What to expect during your consultation?
The success of the consultation depends on your openness and honesty in relation to what troubles you and your expectations of surgery. You will be asked questions about your health, desires and lifestyle. Different operations can be tailored to your needs and the potential outcomes and the risks and complications will be discussed with you. The operation often involves the removal skin and removal / reduction or repositioning of fat. The operation can be combined with other operations such as a midface lift or a brow lift.
Preparing for blepharoplasty surgery
Blepharoplasty procedures may be performed under either general or local anaesthetic. Your health is a prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us. You should ideally stop smoking 6 weeks prior to surgery and stop taking aspirin, anti-inflammatory drugs and herbal supplements before surgery. You may need preoperative tests prior to surgery, which we will arrange if required. You will generally experience bruising, swelling and discomfort following the surgery and should aim to be off work for at least 1 weeks depending on the type of work you do.
Blepharoplasty usually takes between 1 and 2 hours. For upper blepharoplasty an incision is made in the crease of the upper lid. For lower blepharoplasty and incision may be made on the skin below your lashes or within the eye. Skin is usually removed as required and the fat deposits may be reduced, removed or repositioned. The skin is sutured and some steristrips are often applied.
You will usually return to the ward within an hour following surgery. You will be able to drink and eat and mobilize. You will feel swollen and have bruising and discomfort that may require analgesia. You may be able to go home on the same day and should keep the wounds dry for the next week. You should keep your head upright and avoid hot baths. You will be given an ice pack to place over your eyes and you should keep this in place for the first 24-48 hours. You should arrange for someone to pick you up following surgery and have some support at home when you are discharged. You may experience either dry or watery eye and occasionally you will feel a sensation of grittiness for a few days/weeks afterwards. You should avoid wearing contact lenses for 2 weeks although for lower lid blepharoplasty this should be extended to 4 weeks. You will be reviewed in clinic and the eyes checked at a week and any stitches removed. The final results of blepharoplasty can take a few months to become apparent. The scars can be red initially but usually fade over time and usually fade to become a white line.
Risks and Complications
The vast majority of patients are delighted with the procedure although common complaints include bruising, swelling and dry/watery eye. Chemosis and conjunvitis are usually temporary but can occur especially with lower eyelid surgery. Uncommon complications include infection, haematoma / persistent bleeding, delayed healing/skin necrosis, irregularities, and thickened scars. It is also uncommon to have drooping of the eyes (ectropian) and although blurring of vision can occur permanent changes to vision such as double vision or blindness are extremely rare.
The pictures shows a patient who underwent upper and lower blepharoplasty. This lady developed chemosis and conjuncitivits and a slight drop of her lower lid a week postoperatively. She was seen weekly as this recovered and pictures are shown at 1, 2 and 3 weeks postop through the recovery phase. The final result is shown at a year for comparison.
Finally there are also uncommon risks of general anesthesia such as respiratory / cardiac compromise and deep vein thrombosis.