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What to expect from eyelid surgery

14:55 17 May in Uncategorized

Blepharoplasty or eyelid surgery is one of the most popular procedures performed at Somerset Surgery with at least two performed every week. Dr Toogood answers some common questions.


What is eyelid surgery (blepharoplasty)?


An eyelid lift or blepharoplasty, is a surgical procedure whereby excess eyelid skin is removed. It may also be necessary to add or remove eyelid fat pads. The term “eyelid lift” is a misconception, because the eyelid is not lifted during surgery and most certainly the shape of the eye is not changed. Blepharoplasty can be performed on the upper or lower eyelids or all four lids simultaneously. A blepharoplasty will not lift the eyebrows, although it can be combined with a specific brow-lifting procedure if required.

With an upper blepharoplasty, incisions on the skin of the upper eyelids are made to allow for the removal of skin and fat. A thin stitch is then used to bring the skin together and to allow for the creation of an eyelid crease. Scars on the eyelid are almost imperceptible.

Lower eyelid surgery can involve skin incisions directly below the lash line or an incision on the inside of the eyelid, called a transconjunctival approach. The transconjunctival approach allows for access to the eyelid fat without visible incisions. This technique is perfect if you need fat removed or re-draped, but don’t have excess lower lid skin. It can also be combined with laser resurfacing of the eyelid skin to reduce lines and wrinkles.

The procedure can be performed under local anaesthesia, but for best results it is preferable to do the procedure using conscious sedation or general anesthesia. It is a day case procedure and you can go home as soon as you have fully recovered from the sedation.


Who is a good candidate for eyelid surgery?


Patients with realistic expectations.

Patients who are in good health.

Patients with upper eyelid excess skin and fat with heavy-looking eyelids.

Patients with an aged appearance and puffiness.

Patients experiencing visual impairment due to sagging eyelid skin and/or fat blocking their peripheral vision. An upper blepharoplasty can be performed to remove excess skin and fat to open the eye and improve vision.

Patients with excess lower eyelid skin, puffiness, tear troughs or bags under their eyes. Lower blepharoplasty can be performed to remove excess skin and reduce wrinkles. It can also improve the shape of the lower eyelid by removing skin and fat. Sometimes tightening the eyelid is needed to correct droopiness or sagging. Adding fat or re-draping the fat is done to improve a hollowed appearance.


Will my medical aid pay for my blepharoplasty?


Medical aids will not pay for purely cosmetic procedures. Depending on the medical aid scheme and option you have chosen, if your vision is impaired by excess eyelid skin, your medical aid may consider funding part of the procedure. You will have to consult an ophthalmologist for a visual field test before you approach a plastic surgeon to address this condition.


What can I expect post-surgery?


Ice pads or cold compresses are required for the first 12 to 24 hours.

Maximum discomfort should occur in the first 48 hours and will improve each day thereafter.

Expect moderate swelling of the eyelids, tightness of the lids, bruising and perhaps a mild dryness, burning or itching of the eyes.

You may have a minor discharge in the corner of your eyes for approximately one week.

For the first few weeks, you may experience excessive tearing, a sensitivity to light or blurred vision. This is mostly caused by the tear replacement gel prescribed to protect the corneas.

You may have difficulty closing your eyes when you sleep. This is due to the swelling and will improve within a short period of time.

Bruising and swelling of your eyelids may last one to two weeks.

Healing is a gradual process and your scars may remain slightly pink for three months or more.

Tiny whiteheads may appear after your stitches have been taken out. These can easily be removed by your surgeon at your follow-up appointment.

After the first two weeks post-op, you should feel confident enough to go out in public with some camouflage make-up (depending on your bruising. The final result will be visible in four to six weeks.

By opting for our Rapid Healing Programme, you can reduce downtime by up to 50%. Contact 021 851 3400 for more information.