Eyelid lift surgery

The aim of operation of the upper and lower eyelids is to correct excess skin and fat pouches, which contribute most towards the appearance of a tired and aging eye. The procedure can also significantly improve subjective ailments such as a feeling of tired eyes, burning eyes, excessive secretion of tears and similar.

Who is a suitable candidate for the eyelid lift surgery?

Most patients who require correction of excess skin and/or fat pouches in the area of the eyes are suitable candidates for blepharoplasty. Whereas excess skin frequently dominates in the upper eyelids, in the case of the lower eyelids it is usually fat pouches which need to be corrected in order to achieve a more youthful and “radiant” look.

How does consultation take place?

The overall state of health and any possible contraindications to the procedure are ascertained in terms of consultation. After examination of the local finding on the face, it is determined whether the condition is suitable for surgical resolution and which technique will be used in terms of the operation. In the case of the upper eyelids, it is necessary to determine to what scope the local finding also participates in drooping of the eyebrows. Sometimes, drooping eyebrows are the only cause of excess skin on the upper eyelids and so in such cases, the condition of the eyebrows must be resolved, not that of the upper eyelids. During operation of the upper eyelids, the excess of regular skin or skin and muscle is removed and in most cases it is also necessary to correct the fat pouches, especially in the inner corner of the eye. The resulting scar is hidden in the crease of the lid. If the scope of the excess skin is greater, the scar could even encroach outwardly from the outer corner of the eye. Scars are usually very fine. Lower eyelid lift is a technically more demanding procedure. If there is an excess of skin or skin and muscle, the cut is made directly under the lashes. In most cases it is necessary to correct the fat pouches, which according to their condition are either partially removed or detached and stretched in such a way that the area of the lower lids is again smooth after the operation. In cases when only fat pouches dominate and where there is no significant excess of skin, it is possible to perform so-called transconjunctival blepharoplasty, which is correction of the fat pouches from an incision via the conjunctiva of the lower eyelid, so the operation does not leave any scars on the skin of the eyelids. In some cases, operation of the lower eyelids is supplemented to include so-called canthoplasty or canthopexy, which are procedures on the suspension system of the lower lid, the aim of which is to stabilise the lower lid. These are used in the case of patients with conspicuously flaccid lower lids, in terms of which the lid can be pulled away from the eyeball by its own weight or for patients where this complication could occur after simple lower eyelid lift. In terms of consultation, it is always necessary to inform the doctor of all medicines which the patient uses. This especially relates to medicines which affect coagulation.

Pre-operative examination

With a view to the fact that in the vast majority of cases this concerns an out-patient procedure under local anaesthesia, pre-operative examination is not necessary.

Post-operative care

Post-operative pain is not usually great for all types of operations and reacts well to regular analgesics. Too much physical activity is not recommended in the period immediately after the operation. Ice must be applied to the eyelids via a bandage after surgery. This is performed by application of a cold compress (ice with cold water in a plastic bag, gel glasses and similar) always for 20 – 30 minutes at a time and afterwards the lids should not be cooled for the same period of time. This measure, together with keeping the head in a raised position, reduces post-operative swellings and hematomas. The stitches are removed after about five days. Bruising and swelling subsides completely within two weeks of the procedure. Care for the scars constitutes an important part of the post-operative regime. After the stitches are removed, they are lubricated and massaged.

Complications

Complications are not frequent in the case of upper and lower eyelid lift surgery. Early post-operative complications include hematomas or in other words accumulation of blood in the wound. This can gradually move from the upper lids to the lower lids and the cheeks. Late complications for example include more rigid scars. A feared and unpleasant complication in the case of operations of the lower eyelids is ectropion or retraction of the lower lid from the eyeball. This is a problem which is not only aesthetic, but also functional, when the eye is usually inflamed and subject to watering.