Surgery » Blepharoplasty (Eyelid Reshaping)

What is Eyelid Reshaping?

Eyelid reshaping involves removing excess skin and fat from either the upper eyelid or lower eyelid, or both. There are three main types of eyelid reshaping procedures:

1. The Upper Blepharoplasty
This procedure will correct "hooding" of the upper eyelid. It involves an incision within the crease of the upper eyelid where the excess skin (and fat if necessary), is removed.

2. The Lower Blepharoplasty (External Incision)
The lower Blepharoplasty procedure will correct excess skin, wrinkles and puffy bags under the eyes. An incision is made close to the lower lash line.

3. The Lower Blepharoplasty (Internal Incision)
This procedure will correct puffy bags or excess fat under the eyes (skin can not be removed through this incision). The incision is made on the inside of the lower lid so there is no visible scar present.

Who is a good candidate for Eyelid Reshaping?

Someone concerned with any of the following characteristics:

• Drooping or hooded upper eyelids
• Impaired peripheral vision
• Eyes feeling and looking tired and heavy
• Wrinkles under the eyes
• Bags or puffiness under the eyes
• Single eyelid (for Asian patients wanting to create a double eyelid)

Who is not a good candidate for Eyelid Reshaping?

Someone concerned with any of the following characteristics:

• Crows feet (a wrinkle relaxer is usually the best option for crows feet)
• Dark circles
• Unrealistic expectations
• Dry eyes

The Procedure

Dr Oates usually performs eye lid reshaping procedures Academy Day Hospital, our government licenced day hospital (on site at Academy Facial Plastics and Laser Specialist) under a combination of twilight sedation and local anaesthetic. The procedure takes approximately 60 - 90 minutes. General anaesthetic (fully asleep) is available if requested.

How long will I need off work?

Most blepharoplasty patients will take between 7 to 14 days off work, depending on the amount of physical activity involved in their line of work.

The Recovery

After the procedure you will remain in the recovery room for one to two hours. You will need a family member or friend to drive you home after this. The next day you return to the clinic for your post-operative review.

On the fifth or sixth day after surgery, your stitches (if any) are removed. Swelling and bruising may still be present so camouflage makeup can be applied.

Is there discomfort?

Most patients will describe the feeling as mild to moderate discomfort (this is mainly due to the swelling). This discomfort can be eased with over-the-counter pain medication. Patients rarely report strong pain and in this case, pain can easily be managed with stronger medications.

Pre and Post Operative Care

Included in the cost for eyelid reshaping is a pre-operative care program delivered by our fully qualified Dermal Therapists. This entails a course of three, weekly glycolic peels with home care products to help prepare and treat your skin prior to surgery. Post-operatively, your Dermal Therapist will recommend a maintenance program for you skin.

PRE-OP INFORMATION

Bruising and swelling
The amount of swelling and bruising will vary from person to person. Although current techniques do help to minimise this, occasionally some patient's will experience more. The swelling and bruising however does not affect the final result. Ice packs (for at least 30 minutes each hour) will help to reduce swelling and most people find it is no longer a significant concern after 1-2 weeks. Occasionally a bruise may spread into the white of the eye, turning it bright red, this will take around 2 weeks to settle.

Milia
Milia are small white heads that can form as a reaction to the sutures. The eyelid skin is slightly more prone to milia than any other areas, especially in oily skins. They are usually not a problem and can be treated if they occur.

Watery eye/dry eye
A slightly watery eye or dry eye can be experienced after blepharoplasty. This may last for a few weeks, it is very rare for this to continue for more than three months. Occasionally a patient may develop Chemois (Jelly eye).  With this there is some swelling of the clear part of the eye. Although it will settle by itself, eyedrops will make it settle more quickly.

Eye Shape
The majority of people start out with slightly different shapes to their eyes and eyelids before the surgery. Every attempt is made by Dr Oates to leave the eyes as asymmetrical as possible. However, occasionally there are minor differences between the two eyes, usually this is not a problem and the difference is too small for other people to notice.

Scaring
The surgery is specifically designed to improve the skin and soft tissues around the eye, however, occasionally the soft tissues heal and give a slightly unnatural appearance to the eyelid. On rare occasions this can require revision to improve the shape. Usually the scars of eyelid surgery heal exceptionally well, however on rare occasions they may be more noticeable. This is particulary with patients who have a history of hypertrophic or keloid scarring. If you have ever had problems with a scar or the way a scar has healed please let Dr. Oates know prior to surgery.

Under correction
Occasionally not quite enough skin is removed, this is done so that the more problematic complication of excessive skin removal, which can result in difficulty in full closure of the eye, is avoided. It is usually a simple procedure of trimming any extra skin under local anaesthetic if this is required.

Double vision
Double vision can result in the immediate post-operative period, however it usually settles very quickly. On rare occasions it is possible for it to persist and further treatment is required.

Visual loss
It has been reported that people can lose their sight following eyelid surgery, but this is extremely rare and is usually due to bleeding behind the eye. Pain is not expected to be significant after eyelid surgery, however if you do experience significant pain after surgery, it is very important that Dr. Oates is informed.

POST-OP INFORMATION

1) Sleep on you back or side with your head elevated.

2) Blepharoplasty usually causes little post-operative pain, if you notice any significant pain which persists notify Dr Oates' office immediately.

3) Cold compresses (gel masks or frozen peas in a bag) should be used over the eyes for at least 30 minutes, 6 times a day.

4) Please do not take Aspirin or medication containing Asprin. Panadol should be sufficient.

5) You may read and watch Television.

6) For upper eyelids, apply the ointment to the incision site sparingly 3 times a day.

7) For lower lids use your eye drops as directed (usually 1 drop 4 times a day).

8) Please don't use mascara, eyeliner or eye shadow until instructed to (usually 10 to 14 days). Minimal make-up applied over any bruising to the lower lid is acceptable at any time, but do not pull on the lids or incisions.

9) Any apparent redness of the white of the eyeball is a form of bruising and will subside during the early healing process.

10) Do not engage in strenuous exercise or sport for at least 3 weeks after the procedure or until approved by Dr Oates.

11) Stitches may be removed at different times after surgery. This depends on the extent of the surgery, the type of stitch and your skin type. We will advise you accordingly.

12) It is not abnormal to feel slight pinching and tightness in the eyelids during the early healing period.

13) If you have any concerns, call the office during normal working hours on 9382 4800 or Dr Oates on his mobile after hours on.

If I am interested, what now?

Step 1
Your first step is an initial consultation with Dr Oates. You do not necessarily need a GPs referral for this consultation.

Step 2
If Dr Oates and yourself have decided that you are suitable for eyelid reshaping and you want to go ahead with the surgery, a booking for the surgery and the pre-operative care is scheduled. The usual waiting period is approximately three to four weeks.

Complimentary Consultations

You may wish to speak with one of our qualified Dermal Therapists prior to seeing Dr Oates. During this free consultation, a Dermal Therapist can discuss both surgical and non-surgical options to treat your cosmetic concern(s).