BLEPHAROPLASTY (EYELID SURGERY)

What is an Upper Blepharoplasty?
Upper blepharoplasty, also known as an eyelift, is a surgical procedure focused on the upper eyelids. The goal is to improve the appearance of the eyes by creating a more open or lifted look. This involves removing excess skin and sometimes fat from the upper eyelid area. Any hooding on the outer corners of the eyes can also be addressed during the procedure.

If the upper eyelid skin touches the eyelashes and obstructs vision, a Medicare item number may apply.

At The Swan Clinic, the technique used aims to provide results that enhance the eyes’ appearance with subtle improvement, avoiding obvious signs of surgery. The procedure is designed to offer long-lasting outcomes.

How to Achieve Optimal Outcomes
In the past, eyelid surgery often involved removing significant amounts of skin and fat, which in some cases resulted in a hollow appearance around the eyes. Current techniques focus on repositioning tissues rather than excessive removal, aiming to preserve eyelid structure and function. This approach is based on updated anatomical knowledge and clinical experience to support improved surgical results.

How to Get the Best Results
A thorough assessment is essential before surgery to identify any underlying conditions that may affect the outcome. These include eyebrow ptosis (where the frontalis muscle compensates to lift the eyebrows), eyelid ptosis (which may require a separate surgical repair), and eyelid asymmetry. Addressing these factors during surgery can help achieve the intended surgical goals.

What is a Browpexy?
A browpexy is a surgical technique used to help lift and support the brow by securing it internally through an incision in the upper eyelid skin. This procedure is often performed alongside an upper eyelid lift. Recovery may take longer than a standard upper blepharoplasty because sutures are anchored to the bone, and additional sutures are used to help define the upper eyelid crease.

How Do I Know If I Need Upper Eyelid Surgery or a Brow Lift? Do I Need a Browpexy?

Everyone’s facial anatomy is different, including the shape of the eyes, eyelids, eye sockets, and brow position. These factors influence which procedure might be suitable.

• Checking for excess eyelid skin: Gently pinch the skin of your upper eyelid and close one eye. This can give an idea of how much skin may be present and whether upper eyelid surgery (blepharoplasty) might be helpful.
  
• Assessing hooding: Excess skin on the outer part of the eyelid, often called hooding, can sometimes be addressed during surgery.
  
• Evaluating brow position: Observe where your eyebrows naturally sit. If lifting the eyebrows improves their position, a brow lift might be appropriate.
  

A browpexy is a technique sometimes used during upper eyelid surgery to support the brow internally, but whether this is needed depends on individual anatomy and surgical planning.

For an accurate assessment and personalized advice, a consultation with a qualified specialist is recommended.

Brow Lift

A brow lift can be performed using different techniques:

• Hairline brow lift: The incision is made within the hairline to lift the brow.
  
• Direct brow lift: The incision is made along the eyebrow line, with the scar hidden within the brow hairs. This method may require makeup such as feathering or brow pencil to further conceal the scar.
  
• Browpexy: This technique involves placing deep sutures to support and lift the brow through an incision in the upper eyelid.
  

To assess if there is excess fat around the eyes, gentle pressure on the eyelid can help detect any bulging. Surgical removal of fat is generally performed under general anaesthetic in a hospital setting. It is important to note that current approaches aim to preserve fat to avoid a hollowed or aged appearance over time.

Surgical planning is tailored to each individual's anatomy and needs, which can be discussed during a consultation with a qualified specialist.

Where Can Upper Blepharoplasty Be Performed?

Upper blepharoplasty can be performed either our clinic or in a hospital as day surgery, depending on the extent of the procedure needed.

• For cases involving only removal of excess skin and a small strip of muscle, the procedure can typically be completed in the clinic. The surgery usually takes about one hour.
  
• Some patients may be eligible for a Medicare rebate if the excess upper eyelid skin touches the eyelashes and affects forward vision or reading.
  
• When there are bulging fat pockets, the procedure is usually performed in hospital under general anaesthesia. During this, the eyelid structures are carefully protected while the fat pads are repositioned with minimal removal to maintain a balanced appearance.
  

Upper blepharoplasty is sometimes combined with other procedures such as browpexy, lower eyelid surgery, brow lift, or fat grafting to the cheeks. Additionally, non-surgical treatments like anti-wrinkle injections may be used alongside surgery to enhance overall results.

Lower Eyelid Lift (Blepharoplasty)

Lower eyelid lift surgery is designed to address excess skin and fat deposits around the lower eyelids. This procedure can be combined with other treatments for comprehensive results.

The surgery involves repositioning or removing excess fat and reducing extra skin. This helps reshape the area around the eyes and improves definition.

Typically, a lateral canthopexy or canthoplasty is performed alongside the lower blepharoplasty. These techniques support and anchor the outer corner of the eye, helping to maintain the results over time.

What Can I Do for Bags Under My Eyes?

Treating bags under the eyes can be challenging and depends on the underlying cause. The first step is to carefully assess the lower eyelid area. Consider whether the issue is excess skin, fatty deposits, or loss of volume due to bone changes or movement of cheek fat pads.

It’s also important to evaluate the outer corner of the eye, as tissue laxity here may require tightening, often through a procedure like a canthopexy.

There are several treatment options available, which your surgeon can discuss with you based on your individual needs.

Fat Grafting

If volume loss in the cheekbones or descent of fat pads is contributing to concerns around your eyes, fat grafting may be beneficial. This procedure involves transferring your own fat to areas around the orbital rim and cheekbones. It can help improve fine lines and reduce the appearance of hollows along the lower eyelid.

One benefit of fat grafting is that a significant portion of the transferred fat—typically between 50-80%—can remain long term, using your body’s own tissues.

This procedure under sedation in our clinic or in hospital. It takes around 1-2 hours and is performed as day stay. The sutures are removed after one week. Recovery takes 1 week, gentle walking returns at 2 weeks and return to exercise in 4 weeks.

Risks and Considerations of Upper Blepharoplasty

Like any surgical procedure, upper blepharoplasty carries some risks. These may include:

• Infection: Although uncommon, infection can occur and may require treatment.
  
• Bleeding or Hematoma: Some bruising and swelling are expected, but excessive bleeding or blood collection under the skin may happen.
  
• Scarring: Incisions typically heal well and scars are usually discreet, but some patients may develop more noticeable scars.
  
• Changes in Sensation: Temporary or, rarely, permanent numbness or altered sensation around the eyelids.
  
• Dry or Irritated Eyes: Temporary dryness, irritation, or excessive tearing can occur after surgery.
  
• Difficulty Closing Eyes: Rarely, patients may experience difficulty fully closing their eyes, usually temporary but occasionally requiring further treatment.
  
• Asymmetry: Slight differences in eyelid appearance or position between the two eyes may occur.
  
• Unsatisfactory Cosmetic Result: The outcome may not meet expectations, and in some cases, revision surgery may be needed.
  
• Vision Changes: Very rarely, serious complications such as vision changes or loss can occur.
  

Recovery Overview

• Swelling and bruising typically peak within the first few days and gradually improve over 1-2 weeks.
  
• Most patients return to normal activities within 7-10 days but should avoid strenuous activity for several weeks.
  
• Follow-up appointments are essential to monitor healing and address any concerns.

FAQs