What is a blepharoplasty?
An upper lid blepharoplasty is an operation to remove excess skin (dermatochalasis) from the upper eyelids. Occasionally, you may require removal of some fat from the upper lids as well. The excess skin is common as we age and this can lead to the appearance of hooding of the skin. This can sometimes be severe enough to interfere with the field of vision.
How is a blepharoplasty performed?
An upper lid blepharoplasty is usually performed under local anaesthesia as a day case procedure. You will be given some anaesthetic eye drops as well as an injection under the skin of the upper eyelids. This will make the area feel numb and so the surgery should not cause any pain.
The excess skin is removed and if any fat removal is required then this can also be performed. The skin is then stitched together and the scar should lie in the natural skin crease of the upper eyelid.
What happens after the blepharoplasty?
It is normal to expect some bruising and swelling after a blepharoplasty procedure. This will take about a week or so to settle and improve. The stitches will need to be removed after 5 to 7 days following the procedure.
What are the potential risks or complications from a blepharoplasty?
The most common side effects include bruising and swelling. The surface of the eyeball or conjunctiva may also swell, this is called chemosis.
Bleeding may occur after the procedure and it is common to have a few drops from the wound after the procedure. Sometimes the bleeding can be more and result in a collection underneath the skin, this is a haematoma. This may recover further surgery to remove the blood collection.
Extremely rarely, a severe bleed may result in blood around or behind the eye that can cause blindness.
Infection can result in redness and swelling of the eyelids. This may also result in discharge or even wound breakdown.
Under or over-correction
If too much skin is removed this may result in difficulty closing the eye, this is called ectropion. If too little skin is removed then you may have residual skin excess.
Most patients will have some degree of asymmetry, which is completely normal. This may also occur after surgery or you may become more aware of asymmetries after the procedure.
You will have scarring from the blepharoplasty procedure, which will be permanent. The scar is normally in the natural crease of the upper eyelid or just under the eyelashes on the lower eyelid. Occasionally, scars can become raised and thickened, also referred to as hypertrophic or keloid.
Eye related complications
Some patients will experience dry eyes or aggravation of dry eyes following the procedure. This may require some lubricant eye drops to help. Vision may also be blurred for a few days following a blepharoplasty.