63 years old Chinese female with hypertension and hyperlipidemia presented to Dr Pek with significant droopiness of her upper eyelids on both sides, affecting the upper portion of her visual field. She would constantly feel that her upper eyelids were heavy, and more importantly, she would appear to look constantly tired and sleepy even after a good night’s sleep. The puffy appearance of her lower eyelids and eyebags also worsened her tired appearance, and these eyebags would not go away despite having tried different eye creams or masks.

On clinical examination of the upper eyelids, she was found to have significant excess eyelid skin (Dermatochalasis), which had drooped downwards to affect her vision. This was more significant over the lateral half of her upper eyelids (lateral hooding), which typically gives a sleepy appearance. For her lower eyelids, she had puffy eyebags, which signified excess lower fat tissue just under her lower eyelids. There was also mild droopiness of her bilateral eyebrows, and she had to use the muscles above her eyebrows on the forehead (frontalis muscle) to elevate them all the time, causing excessive wrinkling. These observed ageing changes contributed to a tired and haggard appearance, which the patient wished to correct.

After a detailed examination and discussion with Dr Pek, the patient had agreed to undergo an upper eyelid lift, lower eyelid scarless eyebags removal and Morpheus8 peri-orbital skin tightening procedures to simultaneously address her concerns in a single surgery. The relevant risks and benefits of the procedures were discussed at length prior to her agreement to surgery. 

The surgery was performed as a day surgery procedure at our Polaris Day Surgery Facility @ Camden Medical Centre, and it took less than 3 hours to perform all procedures combined. For the upper eyelids, excess skin and soft tissue were removed, and the upper eyelid skin and muscle were lifted. At the same time, the brow position was fixed at a higher position; these surgical corrections contributed to a more rejuvenated appearance of her upper eyelids. For her eyebags, a scarless eyebag removal procedure was performed through a trans-conjunctival approach (through the inner side of the lower eyelid), where meticulous and careful dissection was performed to remove excess eyebag fat. This procedure leaves no external scars on her lower eyelids. Finally, Morpheus8 skin tightening procedure was performed on the lower eyelid skin to allow for smoothening of the lower eyelid skin.

Post-operative recovery was smooth and uneventful. The patient experienced mild pain for the first couple of days, and only required simple oral painkillers for the first day. The sutures were removed on the 6th post-operative day, and most of the swelling and bruising subsided after the first two weeks. The overall youthful appearance of her upper and lower eyelids was more apparent as the weeks passed, and the patient was very satisfied with the outcome of her surgery. The surgery helped her to see better, as she managed to regain sight of the previously blocked upper visual fields. The patient also reported that she looked better in photographs and during online meetings.