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The operation to correct ageing of the eyelids is known as Eyelid Surgery.
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Our eyes are the most important feature on our face and their beauty can be greatly reduced by excess skin creases and eye bags. There are several factors contributing:
A) Heredity is an important factor where young or middle-aged patients may exhibit changes which are usually associated with older age.
B) The bony structure of the face. Slightly under-developed malar bones provide insufficient support to the lower lids and may lead to appearance of lower lid bags in the young patient, as well as a low position of the lid.
C) Exposure to sunlight or ultraviolet rays is also damaging to eyelids, both due to the direct effect on the skin and overactive muscles from frequent squinting.
D) The normal ageing process involves the stretching of the eyelid skin which results in excess folds and wrinkles and the sagging of the fat around the eye itself which appears as bulges in the upper and lower lids.
Unfortunately, it is never possible to eradicate all eyelid creases, for to do so would invariably produce an over correction, due to excess tension on the eyelids. Eyelid Surgery removes excess skin and bags to give the eyes a fresher look but will not remove the wrinkles or laughter lines from the sides of the eyes.
Malar bags (bulges high on the cheek bones) are also not corrected in this procedure.
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As people age, the eyelid skin stretches, muscles weaken, and fat accumulates around the eyes, causing "bags" above and below.
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After surgery, the upper eyelids no longer droop and the skin under the eyes is smooth and firm.
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At your consultation you will be asked your general medical history with details of any previous Eyelid Surgery and you will also be asked about possible thyroid or kidney disease as these can cause swelling of the eyelids.
Slight differences in facial symmetry are normal and are usually pointed out as they are often unnoticed by the patient. The surgeon will describe the positioning of the scars and indicate the likely postoperative results.
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Eyelid Surgery can be carried out both with local anaesthetic and sedation or under general anaesthetic. They are usually performed as day case operations. This procedure is often carried out at the same time as a facelift giving excellent overall results.
The incision for the upper eye is the natural crease line approximately one centimetre above the eyelashes and extends out into the ‘crow's foot' area. The excess skin is trimmed, any fat usually present in the adjacent area to the sides of the nose is removed and the lid is then sutured using one continuous stitch. The incision for the lower eye is just below the eyelashes, again, extending out into a natural laughter line. The tissues are then elevated and hinged forward and excess fat removed or redraped.
The skin is then lifted upwards and outwards gently tensioning the area and removing the overlapping skin and suturing to close. Sometimes the lower lid Eyelid Surgery can be carried out without external scars if the skin excess is minimal.
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Before surgery, the surgeon marks the incision sites, following the natural lines and creases of the upper and lower eyelids.
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Underlying fat, along with excess skin and muscle, can be removed during the operation.
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Sutures will be removed at the surgeon's discretion three to seven days post operatively. It is important not to stoop or carry out vigorous activities for two or three days, otherwise postoperative bleeding could result. The eyelids should be gently splashed with water and not rubbed in any way. It is advisable to apply antibiotic eye ointment for three or four days and eye makeup should not be used for the first week or two. You may also be comfortable using artificial tears for the first few days. Discomfort around the eyelids following Eyelid Surgery may be controlled by mild analgesics such as Paracetamol (Aspirin must be avoided).
The scars may appear pink for some weeks, occasionally months, although they are easily disguised with makeup. The scars in the ‘crow's feet' area may become lumpy for a period but these invariable flatten with a period of time. This may be helped by gentle massage, starting three to four weeks post operatively. Complications after Eyelid Surgery are rare.
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The surgeon closes the incisions with fine sutures, which will leave nearly invisible scars.
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After surgery, the upper eyelids no longer droop and the skin under the eyes is smooth and firm.
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Most are temporary i.e. excess tears or abnormal pigmentation of the eyelid skin. As after any surgery, bleeding and infection can occur. Bleeding might require a return to the operating theatre to avoid damage to the eye, whilst an infection is usually readily treated with antibiotics. Occasionally, what appears to be a transparent sack of fluid develops and covers part of the eye. This looks quite frightening but you should not be alarmed as this will not settle on its own. A scratch on the cornea (surface of the eyeball) while not serious, can be irritating and may take several days to heal.
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Eyelid Surgery is one of the most popular aesthetic plastic surgery procedures. The results are significant and give a freshened appearance to the eyes, however it rarely produces smooth, crease-free eyelids. Following Eyelid Surgery, you may not be able to wear contact lenses for some time and should discuss this possibility with your surgeon.
Do bear in mind that you will require glasses of a suitable prescription during the early post-operative stage of your treatment and – most essential – a large pair of sunglasses.
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You can expect to have some bruising and swelling following this surgery, particularly during
the first two days. You may use gel eye packs, or ice packs (you should not place the ice
directly on the skin as this may burn, but instead place it in a clean cloth or flannel)
intermittently to the eyes for comfort, and this will also aide in reducing swelling. Try to rest
in an upright position as much as possible, as this will also help to reduce any bruising and
swelling. If you feel that your bruising is more significant on one side, or there is a change in
your vision, you should ring Mr Ion’s practice nurse or the hospital immediately.
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| Your stitches will be covered with small strips of tape, these should stay in place until your
first follow when the sutures will be removed. (This is usually at 5 days following the
surgery)
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You will be discharged from hospital with some eye ointment, this will cover you for 5 days,
and normally there is no need for further use. You may also be discharged with some
antibiotics and it is important that the whole course is completed.
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Strenuous exercise or anything that is likely to increase your blood pressure should not be
resumed for 3 weeks. Try also to avoid leaning or stooping forward, and straining following
surgery as this will reduce the risk of a secondary bleed.
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You can resume your normal diet, and if taking regular pain medication other than
paracetamol, we recommend that you eat plenty of fresh fruit and vegetables to avoid
constipation, or commence taking a gentle laxative.
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Please avoid taking aspirin/anti inflammatories as these can cause bleeding. You may
recommence your usual medication as soon as you can eat or drink unless otherwise advised.
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During office hours you are welcome to telephone or visit Mr Ion’s nurse at the consulting rooms.
Please call her prior to your visit on 0207 486 77 57.
In an emergency or in case of doubt regarding your surgery and post operative condition, out of office
hours, please contact Mr Ion’s nurse on 0774 96 44 519 or the hospital where you had your surgery:
The Wellington: 0207 586 5959
The Cromwell Hospital Resident Medical Officer: 0207 460 2000
St Luke’s Hospital: 0207 388 4954
The Hospital of St John & St Elizabeth 0207 806 4000
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NEXT: More Information
If you would like to know more information on Eyelid Surgery,
please do not hesitate to get in touch.
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The Complete Article
About the Procedure
Informative Brochure
