Have you ever wondered about eyelid surgery?

Mr Joe O’Donoghue is a cosmetic surgery specialist practising at Spire Washington Hospital. Here he looks at blepharoplasty – also known as eyelid surgery and eyebag removal – so if you’ve ever wondered whether this is for you, the following short question and answer session is sure to help.

What is blepharoplasty?
Blepharoplasty is an operation on either the upper or lower eyelids, which can be done separately or together to improve the appearance of the eyelids, particularly in those approaching middle age.  Patients may have heaviness of the upper eyelids with extra skin creating a tired appearance or have ‘bags’ under the lower eyelids. The surgery helps smooth out droops and bags to create a more alert and youthful appearance. What it can’t do is remove crow’s feet or change the colour of dark shadows under the eyes.

Who is the operation suitable for?
The operation is suitable for patients in whom surgery is likely to be of more benefit than non-surgical treatments such as Botulinum toxin or fillers. To be eligible for this surgery, patients need to be in good health and ideally not have problems with their vision or dry eyes because surgery could potentially make things worse. Some patients may be sent for a formal eye assessment before the operation if there are any concerns.

What does the operation entail?
The operations can be done under local anaesthetic although they are usually carried out under general anaesthetic as a day case procedure. Blepharoplasty is regarded as a relatively painless procedure, which takes from one to three hours to perform depending on the complexity of the surgery, the number of eyelids being operated on and whether other procedures are being carried out as part of the operation, such as a brow lift. During the surgery, incisions are made in the upper eyelid skin crease and just below the eyelashes in the lower eyelid in order to hide the scars as much as possible. In selected lower eyelid blepharoplasties, incisions can be made inside the lower eyelid.  Fat and excess skin are then removed and repositioned.

What type of recuperation period is required?
Overall, recovery is usually rapid with most of the bruising and swelling settling within seven to ten days. Patients are recommended to use eye drops after surgery for at least a week and can return to normal activities within a fortnight. The results from the operation usually last several years but this is dependent on numerous factors.  

What risks are there with eyelid surgery and eyebag removal?
The risks with this type of surgery include bleeding, infection, abnormal visible scars, cysts developing within the scars, injury to the underlying levator muscle in the upper eyelid producing a droop of the eyelid, watering eyes (particularly if too much skin is removed from the lower eyelid), dry eye syndrome and in very rare instances blindness. Malposition of the eyelid after surgery would require a revisional operation. Although this is a daunting list of potential risks and complications, these happen very infrequently.

What questions should you always ask your consultant before cosmetic surgery?
It is always advisable to check that your consultant is on the specialist register of the General Medical Council (GMC) and has experience in doing this type of surgery. Ideally your consultant should also be a member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Association of Aesthetic Plastic Surgeons (BAAPS).

More information from Spire Washington Hospital

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