Areas of Surgery

Eye / Eye Lid

Q: What exactly is eyelid Cosmetic Surgery/Blepharoplasty?

This is a surgical procedure to remove the excess fat and/or loose drooping skin of the upper eyelid that gives a sad look to the person's face. It also removes the bags under the person's eyes and tightens the lower eyelids. All this results in a rested, more alert and brighter appearance to the face.

Q: Why do the eyes loose attractiveness with increasing age? How does the procedure correct these problems?

With increasing age, the eyelid skin looses it's elasticity. The structures supporting the skin of the forehead weaken, leading to excess skin that may hang over the edge of the brow. The muscles and fat of upper eyelid change with age, leading to an unattractive bulge. The Blepharoplasty procedure will restore a sharp eyelid crease and smooth overall look by removing excess skin, muscle and fat.

In the lower eyelid, weakness/loosening of the eyelid muscles is seen with increasing age. This causes the fat that is normally behind the eyes to bulge in front of the muscles and give an appearance of 'bags'. This excess fact and muscle are removed in the Blepharoplasty procedure to tighten the eyelid and restore a youthful, fresh look.

Any minor asymmetry in the eyelids on the two sides will be corrected to give a smart look.

Q: What problems of the eyelids can be corrected by Blepharoplasty?

Excess skin from upper eyelids obscuring the eyelid fold
Loose hanging upper eyelid skin that may obscure vision
Puffy, tired looking appearance to the upper eyelids
Bags and dark circles under the lower eyelids
Loose lower eyelid, showing white part of the eye below the central coloured iris.

Q: What all is considered in the initial evaluation by the surgeon?

A frank explanation of your problems is expected with your desires and expectations. Your evaluation by the surgeon will include collecting information about

• Allergies
• Use of contact lenses or glasses
• Any other eye problems needing a visit to the Eye Specialist
• Photos of the problem area for records.

Examination will reveal the amount of excess skin, muscle and fat that needs to be removed from each area to improve the appearance.
Forehead skin laxity is evaluated; if significant, correction of this problem by a brow lift will improve the eyelid condition as well.

Some details about the surgery.
Upper eyelid Blepharoplasty: the skin is made numb with the injection of a local anaesthetic. An additional sedative can be given if needed. The excess skin and muscle is cut and removed. The excess fat is gently teased out. The skin wound is finally closed after ensuring a neat upper eyelid fold.
Lower eyelid Blepharoplasty: local anaesthetic injection is given into the lower eyelid skin. The skin is cut open to reveal the muscle and fat below. Excess fat is teased out and removed, excess muscle and skin are cut and removed. The external wound is finally closed with delicate stitches to restore a smooth look. Sometimes, when the eyelids look baggy, without any droopy appearance, only excess fat needs to be removed. This can be done by avoiding a skin incision by making an incision on the inner side of the eyelid.

Q: Will the scars of the surgery be visible?

No, they will not be seen.
In the upper eyelid, the fine scar goes into the eyelid fold. In the lower eyelid, the fine scar blends into the natural skin creases seen naturally even in a young person.

Q: What are the risks/complications associated with the surgery?

Certain uncommon but important complications related to eyelid surgery need to be discussed in detail with the surgeon before taking the decision to go ahead with the Blepharoplasty procedure.
Asymmetry-this is a very common perception after surgery, usually due to a difference in the amount of the skin removed. Deciding the exact amount of skin is a very critical decision, if excess skin is removed, the eye will not function properly-as explained below. This problem can be fortunately corrected by an additional minor touch-up procedure. This decision should be taken only after the initial eyelid swelling due to the procedure has settled reasonably, which can take upto a few weeks. Bruising and Swelling last for a few weeks, this can be minimized by stopping medicines such as Aspirin (these increase bleeding risk) that you may be taking, after speaking to your surgeon.
Bleeding & Retrobulbar hematoma-this is the worst possible complication, can occur after a lower lid Blepharoplasty. The blood accumulates in the space around the eye causing pressure on the optic nerve or it's blood vessels. However, problem can be tacked adequately when picked up early, when pain or early disturbances in vision are noticed. Lagophthalmous- this is an inability to close the eye completely. This may be transient from eyelid swelling or permanent if too much skin from the eyelid has been removed. This results in drying and irritation of the cornea. Problem can be treated initially with eye drops and lubrication ointments; sometimes a skin graft may have to be used to correct the problem.
Scarring-when this occurs in excess, it can pull the lower eyelid, causing eyelid dysfunction or a poor cosmetic outcome.

Q: What preparations are required before the surgery?

Smoking has to be stopped about 4 weeks prior to the procedure.
Blood thinning drugs (Aspirin/Dispirin) and Vitamins need to be stopped 2 weeks prior.
Fasting is needed at least 6 hours prior to the procedure.
You need to be accompanied by a responsible adult throughout your stay in the hospital.

Q: What can I expect immediately after the surgery?

Eyes will be lubricated and small dressings will be applied. As the anaesthetic wears off, eyes will feel sore and tight, which will soon settle as the pain medication begins to work. If however, the pain goes on increasing,

Q: How is the recovery after the surgery?

Swelling and Bruising will be the main issue in the initial few days, it be take upto 3 weeks to subside. Sleeping with head elevated or by using two pillows will help minimize the swelling. Appling cold packs to the eyes will also help keep swelling under check. Each patient is different and some may have more bruising than others. Remember that rest is an essential part of the healing process. The eyes may feel tight for a few days initially. This is however a normal feeling. Do not exercise, smoke or drink in the initial period as this may slow down the recovery process. Stitches will be removed at 5 days after the procedure. About 2 weeks off work may be needed; residual bruising after this can be hidden with make-up. Use of contact lenses will need to wait for 2 weeks after the procedure, sunglasses with good UV protection is also helpful over the initial few weeks.

Q: What is the long term outcome after the surgery?

Visits to the surgeon as specified will keep your recover smooth.
It will also help clarify all your remaining doubts if any.
Photos of the surgery result will be taken when appropriate.