What is a blepharoplasty?
Also known as an eyelid lift for hooded eyes or droopy eyelid skin, blepharoplasty is an operation with long-lasting effects which removes excess skin (dermatochalasis) from the upper eyelids. A blepharoplasty will make the upper lids feel less heavy, provide a more youthful appearance and can provide space for upper eyelid makeup. Mr Lin will aim maximise symmetry and minimise scarring. Further benefits are listed below. This is different to ptosis surgery where the muscle that lifts the eyelid has become detached and is reattached.
Mr Lin will assess your eyes for dryness as blepharoplasties can make this worse. Any damage to the muscles around the eyes that close the eyelids can reduce your blinking, as can removing too much skin.
If your brow has dropped, Mr Lin will also perform an internal browpexy. This is a scarless approach to fix the brow higher to recreate the natural contour. The contour is naturally more curved in women.
Please note that the Ramsay policy (eg Oaks/Springfield and other private hospitals) do not permit aesthetic/cosmetic treatments. Mr Lin can consult for you at Colchester Eye Centre instead.
Mr Lin’s also supervises his team performing blepharoplasties in the NHS setting if the excess skin is significantly affecting vision (typically to the point where you are no longer eligible to drive), obviously not for cosmetic reasons purposes.
What are the causes of excess upper lid skin?
- The collagen in skin changes with exposure to the sun and over time. Sometimes episodes of swelling of the eyelid due to infection or allergy can stretch the skin.
- The septum which is a layer of tissue that holds fat back weakens with age and this can lead to fullness of the upper lids.
- The brows which normally sit above the bony ridge (women) or on the bony ridge (men) can gradually drop which leads to the appearance of excess skin on the upper lids. See brow lift.
It is important all of these factors are taken into account in your assessment.
What are the potential benefits of blepharoplasty surgery?
- The appearance of bigger and more youthful eyes and more alertness and less ‘hooding’
- The upper eyelids feeling less ‘heavy’
- Space on the upper eyelids for makeup
- Improving symmetry with the other eyelid
- An improvement in the upper part of your field of vision
- Reduced headaches. Some patients constantly raise their eyebrows to pull the excess skin out of the way, which can cause a headache.
Do you have any before and after photos?
It is important to be mindful of images posted online that have added lighting, make-up and a smile in their ‘after’ photos. Filters can also be deceptive.
Our practice caters to a discerning clientele who value their privacy. As such, we maintain a strict policy of not sharing pre- or post-operative photographs on public platforms. This approach aligns with our commitment to discretion and our patients’ preferences for confidentiality.
We believe that the feedback and reviews (here & here) shared by our patients speak volumes about the quality of care and results we provide, and we are proud to let their experiences reflect our commitment to excellence.
What does the blepharoplasty operation involve?
Removal of excess upper eyelid skin and sometimes muscle/fat is carried out as day case surgery, generally under local anaesthesia which means you will be awake for the procedure. Occasionally the surgery is performed under local anaesthetic with sedation.
Mr Lin will use a surgical pen to mark out the skin to be removed, which is the most critical part of the operation for symmetry. Anaesthetic is then injected under the skin, which feels sharp and stings for about ten seconds. After this the eyelid will be numb and the surgery should not hurt, but you may still feel touch, fluid or pressure.
The excess skin is cut away. If removal of muscle/fat is needed, the operation will take longer and the recovery time is also longer. The wounds are then closed with stitches that minimise scarring. The scar – if there is any – is usually hidden in the natural skin crease of the eyelid.
At the end of the operation, ointment is put on the wounds and dressings applied to the eyelids to reduce bruising and swelling. Both dressings will be removed before you leave.
What happens after the operation?
Written instructions will be provided for you. The key aftercare aspects are to minimise infection, bleeding/bruising, swelling and discomfort. Before you leave you will be given lubricating drops for the eyes and antibiotic ointment for the wounds to use for a few weeks after the surgery. You should not drive yourself home. Clean the eyelids gently with cooled, boiled water. If your eye feels sore when the anaesthetic wears off, take paracetamol. Avoid aspirin as this will encourage bleeding. Normally, the discomfort will settle within a few days. Ice packs (such as frozen peas wrapped in a clean towel) will reduce pain and swelling, and sleeping with more pillows to keep the head elevated will help.
You may start driving and working again as soon as the dressing is removed, as long as your vision is clear and you are not light-sensitive. Most forms of light exercise and a normal work pattern may be resumed within a few days of surgery. Avoid heavy lifting, running or strenuous work-outs for four weeks as you may worsen any bruising or swelling. Eyelid makeup can be worn once any scabs fall off. Mr Lin will remove the stitches after 1 week. You cannot wear contact lenses for at least two weeks after surgery, as the eyelids may be stiff/sore, and your eye surface may be dry.
If you have severe pain, not relieved by simple painkillers, please contact Mr Lin on his mobile phone as provided.
Eyelids normally heal very well and the wound is usually hidden in the natural skin crease of the lid.
What problems can occur after the operation?
Mr Lin performs many hundreds of eyelid operations per year and will draw on his expertise to minimise the risk of problems. Eyelids normally heal very well and the wound is usually well hidden.
- Bruising and swelling of the eyelids is normal. The surface of the eye may also swell. These changes will settle after a few weeks, and will take longer to resolve in patients with blood thinners.
- Dry, gritty, sensitive eyes for a few weeks can be helped with lubricant eye drops. The vision may be slightly blurred for a few days. A dry eye problem should be diagnosed and treated before surgery as it may be worsened by the surgery.
- Bleeding after the operation is usually slight and stops within a short time. If bleeding continues you should contact the hospital in case further treatment is required.
- A post-operative infection may rarely develop in the lids when they would become tender, red and more swollen and the wound may open and discharge. If this happens then you should contact the hospital as antibiotic tablets may be needed to help correct this and allow the lids to heal. Smoking impairs healing and should be avoided a month before and after your procedure.
- Occasionally some loose skin or asymmetry persists, and further surgery may be required.
- Rarely, too much skin or muscle is removed and the eyelids cannot close fully. This leads to dryness of the eyes. Mr Lin is often asked to advise on patients who have had their surgery abroad and have suffered this problem. As a specialist in eye and eyelid surgery, he takes extra care to ensure both are looked after
- Extremely rarely and only in cases where fat is excised, severe bleeding can spread behind the eye that can cause loss of vision. This is why aspirin and physical exertion are discouraged for the few weeks after the operation. This requires emergency treatment from an eyelid surgeon.
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