Cosmetic eyelid surgery removes or repositions
fat, excess skin and muscle from the upper
and lower eyelids to rejuvenate drooping
upper lids and puffy bags under the eyes
and make you appear young and vibrant rather
than old and tired.
My aim is to rejuvenate your eyelids by
restoring their youthful shape and contour.
Commonly asked questions
a good candidate for a blepharoplasty?
This is best decided
during a consultation, but generally speaking,
the ideal candidates for blepharoplasty
are women or men in good physical and mental
health with reasonable expectations who
have started to develop droopy upper eyelids
or baggy lower eyelids. This may occur at
any age, but usually starts in the early
to mid thirties. However, because the eyelids
are one of the first parts of the face to
show signs of aging, many have this part
of the face operated on early to good effect,
because once done, the rest of the face
If you have certain medical conditions:
thyroid disease affecting the eyes; dry
eyes; glaucoma or retinal detachment, I
will refer you to a specialist ophthalmic
surgeon before proceeding any further.
Many people who come to talk about upper
eyelid surgery, need a brow
lift instead. To the untrained eye,
what looks like baggy, loose upper eyelid
skin, is actually the result of gravity
and skin laxity in the forehead and brow,
which pushes the eyelids down. A significant
number of patients who consult me about
blepharoplasty, will be advised that they
would benefit from a brow lift instead.
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should I expect from my consultation?
First, I will take
a full medical history and examine you completely;
then I will focus on your face, and specifically
your eyes. I will assess the shape of your
upper and lower eyelids, along with your
facial asymmetries - everyone has an asymmetrical
face, and it is important to realise this
before surgery, rather than notice it for
the first time after surgery! This is especially
important for surgery in the upper eyelid
and brow regions where a slight pre-existing
asymmetry can be magnified by surgery and
become noticeable when it wasn’t so
previously. With this in mind, please come
to your consultation prepared with some
pictures of yourself 10 and 20 years ago,
which along with some standardised-view
photographs that I will take during the
consultation, will help us plan and discuss
your operation. During our consultation,
you will learn about the surgery, and we
will discuss its limitations and risks.
I will ask about your expectations and goals
and by the end of it, we will decide whether
I can realistically achieve them.
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the surgery performed?
In a typical operation
on the upper eyelids, I incise the skin
along a natural crease/ wrinkle line. Then
I separate the skin from the underlying
fatty tissue and muscle and depending on
your eyes, I may remove or a minimal amount
of excess fat, before and trimming skin
and muscle to rejuvenate your upper eyelids.
In the lower eyelids,
incisions are made just below the lashes
on the skin, or hidden just inside the eyelid
on the conjunctiva. Lower eyelid surgery
is more extensive and challenging, and I
usually combine it with re-shaping and re-draping
the midfacial skin to rejuvenate the triangle
of skin that is bounded by your eye, the
nose and the naso-labial fold (which becomes
more prominent as you age). This involves
re-shaping fatty tissue, tightening and
re-draping the lower eyelid musclulature
and trimming excess skin. Along with this,
in patients who need it, I may perform a
lateral canthopexy to tighten the lateral
part of eye and make it appear more youthful.
All skin incisions
are closed with very fine sutures which
will be removed after 3 - 5 days.
Occasionally, all that
needs altering is a small fatty bulge in
your lower eyelids, and these can be dealt
with through incisions hidden just inside
the eyelid on the conjunctiva (so-called
transconjunctival blepharoplasty) leaving
no visible scar in your lower eyelid.
does my operation involve?
be performed under local or general anaesthesia.
I am happy to perform upper lid surgery
under local anaesthesia, but the midfacial
rejuvenation I include in my lower blepharoplasty
is too extensive for local anaesthesia.
Before surgery, you
will meet and be assessed by your anaesthetist
who will prescribe you medications for your
comfort and to lessen anxiety if need be.
On the evening before, or the morning of
your operation I will review what we have
discussed and planned previously and we
will both sign your operative consent forms.
The operation lasts
1-2 hours, but may be considerably longer
if combined with operations on the face
After surgery, you
will awake in a recovery area and soon afterwards
you will be returned to your room. Most
patients go home the day after surgery on
simple pain relieving medications and a
short course of antibiotics.
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about my recovery and return to normal activities?
You are likely to
have swelling and bruising for several days
after your surgery. Although you will notice
a difference in the shape of your eyelids
soon after surgery, the final result will
become apparent gradually - starting from
when the swelling resolves after 2 weeks,
and maturing over 2 months or so.
You will be given special
cold packs to dress your eyes for 2 days
after your surgery and for the first few
nights after your operation I ask you to
sleep with your head and chest propped up
several pillows to help decrease the swelling.
Your vision may be somewhat blurred for
several days after your surgery - in part
because of your surgery and in part, from
the ointment you will be given to apply
to your eyes to moisten them just after
the operation and when you go home. This
ointment is necessary whilst post-operative
swelling is present because during that
period (usually less than a fortnight) your
upper and lower eyelids may not close normally
- especially when you are asleep.
You can expect to be
up and about a day or so after the operation,
but you should take life easy for a week
or so and avoid strenuous exercise. Initially
you may find it uncomfortable to read or
watch television, but this will resolve
after 2 - 3 days. You should not wear contact
lenses for at least two weeks, and even
then wearing them may feel uncomfortable
for a while.
Depending on your occupation,
and whether your blepharoplasty was combined
with other surgery, you should be able to
return to work in 7 - 10 days. Bruising
and swelling will resolve in 10 - 14 days
and will usually be concealable with simple
make up within a week.
The scars from your
operation are positioned so as to be hidden
within natural skin creases. Initially,
during the inflammatory stages of healing
they are red and visible, but ultimately
they will fade in colour. That said, new
scars benefit from friction-free massage
(using vaseline, for instance, to lubricate
the massaging process). Beginning to massage
blepharoplasty scars very gently 2 - 3 weeks
after surgery, will help them mature, soften
and flatten faster than if left to their
own devices. New scars should be protected
from sunlight for 2 years to avoid them
pigmenting differently to the surrounding
skin and becoming a different colour permanently.
Factor 15 sun block should be applied whenever
they are exposed - even to a British winter
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