Eyelid surgery (Blepharoplasty)

As men and women age, their upper eyelids tend to sag and their lower eyelids tend to become puffy. These developments can lead to a tired and older looking appearance. Blepharoplasty is a procedure designed to remove puffiness and sagging around the eyes, as well as any under eye baggage. The aim of surgery is to give the eyes a smoother, more youthful appearance.

Throughout your consultation, Mr Henley will listen carefully to you about the look you wish to achieve. Following an examination of your eyes, eyebrows and face, he will then be able to advise you on the most suitable form of treatment. Remember, there may be non-surgical solutions to correct your concerns, which might include a rest or a good holiday.

Usually, there is very little chance of obtaining correction of lower eyelids on the NHS or through private healthcare insurance. However, if your upper eyelids are sagging to such an extent that it affects your vision, funding may be possible. Mr Henley will advise you about your possible options during the consultation. Where appropriate, he will help you to obtain NHS or insurance funded treatment if this is what you want.

Eyelid operations take between one to three hours, depending on whether the surgery involves both upper and lower lids. Eyelid surgery is most often performed as a day case procedure, using local anaesthetic along with some drugs to make you feel drowsy. Once you are awake and stable you will be able to go home, accompanied by a relative or friend. Occasionally, a general anaesthetic is given and an overnight stay may be recommended. Mr Henley will discuss your anaesthetic preference with you.

Risks and Side Effects of Blepharoplasty

Eyelid surgery is very safe in well trained hands, although Mr Henley cautions that “No surgery is without risk; there are no guarantees.” However, he continues to say, “The importance of going to an appropriately qualified surgeon cannot be stressed enough.”

When the local anaesthetic wears off there can be a slight throbbing tenderness around the eyes. However, blepharoplasty is a fairly comfortable procedure and many people require no painkillers at all. There will be bruising and swelling and your eyes may be watery for the first two days. You may also experience a dry and gritty feeling for up to six weeks. People whose eyes water easily anyway, may find that this surgery makes them water all the more. This problem can persist for the first month or two. Avoiding contact lenses during the first six weeks is a must.

After surgery, it may feel tight when closing your eyes. You may even be unable to close your eyes at first. Do not be alarmed - this feeling will disappear within the next week or two.

The scars occasionally become a little tight during the four to six weeks following surgery and their appearance may concern you. Should this problem occur, it usually settles down on its own within six months.

Other risks include bleeding and infection, although these are extremely rare.

After this operation you may feel that your eyesight is not quite so good and that you now need glasses. This is because the swelling, which occurs after surgery, can make you more aware of any age related changes (decline) in your eyesight. As the swelling subsides over the coming months, much of this is likely to improve.

Blindness has been reported as a complication of blepharoplasty in some medical journals. However, this was some time ago and when surgical practices were much less sophisticated than they are now. Mr Henley has no experience of this complication in any patient he has operated on and neither have his colleagues. He, nevertheless, believes that you should be aware that these reports exist.

The risks will be discussed in detail at your consultation. You will also be provided with detailed written information to help you make an informed decision about any surgery.

Differences in eye shape and size (Orbital Asymmetry)

Don’t expect your eyes to match perfectly. Most people have minor differences in the size and shape of their eyes and cheeks. Cosmetic eyelid surgery can make such pre existing differences much more obvious to you although others are unlikely to notice. An example is shown here 

All the risks will be discussed in detail at your consultation. You will also be provided with detailed written information to help you make an informed decision about any surgery.

Recovery

Remember to expect some bruising and swelling at first – those black eyes are normal. You may want to pack a pair of sunglasses for the journey home. The swelling may also blur your vision for a day or two, but this will subside. You can keep these side effects to the minimum by sleeping in an upright position for the first few nights. Ice packs (wrapped in a towel or cloth and never directly to the skin) applied to the area two or three times a day can be soothing.

Four to seven days after surgery, the surgical glue used to close the incisions will be peeled away. Concealer make-up can now be applied if you wish, and you should be presentable to go out and about or back to work within two weeks. Remember to avoid using contact lenses for the first six weeks following the surgery.

People often say that they can see a dramatic improvement in looks within the first few weeks. However, you should not judge the final result until about six months.

Eyelid surgery before & after surgery

Patient A - Upper and Lower Eyelids

Before surgery This lady wanted an upper and lower Blepharoplasty. The pre-operative photograph shows that there is an excess of skin on both the upper and lower lids.	At the end of the operation This next photograph shows the patient immediately at the end of the operation. The incision lines and inevitable bruising that goes with this surgery are clearly visible.

Seven weeks after surgery	Eight months after surgery

 

Patient B - Upper Eyelids Only

You can see in this lady’s pre-operative photographs that the skin on the upper eyelid has lost its shape and tone, causing droopiness and hiding of the upper eyelid crease. To correct the sagging upper eyelid, incisions are made where the natural arch and crease of the eye should be.

Before surgery	Six weeks after surgery You can see that the youthful looking upper eyelid crease has been restored	Eight months after surgery

Before surgery	Eight months after surgery

This photograph shows the markings made by Mr Henley just before the operation. These markings assist the surgeon in determining where the natural crease should be and how much skin needs to be removed	Six weeks after surgery These photos show the scar line at six weeks.	Eight months after surgery Note how the scar changes with time from a red line to one that is almost invisible.

Patient C - Upper Eyelids Only

Before surgery This lady was also concerned with the droopiness of her upper eyelid.	Seven months after surgery

Before surgery	Seven months after surgery

Scars at six weeks after surgery	Scars at six months after surgery

 

Orbital Asymmetry

Before surgery This gentleman was made aware of his Orbital Asymmetry during consultation with Mr Henley before his surgery.	Eleven months after surgery If you look closely, you may be able to see that this gentleman's left eye sits a little more forward than the right

 

Mr Henley would like to thank these patients for allowing their photographs to be displayed for the benefit of others who may be considering cosmetic surgery.

The information provided is intended to give a brief outline of the procedure. It is not a substitute for a personal consultation with a surgeon.