If you’re searching for eyelid surgery in Perth because you feel your eyelids are drooping and ageing your face before its time, you should consider a consultation with a plastic surgeon. Dr Patrick Briggs performs eyelid surgery (Blepharoplasty), which involves a surgical procedure removing excess skin and bags to give your eyes a fresher, younger and more relaxed look. Visit our Perth-based clinic, or contact us for a consultation.
Your eyes are what people notice and focus on when they first meet you. The appearance of your eyes plays a large role in how young, attractive and vital you appear. Unfortunately, over time, the skin around the eyes begin to crease, the muscles weaken, and then folds and bags develop. These changes occur for a number of reasons:
- Genetics is an important factor; young or middle-aged men and women with certain genes often notice these changes occurring well before advanced ageing.
- Facial structure also plays a role; even slightly under-developed malar and upper jaw bones will offer insufficient support to the lower lids, which can lead to bags and a low position of the lids, even in younger patients.
- Sunlight and ultraviolet rays directly affect the area around the eye by causing us to squint, which in turn builds up muscle thickness below the eyelashes.
- Ageing; a natural process that causes the eyelid skin to stretch, leading to excess folds, wrinkles, and sagging of the fat around the eye. This appears as bulges in both the upper and lower lids.
Eyelid surgery can improve many of these problems, however, it cannot eradicate all eyelid creases. Doing so would create tension on the eyelids resulting in over-correction. Surgery also cannot remove laugh lines at the sides of the eyes, or malar bags (bulges high on the cheek bones). Upper and lower eyelid Blepharoplasty has evolved significantly in the last 15 years with surgery moving forward in leaps and bounds, and new discoveries constantly being made:
- On the upper eyelid, attempts to clear heavy fatty tissue excess has produced a hollow appearance (doll’s eyes), that can make the patient look more tired, and is objectionable to most women and men.
On the lower eyelids; there is a better understanding of the relationship between the cheek, the rim of the orbit and the eyelid bags. This has led surgeons to understand that a youthful appearance does not come from purely removing the bags, but rather from a more complex procedure to reduce volume and re-drape the tissues over the bony edge. The aim is to restore a smoother contour between the lower eyelid and the cheek, reducing the appearance of the circles under the eyes as much as possible. This also allows us to avoid a hollow appearance of the lower eyelids.
During your consultation for eye plastic surgery, you will be asked about your general medical history and any previous surgeries. Your surgeon will enquire about any possible thyroid or kidney disease, which can produce swelling of the eyelids, and about any history of eyelid conditions and dryness of the eyes.
Your surgeon will also point out normal differences in facial symmetry that you may never have noticed, and will describe the results you can expect from surgery, such as the positioning of the scars.
It is very important to highlight to your surgeon what you want to avoid in terms of the appearance of your eyelids, and define what results you would like to see.
Frequently, heavy upper lids can be significantly corrected using a forehead lift.
You will be made aware of the kinds of changes you can expect, as well as the inherent limitations of any surgical procedure.
New surgical techniques allow for elevation and support of the lateral part of the eyebrow through the upper eyelid surgery. This can combine the benefits of a forehead lift and upper lid blepharoplasty in a smaller procedure. At the same time, by directly accessing the muscles that produce the lines and weaken them, reducing the frown lines between the eyebrows, during a upper eye surgery.
Eyelid cosmetic surgery can be performed under general anaesthesia, or with a local anaesthetic and sedation, for your comfort – it also depends on the procedure. The upper eye surgery involves an incision being made in the natural crease line approximately one centimetre above your eyelashes, and extends a little into the ‘crow’s foot’ area at the side of the eye.
Excess skin is trimmed and any fat in the area on the side of the nose, is removed.
In instances where significant fullness is present in the lateral part of the eyelid, a small amount of fatty tissue is also removed.
Subsequently, the lid is sutured using, most commonly, one continuous stitch.
The incision for the lower lid is made just below the eyelashes, and runs out to the natural ‘laugh line’ area.
Tissues are then elevated and hinged forward, and excess fat is partly removed and re-draped.
During this operation, a light uplift of the cheek fullness contributes to a more attractive appearance of the cheek and eyelid complex.
Finally, the skin is lifted upwards and outwards, with no tension, and overlapping skin is removed before the incision is closed.
If excess skin is minimal, it is sometimes possible to perform the lower lid surgery without external scars, a procedure known as ‘Transconjuctival Blepharoplasty’. This allows for contouring of the lower eyelids and circles under the eyes, without leaving external scars. It can be accompanied by resurfacing of the lower eyelid by using either a chemical peel or laser.
You will be advised to take a number of precautions:
- To avoid bleeding, you should not stoop or carry out vigorous activities for five days after your surgery.
- Your eyelids should be gently splashed with water but not rubbed in any way.
- Antibiotic eye ointment should be applied for three or four days and you should not use eye makeup for the first week or two.
- It is important to avoid aspirin after your surgery. Any discomfort around the eyelids may be controlled by mild analgesics such as Paracetamol. You may also find the use of artificial tears helpful in the first few days.
- You will not be able to wear contact lenses for some time after your surgery, so you will want to arrange for glasses during this time.
- It is essential that you have large sunglasses to wear after your surgery.
- Your stitches will typically be removed three to seven days after your eyelid procedure. Scars will be pink for some weeks, occasionally months, however they are easily hidden with make-up. Scars in the ‘crow’s feet’ area may become lumpy for a while but will invariably flatten in time. The flattening may be helped by gentle massage, which you may begin two weeks after eyelid surgery.
Complications after eyelid surgery are rare and most, including excess tears or abnormal pigmentation of the eyelid skin, are temporary.
As with any surgery, bleeding and infection can occur. Bleeding might require a return to the operating theatre to avoid damage to the eye. Infection is usually readily treated with antibiotics, extending the course of treatment that you will have received after your surgery.
Occasionally, what appears to be a transparent sack of fluid develops and covers part of the white of the eye mostly in the outer corner. People who suffer with hay fever may be familiar with this problem as they sometimes notice it during a bad season. While this looks distressing, you should not be alarmed as it will settle on its own. During the period when it is settling you need to use eyelid lubricants regularly.
A scratch on the cornea (the surface of the eye itself) while not serious, can be irritating and may take several days to heal.