eyes. In that situation a browlift would be necessary to reposition this.
Lower eyelid blepharoplasty
In the lower eyelids there is often bulging or prolapse of fat. This bulging accentuates the appearance of the bony rim of the eyelid and creates an unnatural shape. The eyelid muscle can also become droopy with age forming what is called a festoon. Some people unfortunately develop recurrent swelling of the lower eyelids from conditions such as allergic rhinitis. This condition generally persists despite surgery.
Lower eyelid blepharoplasty can be performed in a number of ways. Traditionally, a small incision was made under the eyelid and skin and muscle was removed externally. More recently the technique of transconjunctival lower eyelid blepharoplasty was developed. This involves making small hidden incisions just inside the eyelid to access the tissues. Dr Roth generally recommends the transconjunctival blepharoplasty technique for most patients.
Am I a good candidate for a blepharoplasty?
Eyelid surgery can address a large number of problems. These include droopiness, bags, fat pockets or excess skin or muscle. A blepharoplasty alone will not lift saggy eyebrows or remove crow’s feet or other wrinkles around the eyes. A blepharoplasty will not remove dark circles under the eyes (melasma).
During your consultation Dr Roth will take photos of your eyes and assess for symmetry. It is not unusual to discover quite a lot of asymmetry between the two eyes. If you have one eyelid that is much more droopy than the other (ptosis) he may refer you to an ophthalmologist to have this addressed as this is a very specialised area.
A blepharoplasty is often performed at the same time as other cosmetic facial surgery. It is fairly routine to address ageing eyelids at the time of a facelift. Younger patients often combine a blepharoplasty with a rhinoplasty.
What Happens During Eyelift Surgery
Upper eyelid blepharoplasties can often be performed under local anaesthetic at his office. Transconjunctival lower eyelid blepharoplasties usually require a general anaesthetic. Upper and lower eyelid blepharoplasties generally take about 90 minutes each to do both eyes, although this can be shorter if the problem is more straightforward.
What Happens After Eyelift Surgery
Mild discomfort and swelling is normal and to be expected after surgery. Generally pain (if any is very mild). You will be given a topical antibiotic ointment to apply.
When you arrive home after surgery, you should apply cold packs for 10-15 minutes every hour. This will help minimise bruising and swelling. On the second day, cold packs can be applied every few hours rather than every hour.
It may take two weeks for your healing to be complete. During that time, your eye area will be bruised, swollen, and red, especially during the first few days. You may also notice that the whites of your eyes are red and bloodshot. These symptoms will all slowly disappear. Sutures may be either dissolving or non-dissolving but are generally removed after 5 to 7 days. Some surgeons will ask you to massage your eyelids a couple of weeks after the stitches have been removed, to soften the remaining skin and allow better closure of your eyelids.