Eyelid Surgery (Blepharoplasty)

A blepharoplasty is an operation to remove excess skin and fat from your eyelids and to tighten your skin and soft tissues around your eyes.

With ageing, a variety of problems can occur.  Most commonly, the upper eyelid tissues become lax, resulting in hooding and sometimes bagging in the inner aspects.  This gives a tired and sad look.

With the lower eyelids, the most common problem is bagging associated with skin and muscle laxity. This is associated with a tired and ageing appearance.  Why some people develop these changes faster than others is due to differences in skin and tissue elasticity, anatomical differences and genetic factors. Maintaining a healthy lifestyle, avoiding too much sun exposure, avoiding smoking and big weight shifts all help in reducing their development.

As you get older, your skin loses its elasticity (stretchiness) and gravity pulls down on the soft tissues of your eyelids, causing them to sag.

Small fat pads behind your eyelid tissue can push forward through weakened muscles, making your eyes look tired and puffy. 

Excess skin in the upper eyelid can sometimes hang down low enough to interfere with your vision.

An upper eyelid blepharoplasty can be an effective treatment to improve your vision and make you look younger.  Sometimes, a drooping eyebrow and forehead can make your upper eyelid look as if it is sagging.  Your surgeon will assess you and may recommend an eyebrow lift instead of, or at the same time as, a blepharoplasty.

Skin in a lower eyelid can lose its tone, sag and develop wrinkles, and appear puffy due to bulging fat pads.  A lower eyelid blepharoplasty can help to reduce wrinkles and puffiness.

Mr Sawyer will carry out a detailed assessment before deciding if surgery is suitable for you.  This may include taking photos for your medical records and asking you questions about your medical history.  

Your face should look younger and brighter.  If an upper eyelid is interfering with your vision, your vision should improve. Most people who have successful blepharoplasty are more comfortable with their appearance and have improved self-confidence.

Surgery aims to reproduce the ideal shape and contour by removing excess skin and/or muscle and recontouring away fatty bulges.  The surgery can be undertaken under either a local or a general anaesthetic and when undertaken alone, is usually a day case procedure.

It usually takes about 1 hour to perform, and once the excess tissue is removed the skin edges are usually closed with a single stitch that runs under the skin.  This minimises the risk of conspicuous scarring.  Paper tapes are then used to hold the stitch in place.  A small amount of antibiotic eye ointment is then applied to each eye and cooling packs are applied.

Bring to the hospital a pair of clean well-fitting sunglasses.  They should not rest on the skin around the eyes.  While these will help to mask the bruising, they also help prevent the eyes screwing up in response to bright light.

Patients are advised not to drive whilst the stitches are in place.

For the first one to two weeks following surgery patients should rest and convalesce.

Do not lift anything heavy or do strenuous exercise, or housework, such as vacuuming or ironing, for 3 weeks.  After this period, light housework and gentle activities can be undertaken, gradually building up to normal activity over six weeks.

Hopes and expectations can be very high for eyelid surgery and in the great majority of patients, this level of satisfaction is achieved.  The application of makeup becomes a pleasure again. Eyeshadow no longer disappears under loose skin.  Sympathetic but unwelcome comments, about tired appearance, will hopefully cease.

It is not possible to guarantee symmetry of the lids after removal of skin and fat from both eyes, and indeed significant asymmetry, of which you are unaware, may exist before the operation. Your surgeon will have the opportunity to assess this at your consultation.  Look carefully at your eyes before surgery as they are often a different shape.

It should be remembered that such cosmetic plastic surgery can only partially set back the ticking clock of time and it cannot stop the ageing process.   It cannot give your eyes that you did not have before.