Blepharoplasty

Disclaimer: The details in this section are for general information only. Always check with your own doctor.

What is Blepharoplasty?

This is a procedure to address excess skin and fat pads around the upper and lower eyelids. Excess skin can result in hooding of the eyes, particularly to the side, or a sack-like appearance in the lower lids with a tendency to form festoons in extreme cases.

Preparation

The fat pads are assessed whilst the patient is seated, as the lower lid fat pads have a tendency to sink back once lying down, creating a slightly less bulky appearance.
The surgeon will also identify the inferior oblique muscle, to avoid injuring it during the operation.

The Operation

Upper Lids
The surgeon will mark out where to make the incisons, aiming to blend in with the natural lines, and a local anaesthetic is injected under the skin. The loose skin will be cut out, and possibly also a strip of muscle if necessary. Fat is then teased from the fat pads, ensuring that the appropriate amount is removed and that there is no bleeding. The cut is then closed with delicate nylon stitches.

Lower Lids
The lower lids procedure may be done either from the inside of the eyelid or with an external approach. The inner eyelid (or subconjuctival) approach requires injection of local anaesthetic and then an incision is made to expose the orbital fat pads, and allow fat to be removed to give a smooth contour.
If there is excess skin in the lower eyelid the surgeon will need to use an open approach. An incision is made just below the eyelid margin and extended up to the eye-socket margin. The skin is then released off the underlying muscle and redraped with the excess skin being trimmed. This technique can also be used to remove excess fat so is oftern chosen if both skin and fat need to be removed. Afterwards the skin will be carefully stitched to avoid tension or pulling on the lower lid.

After the operation

The stitches are covered with an antibiotic cream to stop any localised infection, and then removed after four or five days. Regular application of a salt water compress is recommended to help reduce swelling.
There will be follow-up checks at approximately five days, one month amd three months after the operation.

Possible complications

Complications with this procedure are uncommon but usually result from either removing too much skin, causing the eyelid to be pulled down, or too little, leaving behind excess folds.
Bleeding into the eye may cause problems with vision but this is a rare complication and can be avoided by making sure that there is no bleeding from the skin or fat at all.