UPPER EYELID REDUCTION (BLEPHAROPLASTY)
oculoplastic surgical procedures
Scroll down to find the surgery you are having:
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Upper eyelid reduction (Blepharoplasty)
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Eyelid lift (Ptosis repair)
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Entroption Repair Surgery
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Ectropion Repair Surgery
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Skin Cancer
UPPER EYELID REDUCTION (BLEPHAROPLASTY)
As we age, the skin around our eyes starts to lose its natural elasticity causing gradual emergence of fine lines. Over time, the upper eyelids can start to droop, and under eye bags can develop as the muscles relax. This can cause discomfort, but also give the eyes an older, more tired look and a hooded appearance that understandably makes people feel self conscious. Symptoms such as heaviness or tiredness can vary with stress.
During a short operation (1-2 hours), loose skin and excess fatty tissue around the eye area is removed, giving the skin a smoother, more youthful appearance. Blepharoplasty can restore your field of vision, as well as the natural beauty of the eye.
The effects of ageing around the eyes
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Loses elasticity, fine lines and wrinkles
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Eyebrow becomes lower
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Crow’s feet appear and the rim of the orbit becomes visible
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Deeper collagen and muscles relax, allowing pockets of fat to bulge forward at the inner angle of the upper eye and in parts of the lower lid
Management options:
Non surgical treatments can reduce wrinkles, but not folds. Surgical skin reduction of the upper eyelid leaves a faint scar, which is usually disguised in the natural crease of the eye. The small surgical scars for lower lid surgery are hidden by the lashes. Bulging fat can be reduced or repositioned during surgery. Fat or filler can be used to restore lost fat or volume.
A simple upper eyelid reduction takes less than an hour, but surgery to multiple lids or manipulation of fat may take longer. Procedures are usually carried out under local anaesthesia, with or without sedation. Initial bruising and swelling resolves in as little as 1-2 weeks, but the final result of surgery may not be seen for several weeks.
Eyelid lift (ptosis repair)
The effect of drooping upper eyelids may be both cosmetic and functional, with the common complaint that the eyelid is obstructing the vision. The term ‘ptosis’ comes from the Greek ‘to fall’ – and represents an eyelid that has fallen down and can’t be lifted. Ptosis can cause visual obstruction, which can limit activities such as driving and reading. The most common cause of this is when the muscle that lifts the upper eyelid becomes stretched or weak. Often patients will try to lift the lids using the forehead muscles, which can lead to frontal headaches and strain. In some cases ptosis may be present at birth, or it can arise after other eye surgery, injury or a nerve palsy / stroke.
There are many techniques for repairing ptosis. Most commonly, surgical repair of ptosis involves shortening the weak muscle in the eyelid which results in raising the position of the upper lid. A small incision is made along the natural skin crease of the upper eyelid, which hides the postoperative scar. In most cases, you will be awake for the surgery so that the eyelid shape and height can be checked during the operation, for the best aesthetic and functional outcome.
entropion repair surgery
Entropion is the turning inwards of the lower (or upper) eyelid causing lashes to rub against the eye. This condition can not only cause irritation, but also carries a risk of corneal ulceration, infection and loss of vision. Entropion typically affects the lower eyelid due to age-related stretching or detachment of the retractor muscles. It can also be caused by scarring of the inside of the eyelid from previous surgery or trauma.
Surgical correction of entropion involves tightening the lower eyelid and reattaching the muscles. This is usually done under a local anaesthetic with or without sedation.
ectropion repair surgery
Ectropion is the turning out or sagging of the lower lid. This can occur naturally as a result of the ageing process, or as a result of previous facial trauma, scarring, paralysis or previous surgery. When the lower lid becomes excessively loose, it sags away from the eye causing increased exposure to wind, dust and the sun – all of which can irritate the eye and the lining of the lower eyelid. The eye can become very watery and irritated, with sticky discharge on waking.
Ectropion repair restores eyelid function by tightening the tendons in the lower eyelids to return it to its normal position. This will cause the underlying muscle to reattach to the lower eyelid tissues. In some cases, tissue can be borrowed from the upper eyelid or elsewhere to reconstruct the eyelid.
skin cancer
The upper and lower eyelids protect your eye. They do this by distributing tears to moisturise the surface of the eye, cleaning the front ‘window’ of the eye – the cornea, keeping out dust and dirt and by protecting your eye while you sleep. A tumour growing on your eyelids may change the shape of your eyelid or affect the surrounding tissue. This can cause irritation to the eye. If left untreated, tumours can grow and affect other structures such as your eyeball, or your eye socket.
Tumours of the skin can be removed by surgery while you are awake. When a surgeon removes a skin tumour, they also need to remove a clear margin of healthy skin around the growth to make sure there are no cancer cells left behind. The piece of skin which is removed is sent to a laboratory for examination by a specialist pathologist using a microscope.
In some cases this is done while you are still at the hospital, so that the eyelid can be reconstructed knowing that no cancer cells are left behind. If some cancer was missed, more skin will be removed, but if the margins are clear of cancer cells, there is no need to remove any more skin.
Reconstruction may involve just a few stitches if the tumour was small. For larger tumour excisions more complex surgery is required which can involve the use of a skin graft. There is usually moderate bruising and swelling after eyelid reconstruction. Sometimes further surgery may be required to fix the eyelid position due to asymmetry, distortion or loss of eyelashes. Even with adequate margins, some tumours may reoccur months or years later requiring further surgery or radiation.
