What is a lower lid blepharoplasty?
A lower lid blepharoplasty is an operation which removes excess skin, muscle or fat or a combination of these from the lower eyelids to reduce the appearance of bags under the eyes. Sometimes fat is repositioned in order to fill in hollow areas (or this can be done with fillers). It is sometimes combined with lid tightening surgery. Mr Lin will aim to maximise symmetry and minimise scarring.
What are the causes of eye bags?
- The collagen in skin changes with exposure to the sun and over time, becoming more lax
- The septum which is a layer of tissue that holds fat back gradually weakens over time and this can lead to the appearance of eye bags.
- The tendons and muscles that hold the lower eyelid in place become more lax with time.
- The bone around the eyes can also shrink over time making any eye bags more prominent
- Loss of volume of the cheeks can also make eye bags more apparent
What are the potential benefits of blepharoplasty surgery?
- The reduction of eye bags
- The appearance of more youthful eyes
- Improving symmetry with the other eyelid
What if I have had fillers?
Fillers can last a very long time and make the results of a blepharoplasty unpredictable. If you have had fillers in the eyelids or tear trough anywhere near the eyelids, regardless of how far in the past, please inform Mr Lin.
What does the blepharoplasty operation involve?
There are two options. If skin or muscle needs to be removed an incision is made just under the eyelashes which usually heals very well with minimal scarring. If only fat needs to be removed the incision is made on the inside of the eyelid which hides any scarring. Sometimes fat only needs to be repositioned and rarely fat needs to be added. Sometimes a lid tightening procedure is required to stop the eyelid sagging down after skin is removed.
Mr Lin will use a surgical pen to mark out the tissue to be removed, which is the most critical part of the operation. 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 tissue is cut away. If removal/repositioning of 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 below the eyelashes or inside the eyelid. A further operation is sometimes required to tighten the lower eyelid to stop it sagging after removal of skin.
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 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, and will take longer to resolve in patients with blood thinners and after more complex surgery. The lower eyelids take long to recover than the upper eyelids.
- If fat is repositioned, there may be some lumpiness which usually resolves, however not always.
- 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.
- Occasionally some loose skin or asymmetry persists and further surgery may be required.
- Very rarely, too much skin is removed and the lower eyelid may sag to show the whites of the eyes or the lower eyelid may turn out (ectropion).
- Extremely rarely, 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.
