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Blepharoplasty (eyelid surgery) – the in’s and out’s

Dr Hanikeri offers a range of surgical procedures for the breasts, body and face.

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If your friends and acquaintances are saying you look tired and you want a more rested appearance, eyelid rejuvenation surgery may be of benefit to you. With ageing, genetic factors, combined with sun exposure, gravity and muscle activity, this often results in eyebrows dropping and loose, puffy skin hanging over our eyelids.

Eyelid surgery, also known as blepharoplasty, aims at addressing these issues in both the upper and lower lids to result in a more relaxed and refreshed appearance. Sometimes, the elevation of the eyebrows (brow lift) could also be recommended to enhance the cosmetic results. Eyelid surgery is one of the most common cosmetic surgery procedures. It can be performed in both women and men and is often combined with other facial aesthetic procedures. In some cases, eyelid surgery is the recommended surgery because the loose upper eyelid skin hangs over the eyelids and interferes with vision.

There can also be a rash in the folds of skin due to accumulation of sweat and irritation. In these cases Medicare rebates, and therefore private health insurance, may apply reducing significantly, the costs of surgery.

Similarly, if there is significant laxity in the lower eyelids, this can lead to a condition where the eyelid starts to turn outwards (ectropion). Again, rebates may apply if this is the case. If the skin on the upper or lower lids is excessive, but not causing these types of functional issues, the surgery to correct this is considered cosmetic and Medicare rebates will not apply.

Whilst lower eyelid surgery can eliminate puffy eye bags and dark shadows, if dark circles under the eyes are caused by skin pigmentation, lower eyelid surgery will not correct this. Whilst the fine lines and wrinkles on the lower eyelids will be corrected with lower eyelid rejuvenation, the skin is not typically changed significantly, so fine lines and wrinkles may recur depending on skin, lifestyle and genetic factors.

Some people get upper and lower eyelid surgery at the same time. Whilst this may reduce the overall cost of surgery and be associated with only one period of recovery, it can increase significantly the bruising, swelling and fluid accumulation that accompanies this type of surgery and may prolong the recovery. Some people choose to have the upper and lower lids done separately to reduce these risks and speed up their recovery.

In most cases, eyelid surgery is performed under “twilight” sedation. However, upper eyelid surgery may be carried out under Local Anaesthesia alone. Lower eyelid surgery can also be performed in this way in selected cases. If patients prefer, a General Anaesthetic can also be offered.

All surgical procedures have some risk, however, complications from eyelid surgery are rare and if they do occur, are usually minor. The results from eyelid surgery generally are long lasting and it is unusual for the surgery to need to be redone, however with time, there will usually be some dropping of the eyebrows, which may result in recurrent hooding over the eyelids. In most of these cases, a brow lift rather than a secondary eyelid reduction would be recommended. The scars from eyelid surgery are often difficult to see as they are usually hidden within existing skin creases.

The majority of patients following upper eyelid surgery return to work within one week and are back to full activities after 10 -14 days. At that stage, the bruising is usually minor and can be camouflaged with makeup. Lower eyelid surgery may require an extra week or two for the bruising and swelling to fully recover. If upper and lower eyelid surgery is performed together, recovery may take up to 6 weeks.

Before surgery, it is recommended that patients have an ophthalmologic examination. They should also stop smoking at least 4 weeks before surgery and make sure that their health is optimised. Any blood thinning medications or supplements should be ceased in discussion with their surgeon and their GP.