Blepharoplasty is the eyelid surgical procedure to improve the appearance and or function of the eyelid. The aesthetic appearance of eyes and the vision can be affected in time by ageing, environmental [sun, pollution] and genetic factors. Laxity of eyelid skin, muscles and excess fat tissue around the eyes lead to settlement of wrinkles and eye bags on the eyes giving a tired look.

What is an ‘upper eyelid blepharoplasty’?

Upper eyelid blepharoplasty is one of the most commonly performed functional as well as cosmetic facial surgical procedure. It deals with contours of the eyelid space, mainly the region between the eyebrows and the eyelashes. Upper eyelid blepharoplasty can be performed for any of the following reasons:

  • Hereditary factors and involutional changes can cause drooping of the eyelid skin and the tissues under the skin with protrusion of fat causing ‘heavy / tired look’.
  • The appearance of eyelid maybe asymmetrical and blepharoplasty may be performed to improve symmetry.
  • Saggy eyelid skin can obstruct the visual field (you may not be able to see the full extent of your lateral/ peripheral vision) so blepharoplasty is performed to relieve this obstruction.

Could I benefit from upper eyelid blepharoplasty?

  • You are bothered by the drooping of your upper eyelid which may give you an old and tired look.
  • There is an asymmetry between your eyelids.
  • Some young patients need this procedure because of congenital characteristics that displease them. Makes line you notice or obstruction of your visual field from drooping of your eyelid skin. The consequent obstruction of your visual field can stimulate eyebrow elevation to relieve visual field which may cause headaches as well as forehead wrinkles.

How is upper eyelid blepharoplasty surgery done?

Blepharoplasty surgery is most often performed either under local anaesthesia  with sedation or general anaesthesia, depending on what individual patients  are able to tolerate and their medical history. Experience and expertise are required to execute the procedure. First, the blepharoplasty incision is measured and marked. Subsequently variable amounts of skin soft tissue and fat are removed to achieve a pleasing and youthful appearance of the eyelid and to improve the visual field. After the desired amount of excision is accomplished skin incisions are closed with sutures.

What can I expect before surgery?

Blepharoplasty can be performed for cosmetic or functional purpose (impairment of peripheral visual fields). Miss. Lwin will ask you about your past medical history, including medications you are taking, allergies, smoking habits, previous surgery and more. At least two weeks prior to the surgery, any patients who are taking aspirin or Warfarin or blood thinners (anticoagulants) are instructed to discontinue these medications. Patients may also be instructed to cease smoking for a given period of time before and after procedure.

Your surgeon may also question you about any dryness or watering of your eyes you may have, and ask for some extra tests to eliminate any problem with your tear functions.

Miss. Lwin will discuss the various options of correcting your upper eyelids. Sometimes other additional procedure may be performed in combination with an upper eyelid blepharoplasty. These include injection of the “crows feet” wrinkles with botulinum toxin or application of fillers to smoothen lines. If drooping upper eyelid is present, the eyebrow position should also be assessed and considered and ‘eyebrow lift’ may also be recommended to achieve the desired affect. Laser treatment and chemical peels of other facial area may also be performed during an upper eyelid blepharoplasty procedure.

What can I expect after surgery?

You can typically get up and walk around the evening of the surgery or the following morning. You should be prepared for moderate swelling and bruising of the skin. The degree of swelling and bruising differs markedly between individuals. Either way the swelling and bruising both subside within one to four weeks, after which time it is typically hardly notable that you just underwent surgery.

Will I have a bandage or dressing after surgery?

A bandage is usually not needed after the surgery. Miss. Lwin may use small steri-strips to cover the incision site. Following the completion of the surgery, ointment may be applied over the incision for approximately one week, artificial teardrops can be prescribed to prevent the dryness at early post operation period. Ice packs are applied over the operated area for 24 to 48 hours.

Do you need to remove the sutures/stitches?

Non absorbable skin sutures are removed five to seven days, absorbable sutures disappears within 2-3weeks. Both types of sutures have advantages and drawbacks and Miss. Lwin will explain to you which suture material is recommended for you.

How long will I be off work?

Generally, the recovery period after upper eyelid blepharoplasty is usually short and you may start doing your daily routine as soon as the following day. The swelling and the bruising (ecchymosis) vary among individuals, but rarely last longer than three weeks and almost never limits patient mobility.

Will I be able to use make up after surgery?

Your surgeon will ask you to refrain from applying makeup for a certain time after the surgery to minimise the risk of infection.

What are the possible risks and complications of upper eyelid blepharoplasty?

Failure to meet the patient’s expectations, residual excess skin, asymmetry or scarring may necessitate additional treatment or a secondary operation.

Over-correction may cause upper eyelid retraction which may result in inability to close the eye. Topical lubricants and massage may be helpful for managing mild situations. Injectable steroids can be used to minimise the scar and severe cases may require a secondary procedure.

Eversion of the eyelid inwards or outwards is a rare complication and may also require a secondary procedure for correction. Very rarely double vision may occur due to injury of the eye muscles.