Natural changes in the upper and / or lower eyelids typically associated with ageing and genetic predisposition can result in loss of tissue elasticity, sagging skin, folds and distortion to the natural contour of the eyelids. Natural fat pads in the upper and lower eyelids tend to droop causing puffiness and bags above and  / or under the eyes. In more severe cases, the heaviness of the upper eyelids can sometimes interfere with visual fields affecting the function of the eye.

 

Surgery of the eyelids can rejuvenate the appearance of the eyelids and improve the function. 

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Forehead and eyelids often function as one unit. Heaviness of the tissues in the upper eyelids can make the forehead muscle work very hard to pull the weight off the upper eyelids so that one can see better. It would be vital for patients who request eyelid surgery to have their foreheads examined to rule out what is called compensated brow ptosis to ensure the correct choice of surgical procedure. 

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Blepharoplasty (eyelid lift surgery)

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Blepharoplasty is a procedure that tightens the structures of the eyelids. Sometimes small improvements might make a huge difference in the appearance and function of the eyelids. The surgery can correct the sagginess, puffy bags and weight restoring more juvenile appearance and better function. The excess tissue of the upper eyelids often hangs over the natural creases and in severe cases can impair the visual field when we look up. Upper blepharoplasty procedure can improve this. 

Modern techniques concentrate on removing less tissue as removing too much will make the eyes look older a lot faster. 

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Browlift 

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Eyebrows undergo gravitational changes and can drop with time. This can be caused by gravitational change, genetic factors and aging. Browlift can improve the appearance of the forehead creases and lift the heavy eyebrow resulting in rejuvenated appearance of the forehead and brows. 

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What to expect from the consultation

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During the consultation, you will be asked about your desires, what you wish to achieve and anything related to the appearance of your eyelids or forehead that you feel is important to you. This will help the doctor to understand your expectations and determine whether they can realistically be achieved. You will be asked about your medical history, eye disease, family history, current medications, drug allergies, smoking, previous operations or non-surgical treatments.

 

There are a few medical conditions that make surgery difficult. These are thyroid problems, dry eye or lack of sufficient tears, high blood pressure or other cirulatory disorders, cardiovascular disease and diabetes. Other conditions such as glaucoma, myastenia, detached retina are also reasons for caution. We might request eye examination prior to proceeding if there is any concern. 

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Before deciding for surgery, it is important to think carefully about what you desire to achieve to be able to discuss this with the surgeon. 

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During the consultation you will learn what the surgery can or cannot achieve and what are the limitations and risks. You will be able to discuss all your specific concerns. 

 

Medical photographs might be taken as well. You will receive a letter summarizing the consultation along with surgery fees. 

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Clinical psychology or ophthalmology consultation might be suggested in order to better assess your expectations and the degree the problem is affecting you. Joined effort from multidisciplinary team helps to improve the overall outcome of surgery. 

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What does the surgery entail

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Depending on the procedure, incisions are placed in natural creases to ensure the scars are as inconspicuous as possible. In the upper eyelids, the incision is typically placed in the natural crease above the eyelashes. In the lower eyelids, the incision would typically sit below the eyelashes. Both incision would typically extend laterally to the side following natural crease lines. Scars usually settle down well. At times, tightening of the lower eyelid (lateral canthopexy) might also be required depending on the degree of laxity of the lower eyelid. 

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Incisions are closed with very fine removable sutures. 

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Depending on the procedures, blepharoplasty can be carried out under local or light general anaesthetic and is typically done as a day case. Recovery takes 2-4 weeks. You will require a nurse appointment a week after surgery and consultant appointment in 4 weeks or earlier if required. 

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Risks and implications will be discussed in detail during your consultation. 

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