 Eyelid Surgery
Aesthetic eye surgery (blepharoplasty) is required to remove the excessive build-up of skin, which causes the patient to have a tired and heavy look and can also reduce the field of vision. Rightly or wrongly, the amount of ´spare´ skin around the eyes determines to a great extent the impression given of youthfulness and well-being from one person to another. You only have to see how caricaturists accentuate excess skin and bags to bear this out. Upper eyelid surgery allows the full eye to be seen - and allows ladies to use eye shadow without the smeared look. Lower eyelid surgery concentrates on reducing the signs of tiredness and stress and can also be operated on to remedy the ectropion look. This is when the eye bulb itself is not being held firmly in its socket, a common problem for older people, allowing the conjunctival lining to be seen during eyeball rotation. Additionally, wind and dust can enter the socket which then becomes red with irritation. Surgery ensures a ´correct fit´. Another simple surgical procedure is carried out when the eyelid allows the lashes to touch the eyeball causing pain and irritation of the conjunctiva and the cornea. Called entropion, the lids are re-aligned to keep the eyelashes away from the eyeball and to avoid infection. Finally we have ptosis. This is when one or both lids droop and hang over and cover part of the pupil. Caused by weaknesses of the upper eyelid musculature - or ´elevators´. Adults can develop the condition through muscle disease. The corrective procedure can be carried out to restore the full field of vision, or for cosmetic improvement or both. New-born babies can be born with ptosis and if the vision is impaired surgery should be carried out without delay. Why Eyelid Surgery?
Upper eyelid plasty is required to deal with a build up of skin or fat or indeed a combination of both. Sagging upper eye lids can also be caused by oversized brows pushing the skin down. Once determined, the problem is easily rectified. Lower eyelid plasty deals with the bags which form under the eyes and reduces wrinkles caused by an excess of loose skin. Ectropian surgery corrects the ill-fitting eyeball, and eliminates to a great extent the discomfort of over-sensitivity to draughts and wind. Entropian procedure corrects damage and discomfort to the cornea by ´rogue´ eyelashes. Surgery to correct the ptotic eyelid is carried out both for cosmetic reasons and to ensure clear, unobstructed sight. Often, the problem intensifies when the patient is tired - say in late evening, making reading more difficult. Children suffering ptotic eyelid need the remedial procedure as early as possible to enable them to develop normal vision. The Surgical Process
All these procedures are carried out under local anaesthetic with the exception of young children having ptotic surgery which would be under a general anaesthetic. We recommend (though not essential) that eyelid plasty be carried out together with a sedative which allows the patient to fully relax. The operation takes between 45 and 90 minutes depending upon the severity of the build-up and whether the lower lid surgery is carried out at the same time. The local anaesthetic is administered within a couple of minutes. Thereafter, the surgery is painless. When the effects of the anaesthetic wears off, some soreness will probably be experienced, but never any real pain. Some skin, muscle and fat is removed and some worked upon in all blepharoplasty procedures. In ptosis, the muscles controlling the upper eyelid are shortened, as is the lower eyelid margin in ectropian surgery. For entropian operations, skin may be removed and the rim tightened so that eyelashes are correctly directed away from the eyeball. Healing
The thin skin of the eyelid heals quickly. As the skin is so thin and the tissue around the eyes so loose, bruising and ´black eye´ develops easily. Swelling will typically occur during the first 2 or 3 post-operative days. Stitches are removed after 5 to 7 days. Other forms of eyelid surgery are usually less eventful. Convalescence
After 1 week, the eyelids are still visibly swollen and some signs of bruising remain. After 10 to 12 days post-operative swelling and discolouration have disappeared. Two to 3 months later, the eyelids have returned to normal in every respect, save some minor insignificant scars. After ptosis surgery, the eyelid is immediately elevated and the pupil uncovered. Complications
At least one good black eye is a normal part of the convalescence period. Swelling too, with narrow slits for eyes for a couple of days. By the fourth day, the eyes are usually wide open again. More unusually, exaggerated swelling caused by bleeding can be more of a complication. The conjunctiva can - very rarely - pick up the bleeding and appears as ´sharp red eye´. In my 25 years specialising, I have never experienced blindness following blepharoplasty, although very rarely, some cases have been reported in the professions journals. Careful preparation and skilled surgery is the key in avoiding complications. Infection is very rare in eyelid surgery and no serious threat. A minor and benign complication is the formation of tiny whitish pearls in the scar. These are easily removed with a needle point. The Result
Upper and lower eyelid surgery (blepharoplasty) is very popular and produces excellent results. After healing, the face shows a fresh and wide-awake look. Those with over-heavy upper eyelids and blinker-like skin folds will enjoy a restored wider field of vision. After the removal of bags, the patient will appear healthier and less worn out. Following ptosis surgery, the patients eyes will be more symmetrical, and the need for tilting the head back to increase vision disappears. Ectropion surgery cures the red and irritated rim of the lower eyelid. The entropion procedure stops the ´rogue´ lashes from damaging the cornea. |
