In your first appointment with a Dr Young, you should clearly explain your expectations of the blepharoplasty surgery and how you would like to look afterwards.
Careful discussions regarding your reasons for wanting eyelid surgery are very important at this stage. Make sure that you obtain as much information as necessary to enable you to make a fully informed decision about whether to go ahead with the surgery.
He’ll also ask for your medical history to make sure that there are no reasons why you shouldn’t have eyelid surgery. At this point, you would also normally be asked to sign a consent form indicating that you have understood the future benefits and possible risks associated with the procedure.
Photographs of your eyes may also be taken by the practitioner, for a “before and after” comparison later. Before your blepharoplasty surgery, Dr Young may require you to be examined by an ophthalmologist (specialist eye surgeon) to test for glaucoma (a disease affecting your eyesight) and to make sure that you have no problems with tear production.
The blepharoplasty operation is generally performed under a local anaesthetic, but some patients are given sedation via an intravenous drip. In rare cases, a general anaesthetic can be used.
As in any surgical procedure, the use of a general anaesthetic carries a small additional risk which your practitioner will discuss with you. No form of anaesthetic will be given to you without your surgeon discussing it with you first.
The eyelid surgery is usually performed in an outpatient surgical centre.
Blepharoplasty is usually performed under a local anaesthetic, and eye drops are used to anaesthetise the eyes, then protective contact lenses may be placed over the eyes during the surgery. When the anaesthetic has taken effect, a mixture of adrenaline and lignocaine (a local anaesthetic) is injected into the eyelids before any cuts are made by the surgeon.
Upper eyelid blepharoplasty involves cutting along the eyelid crease, in the natural skin fold of the eyelid.
The cuts for both upper and lower lid procedures can be made with either a surgical scalpel or a laser. Then, excess skin is removed and a thin strip of muscle is also taken out to give the eyelid crease more shape. Next, unwanted fatty tissue is removed and the cut is then closed with a single layer of stitches, hiding the scar inside the natural fold of the upper eyelid.
Two most common methods of performing lower eyelid blepharoplasty
- through a direct cut made just below the lower lashes. The surgeon lifts the skin and muscle to remove a small amount of fat. Excess skin and muscle are then trimmed from the lower lid
- a technique called transconjunctival blepharoplasty may be used if you have a pocket of fat beneath your lower eyelids, but do not have any loose skin. It is usually performed on younger patients who have fat pads that push out through the eye muscle wall into their lower eyelids.
The transconjunctival method leaves no obvious scars. The cut is closed with self-dissolving stitches or is left to heal naturally. In addition to this eyelid surgery, a lid tightening procedure may be recommended and can be performed at the same time.
A newer procedure sometimes used is the so-called S.O.O.F. lift. This is an abbreviation for a procedure which lifts the Sub Orbicularis Oculi Fat (SOOF) pad (the fat in the eyebags).Usually in standard blepharoplasty operations, the fat pads inside the eye bags are removed along with any slack muscle tissue.
If you choose to have a S.O.O.F. operation, the fat is put back behind the muscle underneath the eye instead of being removed completely. If too much fat is taken away, the eyes can take on a sunken appearance.The S.O.O.F. technique avoids this as the fat is not taken away.
A blepharoplasty operation takes about 2 to 2 1/2 hours for the upper and lower lids on each eye to be treated. If you are having another procedure, such as a facelift, at the same time, then an overnight stay in hospital may be required. Otherwise, patients can usually go home after eyelid or eyebag surgery on the same day as their operation.