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Aesthetic Procedures: Eyelids

Aesthetic Procedures: Eyelids

Aesthetic Procedures: Eyelids

Upper Eyelid Surgery (Upper Blepharoplasty)

Upper Eyelid Surgery-enchor
Whilst every individual is unique, there are commonalities in attractive eyes. They should appear bright and engaging, with proportionate dimensions to the rest of the face.
 
Upper blepharoplasty refers to surgery of the upper eyelid. It is performed to enhance the appearance of the eye as well as correct deformities. Depending on the individual’s requirements and desires, the upper blepharoplasty procedure is performed on complex anatomy of the upper eyelid, including the skin, muscles and tendons, ligaments, and fat, to achieve an aesthetically pleasing, lasting result.

Often, this would involve addressing the continuity of the upper eyelids with the brow and forehead to ensure a harmonious outcome. Sometimes, enhancement of the upper eyelid may also involve procedures to enhance the volume of the upper eyelid (see periorbital fat grafting) or to correct the position of the eyebrow (see browpexy). Our plastic surgeon will perform a thorough assessment and tailor the procedures according to your needs.

Types of upper eyelid surgery

There are many procedures that fall under upper eyelid surgery. These include:
 

What to expect during upper eyelid surgery

Many upper eyelid procedures are performed as day surgery under local anaesthesia. A small injection will be placed at the operative site and any pain recedes in seconds, and the procedure will proceed once you are ready. Depending on the complexity of surgery, upper eyelid procedures usually range from 45 minutes to 2 hours.

During the procedure, you may be sat up to check for symmetry. At the end of the procedure, you will be monitored for about an hour or so before being discharged. This is to help with any pain control and monitor for any immediate post-operative complications. Your comfort, safety, and satisfying outcomes throughout are our priority. Vision will not be obstructed by the procedure, though we would advise that a responsible individual accompany you after you are discharged.

After your upper eyelid surgery

You may be given eyedrops, antibiotics, and medication to help with pain, swelling, and reducing the risk of infection.

Pain usually starts once the effects of the local anaesthesia have worn off but is generally well-controlled with oral painkillers and lasts for 2 to 3 days.

Slight bruising and swelling at the surgical site are to be expected and will be maximal at 24 to 48 hours after your procedure. These can be managed by cold compress and medication. Much of the bruising and swelling will resolve around 2 weeks, and the final long-term result is usually seen at 2 months.

External sutures are removed 5 to 7 days after the procedure. Scarring is usually negligible and can be managed with topical treatment if required.

Your surgeon will always strive for absolute perfection and symmetry in one sitting. However, there may be slight asymmetries once the healing is complete. If these are obvious, they can be corrected with a minor procedure.

Potential risks and complications

Great upper blepharoplasty surgery should give you pleasing, lasting results, and is generally very safe when performed by a well-qualified plastic surgeon. Complications that occur with upper blepharoplasty are uncommon and very treatable. These include bleeding, infection, scarring, asymmetry, and dry eyes.

Very rarely, uncontrolled bleeding leads to the need for an expedient operation to prevent a hematoma compressing against the eyeball and its nerves, which when left untreated has led to permanent visual problems in isolated reports. You will also be monitored post-operatively to make sure you are safe before going home.

FAQs

What can I do to fix my uneven eyelids?

Uneven eyelids can be addressed through minimally invasive or surgical methods. You would need an assessment as to the cause and severity to see which method would be most appropriate for you.

Is double eyelid surgery painful?

Double eyelid surgery is commonly performed under local anaesthesia (LA), as it better allows intraoperative assessment if you are awake. LA involves using a small needle to instil gentle local anaesthesia to the upper eyelids and can be painful for a few seconds at the time of injection. After this and during the surgery, you will be very comfortable. After the anaesthesia wears off (usually a few hours after surgery), oral painkillers usually control the pain very well.

Why do my double eyelids sometimes disappear?

The upper eyelid is made up of delicate structures including very thin skin. Additionally, in East Asians the attachment from the levator muscle to the skin forming the upper eyelid crease may not be very strong. Hidden double eyelids usually occur when there is excess swelling of the upper eyelid, which can occur in the morning after waking up, poor sleep, crying, or other factors such as trauma.

Can double eyelid surgery change the shape of my eyes?

Yes, it can. The vertical aperture of your eye can be altered by tailoring the pull of the muscle on the upper lid margin, whilst epicanthoplasties can increase the horizontal dimensions of the eye, making the eyes appear longer.

How long can the results last?

If done well, upper eyelid surgery results last for many years. However, it does not reverse the normal effects of ageing, which may need to be addressed at a later stage.

What causes triple eyelids?

Triple eyelids are caused by excess upper eyelid skin and/or levator mechanism dehiscence. Both can be addressed through upper blepharoplasty.

What kind of doctor does ptosis surgery?

Ptosis surgery is usually performed by trained plastic surgeons or specially qualified facial plastic surgeons or oculoplastic surgeons.

Does Botox lift eyelids?

Botox can give a very mild lift or the appearance of lift to the eyelids by careful injection to the muscles opposing eyelid closure (the orbicularis oculi). When injected at appropriate points in the forehead, it can also help to improve the appearance of the brow, which can indirectly make the eyelid appear lifted.

Will health insurance cover eyelid surgery?

If performed for medical reasons such as functional ptosis or reconstructive purposes, eyelid surgery can be covered by insurance. There are strict criteria that need to be met, and your plastic surgeon will assess you and discuss the possibility of using insurance with you.


References
1. Chen WPD. Techniques, Principles and Benchmarks in Asian Blepharoplasty. Plastic and reconstructive surgery Global open [Internet]. 2019 May;7(5):e2271-11.

2. MD SS, MD SWP. Surgical Treatment of the Brow and Upper Eyelid. Facial Plastic Surgery Clinics of NA. 2015 May 1;23(2):167–83.

3. Park JI. Modified Z-epicanthoplasty in the Asian eyelid. Archives of facial plastic surgery. 2000 Jan;2(1):43–7.

4. Chae SW, Yun BM. Cosmetic Lateral Canthoplasty: Lateral Canthoplasty to Lengthen the Lateral Canthal Angle and Correct the Outer Tail of the Eye. Archives of plastic surgery [Internet]. 2016 Jul;43(4):321–7.

5. Mizuno T. Two modified techniques to decrease complications of buried suture double-eyelid blepharoplasty. British Journal of Plastic Surgery. 2013 Apr 1;66(4):e95–100.

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