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Waterside Aesthetics
60 Waterside,
Bridge House,
Dickens Heath,
Solihull
B90 1UD
Tel: 0121 733 6195
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The operation to correct premature ageing of the eyelids is known as a blepharoplasty.
Our eyes are the most important feature on our face and their beauty can be greatly reduced by excess skin creases and eyebags. Heredity is an important factor where young or middle-aged patients can exhibit changes that are usually associated with older age. These patients tire of comments from their friends that they look weary, or worse, must be leading a strenuous alcoholic nightlife! Exposure to sunlight or ultraviolet rays is also damaging to eyelids, both due to the direct effect of the rays and overactive muscles from frequent squinting. The normal ageing process involves the stretching of the eyelid skin which results in excess folds and wrinkles and the sagging of fat around the eye itself which appears as bulges in the upper and lower lids.
It is important to realise that it is never possible to eradicate all eyelid creases. To do so would invariably produce an over-correction, causing a staring appearance of the eye due to excess tension on the eyelids. This operation will remove excess skin and bags to give the eyes a fresher look but will remove neither the wrinkles or 'laughter lines' from the sides of the eyes, (although they may be improved with laserbrasion), nor any malar bags (bulges on the cheek bones which can be removed by direct excision or superficial liposculpture with a facelift).
You will be asked for a general medical history, with details of any previous eyelid surgery and you will be asked about thyroid or kidney disease as these can cause swelling of the eyelids. Slight differences in facial symmetry are normal and will be pointed out as they are often unnoticed by the patient. The surgeon will then describe the positioning of the scars and indicate the likely post-operative results.
The operation
Blepharoplasty can be carried out both under general or local anaesthetic with sedation and usually involves a one night stay in hospital.
The incision for the upper eye is in the natural crease line approximately 1cm above the eyelashes and extends out into the 'crow's foot' area. The excess skin is trimmed, any fat (usually present in the area adjacent to the sides of the nose) is removed and the lid is then sutured using one continuous stitch.
The incision for the lower eye is just below the eyelashes again extending out into a natural 'laughter line'. The tissues are then elevated, hinged forward and the excess fat removed. The skin is then lifted upwards, gently tensioning the area, removing the overlapping skin and suturing with multiple small single stitches.
Post-operation
Following blepharoplasty surgery, you will be carefully observed for the first three or four hours to ensure that no bleeding occurs which could spoil the final result. You should expect the application of antiseptic eye ointment (this is not always the case) which will most likely blur your vision initially but will soon clear.
Considerable bruising and swelling usually occurs after eyelid surgery because the skin is so fine and delicate that even minute traces of blood will be revealed as a bruise. You should not be alarmed by this perfectly normal occurrence and it should mostly subside within two weeks. Small residual amounts of swelling may persist a little longer. To help lessen the bruising we suggest patients take arnica one week prior to the surgery and two weeks afterwards. Numbness is quite normal for some weeks.
Try to avoid bending straight down for the first few days as this puts pressure on the eyes. You cannot have alcohol for five days. Avoid sunbed or direct sunbathing for six to eight weeks and excessive exercise for one month (eg. swimming).
Sutures will be removed at the surgeon's discretion between one and seven days after the operation. It is important not to stoop or carry out vigorous activities for two or three days, otherwise post-operative bleeding could result. The eyelids should be gently splashed with water and not rubbed in any way. It is advisable to apply antibiotic eye ointment (if prescribed) for three or four days and eye make-up should not be used for the first week or two. You may also be more comfortable using artificial tears for the first few days. Discomfort around the eyelids following surgery may be controlled by mild analgesics such as paracetamol (aspirin must not be taken).
The scars may appear pink for some weeks and occasionally months, although they are easily disguised with make-up. The scars in the 'crow's foot' area may become lumpy for a period but these invariably flatten with the passage of time. This may helped by gentle massage starting at three to four weeks post-operatively.
Complications after blepharoplasty are rare. Most, like excessive tears or abnormal pigmentation of the eyelid skin are temporary. As after any surgery bleeding and infection can occur. Bleeding might require a return to the operating theatre whilst an infection is usually treated with antibiotics. Occasionally, what appears to be a transparent sack of fluid develops and covers part of the eye. This looks quite frightening but you should not be alarmed as this will settle on its own. A scratch on the cornea (the surface of the eyeball) is not serious but can be irritating and may take some time to heal. Damage to the nerves of the eyelid or eye have been reported during blepharoplasty. Other complications are the risk of haematoma and ectropion.
Occasionally, patients will require a secondary tightening of the eyelid skin at approximately the six month stage.
Summary
Blepharoplasty is one of the most popular aesthetic plastic surgery procedures. The results are significant and give a "freshened" appearance to the eyes. However, it rarely produces smooth, crease free eyelids.
Following blepharoplasty you may not be able to wear contact lenses and should discuss this possibility with your surgeon. Do bear in mind that you will require glasses of a suitable prescription during the early post operative stage of your treatment.
Most essential - a large pair of sunglasses!
For any further information please do not hesitate to contact us and we will be happy to help
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