Surgical correction of either the upper or lower eyelid is termed blepharoplasty. Upper eyelid blepharoplasty surgery is a short surgical procedure to remove excess skin and restore the natural beauty of the eye. In contrast lower blepharoplasty is more complex and can carry a higher complication rate.

Can this surgery be done on the NHS or Insurance?

If the upper eyelid skin obscures the vision or causes functional issues it can be performed on the NHS or insurance. However it cannot be covered through these pathways if the indication is purely aesthetic rejuvenation of the eyelid.

How is Upper Blepharoplasty performed?

Excess skin in the upper eyelid can be removed through a transverse incision lying in the natural skin fold, leaving an imperceptible scar. The procedure is done under local anaesthetic with or without intravenous sedation.

How is Lower Blepharoplasty performed?

Correction of lower eyelid bags can be corrected either through the eyelid (Transconjunctival) or through the skin (Transcutaneous) the latter is often used when there is skin excess. Fat in the lower eyelid compartments is either re-draped or removed. If the lower eyelid has laxity it will need to be supported and a tightening procedure (Canthopexy) will be necessary.
 
What would expect in post operative course?

For the first 24-48 hours swelling and bruising will occur and we recommend to use cold compresses. Sleep propped up to reduce oedema after the operation. Your eyes may feel gritty, it is recommended to use eye ointment to prevent this sensation.

Permanent sutures are removed on day 7 in the plastic surgery dressing clinic. In upper blepharoplasty a running continuous subcuticular prolene suture is removed.

What are the Complications?

Excess bruising and eyelid haematoma

Infection

Poor scarring

Chemosis - conjunctival oedema

Dry eyes

Ectropion (Pulling down of lower eyelid)

Lagopthalmos (Inability to close eye) - often temporary lid massage and lubrication is advised to resolve this complication

Retrobulbar Haemorrhage - this will necessitate a return to theatre to release pressure

Corneal abrasion - treated with ophthalmic antibiotic ointment

Lower eyelid malposition

Ptosis - damage to the levator muscle

Diplopia or double vision - rare complication

Blindness and visual loss secondary to bleeding - extremely rare

Procedure Summary

Blepharoplasty

Anaesthetic : Local Anaesthetic with or without sedation or General Anaesthetic

Operative time : 1-2 hours

Hospital Stay : Daycase

Time off work : up to 2 weeks

Recovery Time : 1 week