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Eyelid surgery (or Upper and lower eyelid surgery/Blepharoplasty)

  • Last modified date:
    8 March 2007

Purpose:

To remove skin and tissue from the upper and/or lower eyelids in order to get rid of hooded eyelids and/or eyebags.

The procedure:

This procedure should be carried out by a surgeon with relevant skills and experience in an establishment registered with the Healthcare Commission. An ophthalmologist should also assess your suitability for surgery.

Upper eyelid surgery is often carried out separately from lower eyelid surgery and if this is the case will be carried out under local anaesthetic with sedation. A general anaesthetic may be used by some surgeons, particularly if both upper eyelids and lower eyelids are being corrected.

In upper eyelid surgery, the surgeon makes an incision along the eyelid crease in the natural skin fold of the eyelid and removes unwanted skin, fat and muscle. He or she then closes up the incision, hiding the scar inside the natural fold of the upper eyelid.

In lower eyelid surgery, the surgeon moves or removes fat from the eyebags either through an external incision made just below the lower lashes or through an incision made on the inside of the eyelid. A small amount of skin may also be removed, but the orbicularis muscle (the muscle that closes the eyelid) should be preserved.

Although eyelid surgery is a fairly comfortable procedure, you will be required to take 5-10 days off work. There will some expected bruising which subsides quickly. The sutures may be dissolvable or a surgical glue may be used. If  the sutures do need to be removed, this will be done between 4 and 7 days.

The results:

Many people find that eyelid surgery can make a real difference to their appearance, especially if they had large bags underneath their eyes.

The results of lower eyelid surgery through an external cut are likely to be more effective than surgery through a cut made on the inside of the eyelid as the surgeon can tighten the skin and reduce some wrinkling as well.

Some techniques of lower eyelid surgery can leave the eyes looking sunken or unnatural because too much fat is removed. Ask your surgeon whether he or she removes the fat or avoids the need for fat removal by moving the fat behind the muscle underneath the eyelid.

The risks:

General risks of surgery - see Considering cosmetic surgery?

The risks of upper and lower eyelid surgery include temporarily blurred vision, infection, scarring, inability to close eyes, lower eyelid sagging, dry eyes, and bleeding behind the eye, which can lead to blindness. Your eyes may end up looking asymmetrical.

If you have glaucoma or dry eyes which don't produce enough tears, there is a higher risk of problems following the treatment and eyelid surgery may not be suitable for you. This is why an ophthalmologist (an eye specialist) needs to assess your suitability before surgery.

Before you start:

Talk to the surgeon about the results that you expect from the surgery. Upper and lower eyelid surgery cannot remove dark circles under the eyes caused by dark pigmentation of the skin or by very thin, translucent skin. Eyelid surgery cannot lift sagging eyebrows and it cannot get rid of crow's feet.

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