Frequently asked questions about eyelid "bag" removal (blepharoplasty)
What can be done by about eyelid skin excess / bags?
Will there be scars after blepharoplasty surgery?
How do I prepare for blepharoplasty eyelid surgery?
What does blepharoplasty eyelid surgery involve?
What should I expect in the recovery period after blepharoplasty surgery?
Is blepharoplasty eyelid surgery safe?
How do I arrange a consultation with Mr Hamilton in London, UK?
What can be done about eyelid skin excess or bags?
By blepharoplasty, the loose skin and bulging fat which gived the appearance of bags on the eyelid is tackled. Usually, the excess skin is removed and the fat is either removed or repositioned to correct the apparent bulging. These problems can affect the upper or lower lids, though very often affect both.
In some patients, drooping of the forehead itself (“brow ptosis”) is a major factor (where the eyebrows have come to sit lower than usual) and may be better corrected by a brow lift (where the brow skin is elevated by means of small, hidden incisions in the scalp).
Will there be scars in blepharoplasty surgery?
Usually, yes - on either the upper lid hidden in the skin crease or on the lower eyelid hidden just below the lashes. Fortunatey, eyelid scars heal very well and in the majority of people are all but invisible once healed. Occasionally the scar on the lower eyelid can be hidden inside the lid.
How do I prepare for blepharoplasty surgery?
It is important that Mr Hamilton is aware of any medication you may be taking or of any pre-existing health problems. These will be discussed at consultation.
It is important to avoid taking “non-steroidal anti-inflammatory” painkillers like aspirin, diclofenac (Voltarol) and ibuprofen (Brufen) for 2 weeks before surgery since these can increase the degree of bruising and the risk of bleeding. Similarly, for smokers it is helpful to stop for at least 2 weeks (and ideally 4) before surgery and a week or two after surgery to reduce the effect on the blood supply to the tissues.
What does blapharoplasty eyelid surgery involve?
What type of anaesthetic is used in correcting baggy eyelids?
In correcting eyelid bags, usually a general anaesthetic is given by one of our experienced consultant anaesthetists, meaning that you will be asleep throughout the procedure. The operation can occasionally be carried out under local anaesthesia with or without sedation.
What happens when I come in to hospital for blepharoplasty ?
You will be admitted to the hospital on the day of surgery. Mr Hamilton will visit you in the ward to re-discuss the procedure. The surgery is usually carried out under general anaesthetic. Once you are asleep, Mr Hamilton will plan incisions on the skin and apply local anaesthetic to reduce the amount of general anaesthetic required and to ensure you are comfortable when you wake up. Usually, an incision is made in the skin crease of the upper lid removing skin above it to ensure the scar remains hidden post-operatively. Any excess fat bulging forward is removed and the incision very carefully sutured with a single pull-out stitch. On the lower lid, an incision is made just under the eyelashes and any bulging fat or skin excess addressed. Again, positioning the incision this way allows the resultant scar usually to be almost invisible. Occasionally, where the problem relates to bulging fat only, the procedure can be carried out from inside the lid with no external incision. The wound is then sutured and some paper stitches for extra support and a cool pad applied. You will then be gently woken up by our anaesthetist before being returned to the ward.
Do I need to do anything special before the surgery?
It is important that Mr Hamilton is aware of any medication you may be taking or of any pre-existing health problems. These will be discussed at consultation.
It is important to avoid taking “non-steroidal anti-inflammatory” painkillers like aspirin, diclofenac (Voltarol) and ibuprofen (Brufen) for 2 weeks before surgery since these can increase the degree of bruising and the risk of bleeding. Similarly, for smokers it is helpful to stop for at least 2 weeks (and ideally 4) before surgery and a week or two after surgery to reduce the effect on the blood supply to the tissues.
Recovery after blepharoplasty
Is it painful?
This kind of surgery is not usually very uncomfortable. By a combination of firm support and adequate painkillers, most patients have a fairly smooth postoperative recovery.
When can I go home?
Usually, you will be able to go home the following day. In some cases, where home circumstances make it desirable, patients decide to stay in hospital for an extra night.
What can I expect?
The eyes can feel a little gritty after surgery for a period. There is usually some minor swelling and bruising which will normally settle in the first week after surgery. You will be discharged home with some pain-relieving eyedrops and should rest for the next few days.
When can I go back to work?
Usually most of the swelling and bruising settles in the first week. Whilst some patients like to go back to work at that stage, the majority prefer to take about 2 weeks off to recover. Mr Hamilton will see you four or five days after surgery to remove the pull out suture. If the lower eyelid has been treated, it is then often supported with a little paper tape for a further week or so. Instructions will be given on exercises to minimise the risk of problems. The scars settle very quickly and makeup can be applied once the tape is no longer being used. The portion of the scar close to the eyelashes is often almost invisible within a few weeks whilst the part towards the crow’s feet can be a little slower to settle and might need to be covered with make-up or concealer initially.
Safety and potential risks in blepharoplasty
Fortunately, complications from this type of surgery are not common. Mr Hamilton and his team will take every precaution to minimise the likelihood of problems developing. This includes a careful pre-operative assessment, a friendly, honest opinion of your suitability for surgery and the best procedure for you and great attention to detail during your surgery and post-operative recovery.
The majority of complications from blepharoplasty are minor and they are typically a short-term nuisance rather than a serious setback or long-term problem.
- Haematoma (blood collecting in the wound, internal bruising) – this occurs occasionally and sometimes the blood has to be washed out after some stitches are removed and the wound re-sutured. When this does happen, it is almost always on the day of surgery and does not affect the eventual results of the operation.
- Gritty or watery eyes, especially in windy or cold conditions. This occurs not infrequently but is usually a minor nuisance which settles within a few weeks of surgery.
- Slow-settling scars occur in a small minority of patients, especially those with a tendency to raised or thickened scars. These scars settle with gentle massage and time and usually resolve within two to three months.
- Lower lid sagging or drooping may be seen just after surgery when the lid is swollen and heavy. Normally this settles as the eyelid recovers. In a small number of patients, further minor surgery may be required.
Summary
Blepharoplasty is a very common and successful procedure in facial rejuvenation, either on its own or combined with other surgery. In those patients with eyelid skin excess or bagginess it can give a very pleasing correction leading to a fresher, more rested appearance of the eyes.
Procedure time |
1-1½ hours |