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BLEPHAROPLASTY
What is Blepharoplasty?

Definition:

Changes in the eye lid caused by droopy or saggy skin as well as bags around the eye can be corrected by eye lid surgery or blepharoplasty. Upper and lower eye lid can be corrected simultaneously and the procedure rejuvenates the eye. Protruding fat and excess skin can be addressed simultaneously by excision.

Eyelid surgery, or blepharoplasty (BLEF-uh-ro-plas-te), repairs droopy eyelids by removing excess skin, muscle and fat. To help decide if this surgery is right for you, find out what you can realistically expect and explore the benefits and risks involved.

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When Should Surgery Be Done? 

Younger patients undergo surgery because of the fat deposits protruding through the wall orbital septum either in the upper or lower lid, making the eyes look dull and tired.
Older people normally have age changes such as excess eye lid skin with and without protruding fat. Most patient seeking surgery wants a rejuvenated appearance that require re establishing   the normal architecture of the eyes that was present when they were younger. Some also have restricted vision because of droopy lids, although more common in women, it’s also performed on men as well.
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How Is The Operation Done?

Marking of excess skin and fat bulges is done in a standing position. The surgery can be done under local or general anesthesia and the incision is made in the natural crease of the lid. The excess skin is removed and the fat excised or relocated and the incision closed by sutures. This leaves a very thin scar in the area which fades over time.

Surgery on the lower lid depends on the preoperative condition. Bulging fat from lower lid without excess skin is treated by a transconjunctival blepharoplasty (Scar less and stitch less). Excess skin and muscle require excision of the same and will leave a scar very close to the edge of the lid. Some time there may be too much laxity of the lid exposing the conjunctiva and causing tearing which may require tightening of the lid in the horizontal direction at the corner of the eye called canthoplasty.

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Post Operation Care

Ice application over eyes keeps bruising and swelling down and sutures are removed in 5 days time. Local antibiotic cream and eye droops are prescribed. The bruising can be covered by a make up and sunglasses.
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Risk of Operation

Due to scar contraction, rarely there is pulling of lid downwards called ectropion. Dryness of eyes and visible scarring are rare.
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Result of Surgery
A fresher and more youthful appearance of the eyes with reduced bags and pouches is the norm. Some actually experience an improvement in their eye sight as a result of removal of excess skin.

Crows feet may be less visible but can only be improved further by laser, chemical peel or botox.
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After Care:

Need a Lubrication ointment at night to prevent dryness and irritation.
Sutures are removed in 5-7 days.
Wound Care- Upper blepharoplasty incision may be cleaned with dilute peroxide and coated with bactroban or Neosporin ointment using a Q-tip applicator twice a day.

Activity – Avoid exercise and activities that increase heart rate or blood pressure significantly for first 7 -10 days. Elevate the head of the bed. Ice application over your eyes off and on much as possible every hour for a day will help.
Special Instruction – Contacts may be worn after about one week. Bloody tears and drainage are normal, especially the first few days.
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