Upper blepharoplasty

Upper Blepharoplasty

What is an upper blepharoplasty?

Upper blepharoplasty is an operation of the upper eyelid, also known as an eyelift. The aim is to rejuvenate, giving the eyes an open or uplifted look. It involves removing part of the excess skin and sometimes fat. The hooding on the outside of the eyes can also be removed at the same time. An Medicare item number may be applicable if the upper eyelid skin is touching the eyelashes causing obstruction of vision. The operation results in a greater “eyeshadow surface area.”

At the Swan Clinic, we aim for natural results, which give a refreshing look, without the tell-tale signs of surgery. In addition, our technique gives long term natural results. Sometimes this operation is combined with lower eyelid surgery, a browlift or fat grafting to the cheeks. Occasionally, anti-wrinkle injections can complement the result.

Male upper blepharoplasty is different in that the markings are different resulting in a different, more masculine eye shape.

When you come to see us, we will spend time asking you about your medical health. You will undergo an examination, looking particularly the ligaments around the eye, your brow shape, eyebrow position as well as cheek position. As we get older, gravity can sometimes alter the shape of our face and eyes. Upper blepharoplasty aims to restore structures to their rightful place, resulting in a balanced appearance.

Anterior lamella: this includes skin and orbicularis muscle
Posterior lamella: this includes the levator aponeurosis inserting into the tarsal plate, muller’s muscle which is responsible for sympathetic nerve elevation of the upper eyelid, and conjunctiva which abuts the eye globe.

Where is this surgery performed?

This procedure may be done in the rooms or in theatre as day surgery depending on the extent of the treatment required. In selected cases, excess skin and a strip of muscle can be excised. With appropriate repair, haemostasis and skin closure. This scar is usually very faint and heals well. The procedure takes about 2 hours and can be done in the rooms. Patients may be eligible for a medicare rebate if the upper eyelid skin touches the eyelashes as this can interfere with front forward vision and reading.
When there are bulging fat pockets, this procedure is done in theatre under a general anaesthetic. In these cases, the eye lid structures are protected and these bulging fat pads are redraped with minimal removal. This allows sculpting of the tissues around the eyes while adding definition.

What is special about this procedure?

The key to a successful outcome is to exclude eyebrow ptosis (which is recognised by overactive frontalis muscle keeping the eyebrows up), eyelid ptosis (which needs a separate operation to repair overstretched levator muscle), and any eyelid asymmetry (which can be corrected for in surgery).

How has this procedure changed?

In the 1980’s, the approach was a very reductive one. Lots of skin was excised with over resection of the fat pads around the eyelid. This over-skeletonisation of tissues paradoxically led to an aged look. We now restore the tissues to their rightful place rather than over resecting them. Our improved knowledge of anatomy and long term study of patients had led to improved outcomes for our patients through modern surgical techniques.

How can I prepare for surgery?

You will need to see Dr Hadi twice. The first consult takes you through the operation as well as expected results. The second consult is at no extra cost to you and runs through things again. All risks and benefits will be discussed with you and treatment will be tailored to your needs and your body shape.
When you decide to proceed, there are a few things you can do to prepare.

 

  1. Eat healthily by avoid excessively fatty foods and foods high in sugar.
  2. Stop smoking as this significantly increases complications rates. You cannot smoke for 6 weeks prior and 6 weeks after surgery.
  3. Two weeks prior to surgery, stop all anticoagulants and antiplatelet medications unless previously discussed with Dr Hadi. Please stop any over the counter medications that might thin the blood, a comprehensive list will be provided during your consultation. Please check any over the counter medications to see whether they contain these ingredients.
  4. Shower the night before or the morning of surgery with anti-bacterial soap. These reduce the bacterial living on the skin and there is evidence is reduces chance of infection.
  5. Fast (do not eat anything) at least 6 hours prior to surgery. You will be given this time.

About the procedure

The procedure takes around 2 hours. You will need to be fasted for 6 hours before the procedure. Pre-operatively the skin is carefully marked. Local anaesthetic is then injected into the area. The excess tissue is removed and the blood vessels carefully cauterized. Sutures are then carefully placed and then tape is applied. You will then be given pain killers.
The surgery is usually performed as day surgery so you can go home the same day as long you are well enough to go home.
You will be given antibiotic tablets and pain relief tablets to take home so that you can be comfortable. You will be given Dr Hadi’s number to contact her if you have any concerns or questions post operatively.

What about the sutures?

Your wound is closed with a blue suture which is taped into place. It will need to be removed at one week post surgery. If the tape falls off, please do not pull the sutures, and contact us so that we can help you.

When can I shower?

You can shower from the next dry. The dressings can get wet, please blow dry them if needed after showering.

When can I drive?

You can drive as soon as your vision is uninterrupted. This generally takes a week.

What can you do after surgery?

Your part in the operation is essential. You can help achieve the best possible outcome by:

 

  • Immediately after the procedure, apply the gauze squares we give you dipped into iced water. Change these regularly. You can apply these that night and continue the next day. Cool compresses are beneficial for up to 24 hours.
  • Sleep on two pillows at night
  • Avoid heavy exercise and lifting for at least 2 weeks.
  • Take the antibiotics we prescribe for you. These will last five days and help prevent infection.
  • Avoid  anti-inflammatory pain killers as they may increase your risk of bleeding. Please check with us prior to taking medication not prescribed by us.
  • Come back for regular review as detailed in the next section to ensure your healing is progressing at each stage.
What about post operative visits?

As a minimum, you will be seen by Dr Hadi after surgery, the next day, at six weeks, at three months and twelve months after surgery. This is so that you can have the best possible outcome.

Please call the Swan Clinic on 9526-6885 following your surgery to ensure we have booked all your follow up appointments.
As our patient at the The Swan Clinic, you will be well looked after and can always count on our honesty as we always have your wellbeing in mind.
Please feel free to contact us if you have further questions.