Blepharoplasty Surgery

Blepharoplasty, commonly known as eyelid surgery, is a cosmetic and sometimes functional surgical procedure that focuses on improving the appearance of the eyelids. It is one of the most popular cosmetic surgeries worldwide, offering patients the opportunity to rejuvenate their eyes and achieve a more youthful, refreshed look.

The primary goals of blepharoplasty are to remove excess skin, muscle, and fat from the upper and lower eyelids, addressing concerns such as drooping upper lids, under-eye bags, and puffiness. The surgery can be performed on both the upper and lower eyelids or on one or the other, depending on the patient's individual needs.

There are several reasons why individuals choose to undergo blepharoplasty:

  1. Cosmetic Enhancement: Many people opt for blepharoplasty to improve their overall appearance. As we age, the skin around the eyes tends to lose elasticity, leading to sagging and wrinkles. Blepharoplasty can restore a more youthful and alert appearance by removing excess skin and fat.

  2. Functional Improvement: In some cases, the sagging of the upper eyelids can impair vision. Blepharoplasty can correct this issue by lifting the eyelids, thus improving both appearance and vision.

  3. Elimination of Bags: Puffy bags under the eyes are a common concern, often caused by the accumulation of fat. Blepharoplasty can address this issue by removing or repositioning the excess fat, resulting in a smoother, more rested look.

The procedure itself involves several key steps:

  1. Anesthesia: Typically, blepharoplasty is performed under local anesthesia with sedation or general anesthesia, depending on the patient's preference and the surgeon's recommendations.

  2. Incisions: For upper eyelid surgery, incisions are typically made along the natural creases of the eyelids. For lower eyelid surgery, incisions are often made just below the lash line or inside the lower eyelid (transconjunctival approach), leaving no visible external scars.

  3. Tissue Adjustment: Once the incisions are made, the surgeon will carefully remove or reposition excess skin, muscle, and fat. This step is tailored to the patient's specific needs and aesthetic goals.

  4. Closure: The incisions are then closed with sutures, skin adhesives, or surgical tape.

Recovery from blepharoplasty varies from person to person but typically involves some swelling, bruising, and discomfort. Patients are advised to keep their heads elevated, use cold compresses, and follow post-operative instructions for optimal healing. Strenuous activities should be avoided during the initial recovery period.

The results of blepharoplasty become more apparent as the swelling subsides, usually within a few weeks. Patients often report a more youthful and refreshed appearance, with improved self-confidence.

Ectropion (outward turning eyelids)
on describes the “rolling out” of the lower eyelid, from its normal position in contact with the eye.
Ectropion is usually a result of age-related stretching of the lower eyelid, but can also follow a facial nerve palsy or stroke, or result from excessive tightening of the lower lid skin following eczema or a facial trauma. It typically results in a tear overflow and watering due to disturbance of normal tear drainage. This may result in inflammation and soreness of the lower lid and a tightening of the lower lid skin which can further increase the degree of ectropion.

Ectropion can usually be corrected by tightening of the lower lid; insertion of a skin graft may be required in cases of skin ‘shortage’ of the lower lid.


Entropion (inward turning eyelids)
Entropion describes the “rolling in” of the lower eyelid (and occasionally upper eyelid), causing the eyelashes to rub against the cornea, that usually results in a feeling of irritation or "foreign-body sensation". It occasionally results in a corneal abrasion and a red painful eye.
Entropion usually occurs as a result of age-related stretching and subsequent instability of the eyelid, and can be readily corrected surgically.


Ptosis (drooping eyelid)
The upper eyelid can gradually drop with age and gravity, eventually obscuring vision, in one or both upper lids. This may require the patient to continually raise their eyebrows or lift their chin in order to see clearly, which may result in headache and neck pain.

Eyelid ptosis is usually due to age-related stretching of the tendon of the muscle that elevates the upper eyelid, and can be corrected by surgical tightening of the muscle and tendon.


Eyelid lumps, bumps and benign cysts
The eyelids, a specialised area of skin, can develop skin tags, moles, cysts and other benign lesions as elsewhere on the body. Styes and meibomian cysts (chalazion) are common inflammations of the sebaceous glands of the eyelids, the majority of which will resolve spontaneously in time. Cysts that are particularly symptomatic or which do not resolve sufficiently quickly can be easily incised and drained.


Eyelid tumours
The most common type of skin cancer of the eyelids (and elsewhere) is a basal cell carcinoma (BCC or “rodent ulcer”). This usually grows very slowly, over months and years, often without symptoms, and may be mistaken for a simple cyst or mole. This type of tumour does not spread elsewhere, but can gradually enlarge to distort and destroy the normal eyelid structure, affecting its protective function. Development of BCCs and other eyelid skin cancers is associated with a history of long-term exposure to sunlight and a pale skin type. Excision of an eyelid tumour, and any necessary eyelid reconstruction, may result in disturbance to eyelid structure and function.

 

Baggy eyelids 
The loss of skin elasticity and a forward movement of eyelid fat normally present behind the eye that occurs with age may result in excess upper eyelid skin, known as “dermatochalasis”, which may lead to a ‘tired’ appearance, a feeling of ‘heaviness’, and can sometimes obstruct vision. It can occur in association with a ptosis of the upper eyelid. If sufficiently symptomatic, the excess skin and fat may be removed in a ‘blepharoplasty’ procedure.

 

For further information please contact Suzanne Quilter on isec@southeasteyesurgeon.co.uk or ring her on 07880 223 212 - she can supply you with an information sheet or alternatively book an appointment.