Our eyes are often the first facial feature that attracts attention and they form an important aspect of attractiveness and beauty. Over time, ageing can cause the upper eyelids to droop and eye bags can appear on the lower eyelids.
Age and gravity may cause the eyebrow and eyelid area to sag or droop. At the same time, sagging skin, the weakening of facial muscles and build-up of fat pockets around the eyes, can give rise to unsightly eye bags or rings, wrinkles and grooves. Other than aesthetics, these conditions may also impair vision and cause eye strain or fatigue.
In addition, younger people may be unsatisfied with their eyes due to problems such as puffy eyelids, eye-bags and asymmetry or absence of their double eyelid fold.
Eyelid surgery, also known as blepharoplasty, is a surgical procedure to improve the appearance of the eyelids, making one's eyes appear younger and more alert. Blepharoplasty can correct the following problems:
Excess skin on the upper eyelids that reduce your peripheral vision
Baggy or droopy upper eyelids
Puffy eyelids
Asymmetric or absent upper eyelid crease ("double eyelid")
Excess skin on the lower eyelids
Bags under your eyes
Surgery can be done on the upper eyelid, lower eyelid or both at the same time. If your eyebrows are droopy and you have deep creases in your forehead, your surgeon may also recommend a brow lift in addition to blepharoplasty.
Every year, many thousands of people undergo successful eyelid surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.
Enhanced appearance: Reduces droopy or sagging eyelids, giving a more youthful look
Improved vision: Removes excess skin that may obstruct vision
Reduced puffiness: Targets bags under the eyes for a smoother, fresher look
Other eyelid procedures include:
Botox injections: While Botox can reduce wrinkles and create a more youthful appearance, it does not address excess skin or vision issues. Blepharoplasty is more effective for sagging eyelids.
Dermal fillers: Fillers smooth wrinkles but do not address puffiness or excess eyelid skin, whereas blepharoplasty targets both.
Non-surgical laser treatments: Laser resurfacing can improve skin texture and reduce fine lines but does not remove excess skin as effectively as surgery.
Benefits of aesthetic eyelid surgery (blepharoplasty) compared to these other procedures:
Permanent solution: Results last many years compared to temporary options like Botox
Functional and cosmetic benefits: Enhances both vision and appearance
Quick recovery: Generally, a short recovery time with minimal downtime
Limitations of aesthetic eyelid surgery (blepharoplasty) compared to these other procedures:
Surgical risks: Includes bruising, swelling and potential scarring
Cost: Typically more expensive than non-surgical treatments
Downtime: Though minimal, it does require a few days of rest post-surgery
The following complications may occur:
Anaesthesia risks
Swelling and bruising
Bleeding
Infection
Blood clots
Visible scars
Tightness in lids
Drooping lower lids
Dry, irritated eyes
Difficulty closing your eyes
An outward eversion of the eyelid (scleral show or entropion)
Injury to the eye muscles
Eyelid asymmetry
Temporary blurring of vision or rarely, loss of eyesight
Usually, these complications will go away within weeks. However, they may occasionally be permanent and further surgical procedures may be necessary to correct them.
The subject of risks, as well as potential complications of surgery are best discussed on a personal basis between you and your plastic surgeon.
Blepharoplasty – an aesthetic eyelid surgery – corrects baggy or sagging tissue around the eyes through removal of excess skin, fat and muscle from the eyelids. It is considered a reconstructive surgery to improve one's vision, appearance or both. After the surgery, it will usually produce an effect that is pleasing to look at and can give one a more youthful, rested look. It can be performed on one or both eyelids.
Blepharoplasty is usually done in an outpatient setting. Depending on the extent of surgery that you require, this surgery may be performed under local anaesthesia or general anaesthesia.
During your preoperative assessment, your surgeon will decide how much skin, muscle and/or fat to remove. Markings will be made to indicate the surgical incisions and where tissue is to be removed.
Typically, for the upper eyelid, your surgeon will make an incision hidden within the natural fold of the upper eyelid. A new fold (double eyelid crease) will be created if you do not naturally have one. For the lower eyelid, the incision will be placed either just below the lower lashes (subconjunctival incision) or hidden inside the lower eyelid (transconjunctival incision).
Through the marked incisions, excess skin, muscle and possibly fat will be removed. Tissues may redistributed internally to reduce bulges and puffiness. The incisions will be closed with sutures or glue.
The preparation process is straightforward in the days leading up to the surgery.
Consult your surgeon: Discuss the procedure, risks and desired outcomes in detail
Medical evaluation: Undergo any required tests or assessments to ensure you are fit for surgery.
Adjust medications: Follow your surgeon's advice on stopping or adjusting certain medications such as blood thinners.
Stop smoking: If you smoke, quit several weeks before surgery to aid in the healing process.
Arrange support: Plan for someone to drive you home and assist you during recovery.
Follow pre-surgery instructions: Adhere to any specific guidelines provided by your surgeon such as fasting before surgery.
After the surgery, you may temporarily experience:
Pain or discomfort
Swelling or bruising
Numbness of the eyelids
Blurred vision from lubricating eyedrops or ointment applied to your eyes
Double vision
Light sensitivity
Difficulty in closing your eyes
These symptoms usually improve over several days with rest.
The recovery process is fairly quick post-surgery and in the weeks that follow:
You will stay in the recovery room for one or two hours after surgery and will be discharged once you are no longer drowsy from the anaesthesia and the risk of abnormal bleeding, nausea or swelling has passed.
Cold compresses are usually helpful to reduce the swelling and bruising, as is sleeping with your head raised higher than your chest for a few days.
You will be taught how to gently clean your wounds and apply antibiotic ointment and eyedrops regularly.
Painkillers and antibiotics will be prescribed to control the pain and minimise the risk of infection.
During the first one to two weeks after surgery, you are advised to avoid strenuous activity, heavy lifting, exercise, swimming, smoking and rubbing your eyes.
You will need to avoid contact sports for three to four weeks.
You will also need to avoid activities that can increase your pulse or blood pressure for two or three days to lower your risk of bleeding or swelling.
Avoid activities that may irritate your dry eyes, including reading, watching television, wearing contacts and using a computer.
Use of darkly tinted sunglasses when you go out during the day will help to protect the wounds from the sun and wind.
Your surgeon will ask you to return to the clinic for removal of the sutures about 5 to 7 days after the surgery. The bruising and swelling generally subsides after 14 days of surgery. Redness of the scars is normal after surgery and typically fades over several months. During this time, it is important to avoid excessive sun exposure on your delicate eyelid skin. It will take several months before the optimal result is achieved.
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