Eyelids can change as we age with development of extra skin and wrinkling in the upper eyelid and bagginess or a ‘tired look’ in the lower eyelid. With time, these changes may worsen so that the excess upper eyelid skin interferes with vision, like a curtain hanging from above.
Eyelid surgery (called Blepharoplasty) is very effective in improving visual troubles due to upper eyelid drooping skin. Eyelid surgery may also make a substantial change to your appearance, providing a more youthful, fresher look.
Upper eyelid surgery usually removes excess skin, while lower eyelid surgery focuses more on tightening and lifting the structures that have weakened with age and gravity. The scars of eyelid surgery are well hidden in the upper lid natural crease line and just below the eyelash line in the lower lid.
If you have restricted vision due to heavy upper eyelid skin, surgery will help to relieve this curtain and improve your field of vision. If you notice changes from ageing around your eyelids and these are of concern to you, eyelid surgery (blepharoplasty) may be beneficial. Individual suitability, type of surgery and expectations of outcome will be discussed with your plastic surgeon at your consultation.
A consultation with your plastic surgeon will enable personalisation of the procedure and care to your unique situation. If you have impaired vision as a result of excess upper eyelid skin, the procedure may be partly rebatable – you will require a referral from your family doctor and also an eye review with your optometrist to support this – don’t worry we can help you with this process.
Surgery is usually booked as a day procedure under local anaesthetic with sedation for your comfort. You will need to fast on the day of surgery, and organise a support person to take you home and be around the first night after surgery.
After surgery, it is normal to have some bruising and swelling in the area that will be most evident 1-2 days after surgery and mostly resolve over 2-3 weeks. While the surgery is not particularly painful (simple pain medications such as paracetamol usually suffice), it is important to rest after surgery and use ice packs to the area to reduce swelling. You will need 2 days without driving, 1 week off for administrative jobs and duties and 2 weeks off physical jobs or activity (including gym or exercise).
A post-operative appointment will be organised for you to see your plastic surgeon 1 week after surgery to remove sutures (usually 1 long suture in each eyelid), check your progress and provide advice to care for your scars as you recover.
Substantial improvement will be noticed once the early swelling from surgery settles in 1-2 weeks. It may take up to 6 months for all swelling to settle and scars to mature, to see your long term result. And note that ageing and gravity continue after surgery so some recurrence of your eyelid changes will occur in time, though this may take 10 -20 years to reach similar levels.
All operations have risks, though major complications are rare after eyelid surgery. There is a small risk of concerns that may delay healing and require a little extra care (eg minor bleeding, infection, over active scars) and small risks of asymmetry in the scars between the eyelids, impairment of the eye opening muscle function, or excessive opening of the eye with dryness of the eye. Abnormal pain, sensitivity or bleeding that may compress structures behind the eye with a risk of blindness are incredibly rare. These risks may vary depending on your specific situation and will be discussed with you at your consultation. Please feel reassured that your plastic surgeon will only recommend surgery if they feel that the benefit of the procedure substantially outweighs the risks.
When upper eyelid surgery is undertaken for improvement in vision, the majority of the cost is rebatable through Medicare and standard private health insurance. This does require a referral from your family doctor and confirmation of visual difficulty from your optometrist – we can provide a letter to help with the optometrist’s assessment.
When upper eyelid surgery is performed purely for appearance, or any lower eyelid surgery for appearance, it is considered cosmetic – no rebate is available from Medicare or private health insurance.
After your consultation, a detailed quote will be provided to you including the surgeon fee, anaesthetic fee and hospital fee.
Please be aware that all surgical procedures require a consultation with our plastic surgeons to allow a thorough assessment and discussion of your specific needs.