BLEPHAROPLASTY

What is a blepharoplasty?
Blepharoplasty is an operation designed to correct the effects of ageing to the eyes and eyelids. As we get older, the effects of sun damage as well as the natural ageing process leads to the skin of the face losing its elasticity and tightness and gravity effects can cause some degree of sagging, particularly around the eyes and cheeks. Skin wrinkling is a result of these factors. Operative procedures, such as blepharoplasty are designed to correct these effects.

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The changes result in a more youthful facial appearance. The removal of the loose skin and fatty pouches below the eyes improves that "tired look". Blepharoplasty has a very high patient satisfaction rate.

How is the operation performed?
Through incisions or cuts in the upper and lower eyelids, excess skin of the eyelids is removed as well as adjustment made to the underlying tissue of the upper and lower eyelids. Some excess fat tissue may be removed from the eyelids and the fat of the lower eyelids may be redraped down onto the cheek. This will smooth the eyelid contours, correcting bulging of the lower lid which often causes a noticeable groove between eyelid and cheek.

How long does the operation take?
The operation takes 1 to 2 hours, depending on the extent of each case.

Do I have to stay in hospital?
No. The operation is performed under general anaesthetic on a day surgery basis.

What happens after surgery?
Following the operation, your eyes will be covered by a padded dressing for several hours. Your eyes may feel strange and a little tight and some pain along the incision lines may be experienced. Simple pain relief you will have prescribed should adequately deal with this.

You will have stitches along the incisions which will be removed at seven days. You should avoid overactivity and bending over for 2-3 weeks after the operation. There may be excessive tear formation and sensitivity to bright light for the first few days after surgery.

When can I return to activities?
Considerable bruising and swelling over the first week may be encountered. This can be expected to settle rapidly over the first week and will usually have completely resolved by the end of the second week. Generally speaking you will be confident and happy to engage in social contact by about the second week following surgery although this varies with each patient.

Are there any risks?
As with any surgical procedure, there is a small risk of complications. Surgery and anaesthesia are very safe and it is most unlikely you will experience any difficulty. However, there is a small chance that a minor complication such as bleeding or infection may occur.

Bleeding: Bleeding is the most likely problem that may occur after blepharoplasty. It can be problematical in about 2-3% of cases. It is most likely to occur immediately following surgery or that evening. It is possible in cases of persistent problematical bleeding that return to the operating theatre will be required.

Infection: Infection following blepharoplasty is very uncommon due to the superior healing qualities of the facial areas. If infection occurs it will become evident within one week of surgery. This may require treatment with antibiotics. In the unlikely event of infection, the ultimate result of the surgery may be adversely affected.

Scars: Incisions used for blepharoplasty are placed where they blend into the natural lines of the upper and lower lids. For the first few weeks the scars may be pink and slightly thickened. Scarring following surgery may take up to two years to fully mature and can be expected to be minimal and unnoticeable. However, while great care will be taken to give the neatest incision closure possible, individual wound healing can be unpredictable and it is possible that you may be unhappy with some aspect of your incision lines. Although rare, hypertrophic scars (widened or thick) and keloid scars (overgrown) can occur in some cases.

It is possible for scarring around the eyelids to result in tightness and tethering. Tightness of the lower eyelid can occur in the early healing period resulting in widening of the eye or slight turning out of the eyelid (ectropion). This can be expected to have resolved by six weeks following surgery and can be helped by regular massage. Permanent ectropion of the lower eyelid can rarely occur . Entropion, where the eyelid is turned in, is less likely although can also rarely occur.

Swelling: Swelling of the eyelids can affect contour for some months and during this period of settling, improvement in eyelid contour can be expected. It is likely that close scrutiny of your eyelids following the procedure may reveal some small irregularity in contour or symmetry.

Vision: Some blurring of vision is not uncommon in the early post-operative phase due to swelling.

Anaesthetic: You will be receiving a general anaesthetic and your anaesthetist will be discussing with you possible discomforts following anaesthesia. Anaesthesia today is very safe and the chance of any problem is very low. Any questions you have regarding your anaesthetic would be best answered by your anaesthetist at the time of surgery.

General Information
It is important to remember that healing continues for some time following surgery . Rarely, the final result may not be what you and Dr Drielsma anticipated. Minor irregularities usually can be corrected with a revision procedure.

You should avoid smoking for at least three weeks before and after surgery to assist the healing process. You should also not take aspirin or aspirin containing medications for two weeks prior to surgery.

Should there be any questions regarding blepharoplasty, be sure they are answered in advance by Dr Drielsma. Well meaning friends are not a good source of information. Find out everything before proceeding with the operation - a well informed patient is a happy one.

Finally, there can be no absolute guarantee with any surgery. Remember, the realistic aim of this operation is improvement, not perfection.

Please note: The above information mentions only some of the benefits and complications of a blepharoplasty. This information should not be regarded as a substitute for information and advice provided by Dr Drielsma during consultation.