Eyelid correction (blepharoplastic) often resolves not only the aesthetic problem of swollen, tired or sagged eyelids, eye bags and sad, fired expression of your face, but also a health issue. When the eye lash of the upper eyelid exceeds its edge your field of vision is reduced.
Advantages of eyelid operation
In addition to the aesthetic effect there is the unquestionable health effect. The eyes are relieved and vision is improved across the field of vision. Your facial expression will refine, your tired, sad appearance will disappear. Another great advantage is the possibility of use of just local anaesthesia without the need for hospitalisation and quick return to normal activities.
Eyelid operation: your surgery
The intervention is usually performed under local anaesthesia applied by injection and takes less than an hour. Overall anaesthesia is exceptional and is usually connected with a combined operation.
The incision is made in the upper lid in its natural folds and continues as far as the fan-shaped wrinkles in the corner of the eye. After profound measurement and careful drawing on the skin the excessive skin is removed, sometimes together with excessive round eye muscle. Then the fat bags under the lids are removed if needed. The skin is sutured with a fine thin suture and fixed with thin adhesive plaster.
In the bottom lid the incision is made as near as possible to the bottom lashes without damaging their roots and ended in the fan shapes wrinkles in the corner oft he eye. Like in the case of the upper lid the fat bags are removed and the sagged eye muscle is tensioned. Excessive skin is removed and the wound is sutured like in the case of the upper lid.
Eyelid operation: methods
Laser assisted blepharoplastic
Operations of upper and lower eyelids may be preferably combined with use of fraction CO2 laser.
The laser lightly tensions the skin surface and removes small wrinkles which further improves the effect of the operation of the upper and the lower eyelids. Laser can also make the incision in the bottom lid not in the skin as usual but in the conjunctiva inside the eye. Thus no scar will develop on the outside of the eye. This variant is limited to small lower lid skin sag and is recommended to be performed under overall anaesthesia.
Eyelid operation: recovery
You can go home soon after the intervention, with dark glasses on and preferably with accompaniment by another person. The operation wound is covered with a sterile adhesive plaster which remains in place until the first post-operative visit to the clinic. Sometimes the eyes need to be tied for the first day after the operation therefore it is necessary to arrange assistance at home for the first post-operative period in advance.
Post-operative care consists in profound cooling of the treated areas to prevent development and spread of swells and bruises. Post-operative pain is not too intense and may be treated with common analgesics like Ibuprofen, Paralen etc.
Rest and eye ease is recommended after the surgery, lying and sleeping with raised head, ideally in supine position, especially for the first 24 hours after surgery. It is necessary to avoid dusty environment and company of smokers and direct sunlight for several days. In the case of intervention performance in the summer it is necessary to protect the eyes for the whole season with good sunglasses. The first post-operative visit with suture removal is usually scheduled after 5-7 days. The resulting eyelid appearance may only be assessed 3 months after the operation. The scars usually disappear in a short time.
Possible risks related to eyelid operation
Facial tissues usually heal very well and that is why absolute majority of these operations is free of any complications. But like in the case of any other operation complications cannot be excluded and their consequences may be serious. An exhaustive list of complications is not possible.
- Persisting swells are caused by worse drainage of the lymph from the operated area – they usually disappear spontaneously after a couple of weeks.
- Bleeding and small bruises cannot be considered a complication as they are inherent in the procedure. Serious conditions may include bleeding in the bulb area after removal of the fat prolapse. The symptoms include pain and pressure behind the eye, the eye is popped forward, double vision appears, and the eye cannot be closed. In such case immediate surgical revision of the wound is necessary or else the overpressure in the bulb may result in irreversible eye nerve damage and loss of sight.
- Ectropism is lower lid detachment. The eye shape becomes circular, the patient often reports "blowing into the eye", and tears may appear. Ectropism results from too radical skin removal or temporarily due to presence of a bruise or swell or in the case of too violent healing process and development of subcutaneous adhesion. Most ectropisms are managed by correct post-operative care without the necessity of a surgical revision. Potential surgical correction is demanding.
- Visible scars may be either stiff and wide with reduced or with increased pigmentation. Scar quality cannot be guaranteed in advance.
- Inflammations – the inflammation nay occur deep inside the eye, which represents a serious condition similar to bleeding, but may also be manifested like a minor transient irritation of the conjunctiva or just a subcutaneous inflammation. In such case the treatment is relatively easy and the result of the operation remains unaffected.
- "Dry eye" – this is a condition of insufficient tear formation. After operation of especially the upper lids tear redistribution on the eye surface results, leading to unpleasant irritation of the eye. This should especially be considered in the case of patients with history of reduced tear formation.
- Eyelash loss after operation – this may be a rare reaction to the trauma, which is the incision in close proximity to the lashes. This is a temporary condition, the lashes will resume growth in 2-3 months.
- Change of sensitivity of the eyelid and lashes – usually at the edge of the upper lid, is caused by interruption or irritation of the minor nerves under the upper edge of the bulb. The feeling is usually temporary.
- Allergic reaction to anaesthetics may appear in the case of unknown allergy. Its clinical manifestations may range from eye rash to a shock.