BLEPHAROPLASTY

Eyelid surgery also known as blepharoplasty is a surgical operation that can remove excess eyelid skin, fix hooded eyelids, lift droopy eyelids and remove eyebags. Eyelid surgery addresses the age- related changes that are commonly seen in the 40s, 50s and 60s and helps improve facial appearance by making a person look youthful. Eyelid surgery or blepharoplasty is highly sought after because of the significant changes that it can bring about in a person.

 

Blepharoplasty Advancements

How has eyelid surgery changed over the ears and what is considered state of the art in eyelid surgery to produce natural results.

Cosmetic Eyelid surgery or Cosmetic Blepharoplasty was started as an operation to remove excess eyelid skin to fix one of the signs of eyelid ageing. 

However, with time, a better understanding of the ageing eyelid emerged and it was discovered that all the tissues of the eyelid showed ageing changes not just the skin, As the result, modern day eyelid surgery does much more than remove skin,  allowing the Surgeon to produce natural looking results.

A comprehensive approach to eyelid surgery will not only treat excess skin but simultaneously addresses ageing changes in fat, muscle, connective tissue and tendons by a combination of 3 surgical techniques namely removal of excess tissue, reposition of tissue that has moved and reinforcement of tissues that are weak.

Modern day eyelid surgery involves removal of precise amount of skin and fat and preservation of adequate skin and muscle. Control of eyelid fat by repositioning fat and the eyebrow restores the natural contours. Invaginating the fold to produce symmetrical  eyelid creases, restoring eyelid tone, correcting suborbital hollows and controlling the orbital fat and restoring the tone and position of the lateral canthus are essential to restore function and good aesthetics.

 

Which conditions can be addressed by eyelid surgery? 

Upper eyelid surgery is a very effective treatment to fix hooded eyelids, droopy eyelids, weak eyelids, double eyelids, eyelid ptosis, excess eyelid skin and eyelid skin cancers.

Lower eyelid surgery is a very effective treatment to fix eyebags, excess eyelid skin, saggy eyelids, inward turned eyelid called entropion, outward turned eyelid called ectropion and eyelid skin cancers.

 

Eyelid surgery in men

Yes, men can undergo eyelid surgery too. Men undergo eyelid surgery to treat hooded eyelids, droopy eyelids and eyebags

Eyelid Surgery & Medicare2Is the surgery covered by Medicare and private health funds
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Eyelid Surgery - What Should I do first2If I am thinking about Eyelid surgery, what should I do first?
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Benefits of eyelid surgery 

are more than just cosmetic

Eyelid surgery and Blepharoplasty consistently rank high in popularity by both men and women to help address age related changes and improve function and looks. Some patients will consider undergoing eyelid surgery for aesthetic reasons whereas others will consider eyelid surgery for functional reasons. Upper eyelid surgery has functional, medical, psychological and cosmetic benefits as it improves vision, quality of life activities, productivity and appearance following eyelid surgery.

Eyelid surgery is very popular because it can address age-related changes and improve the appearance and function of the eyelids. Eyelid surgery has functional, medical, psychological and cosmetic benefits as it improves vision, quality of life activities, productivity and appearance following surgery. Some patients will consider undergoing eyelid surgery for aesthetic reasons whereas others will consider eyelid surgery for functional reasons.

Why eyelid surgery – first impressions matter

Your eyes are the first thing people see. Hence the appearance of your eye and the area around the eye will affect the way somebody perceives you. From a very young age, people invest in beauty products and cosmetic services to look after their eye area.  As people age, the ageing changes cannot be fixed effectively using non-surgical methods and hence people consider eyelid surgery as the go to option after a certain age.

How does eyelid surgery help? 

Eyelid surgery reverses the age-related changes to help to restore a youthful and energised look to the face.

With advancing age, people begin to notice changes in the eyelids that include excess eyelid skin, bulging fat, wrinkles, dark circles and droopy eyelids. These features make a person appear tired or dull even if that is not the case. So, it is natural that patients who are keen to do something about it, visit a Plastic surgeon to consider having eyelid surgery.  Eyelid surgery can help to restore a youthful and energised look by getting rid of most concerns such as excess eyelid skin, bulging fat, wrinkles, dark circles and droopy eyelids.

Is eyelid surgery worth it?

According to www.realself.com 95% said eyelid surgery was worth it. Realself.com based this on 1200 ratings and this information was last updated on 23 May 2020.

 

Find out if you are the ideal candidate for eyelid surgery.

You are an ideal candidate for Eyelid Surgery if you have 

  1. Over hanging excess upper eyelid skin or eyelid hooding
  2. The hooding or excess skin restricts your visual field or causes heaviness in the eyelids
  3. Droopy or weak eyelids that make you look tired or sleepy
  4. Eyebags or Fatty bulges in the under-eye area that make you look tired

What is an Eyelift and is it the same as a brow lift?

An eyelift is another term used to refer to upper eyelid surgery or blepharoplasty.  The term eyelift is not to be confused with a brow lift which is surgery to stabilise and lift the eyebrow. In patients over 50 it may be necessary to combine upper eyelid surgery along with a brow lift to harness the combined power of both these operations for a better result to improve vision and appearance.

 

Your eyelid surgery consultation with Dr Naveen Somia

The in-clinic eyelid surgery consultation usually lasts about 45 – 60 minutes and is an interactive process to help you determine whether eyelid surgery will address your concerns and more importantly, whether you trust me as your Surgeon.

I take a detailed medical history followed by evaluation of the structure, function and aesthetics of your eyelids and how they relate to your face. This is followed by clinical photography which is an important record. All these help me to determine whether you are a suitable candidate. Bringing a couple of photos from your 20s or 30s will help.

This is followed by a discussion of all risks and benefits of the proposed surgery. I expect you to have questions and there will be ample time to ask them. After the consultation you will be given information that describes the eyelid surgery procedure, lists the risk factors and complications of eyelid surgery and the costs of eyelid surgery.

It is standard practice that we schedule a second consultation which provides you another opportunity to clarify the doubts and ask questions and be reassured of your safety.

 

What determines cost of eyelid surgery

The cost of your Eyelid Surgery (Blepharoplasty) depends on the following five factors but not limited to 

  1. Purpose of the eyelid operation: is it primarily for cosmetic reasons or is it medically indicated due to vision impairment?
  2. Does the operation qualify for Medicare Assistance or a Medicare rebate under the current MBS scheme?
  3. Do you have Private Health Insurance / Health Cover?
  4. Does your Private Health Insurance policy cover the eyelid operation you require?
  5. Is the eyelid surgery a straightforward eyelid operation, or is your surgery a particularly complex operation, such as a revision eyelid surgery?  Are there other complications involving the eyelid skin or your facial anatomy or overall health that could impact on your eyelid surgery?

Is eyelid surgery or blepharoplasty covered by Medicare or private health fund

Upper eyelid surgery may be partly covered by Medicare and private health fund if it classified as medical by fulfilling certain criteria. If the upper eyelid changes affect your vision as proven by a visual field test done by an Optometrist, your surgery may be eligible for cover. Your Plastic Surgeon will assess your eyelid at the consultation and will recommend and refer you for the Visual Field testing by the optometrist. 

Lower eyelid surgery and eyebag surgery are not covered by Medicare or Private Health fund.

 

What results can I expect after eyelid surgery

Generally speaking, eyelid surgery will get rid of the visible signs of ageing and give you a fresh, rested and youthful look in both your upper and lower eyelids. Although most changes are noticeable straight away, we recommend waiting for a good 6-12 weeks for all the temporary changes including swelling to resolve to experience the final result. 

Upper eyelid surgery will get rid of loose and excess eyelid skin, tighten and lift droopy eyelids to give you a fresh look. If you have eyelid hooding, it can be corrected. If you notice that your “eye shadow space” is no longer visible and your eye shadow smudges, upper eyelid surgery to get rid of the excess and over hanging eyelid skin can help.

Lower eyelid surgery helps to remove loose and excess skin, remove eyebags and wrinkles around lower eyelid, tighten the loose muscle and ligaments, blend the eyelid and cheek junction to give you're a fresh, youthful look and improve your cheek contours.

 

Eyelid Surgery Recovery

What happens after the operation- overnight stay is desirable.

Immediately after the operation you will spend some time in the recovery ward where you will be closely monitored till you are fully awake. There will be no bandages on the eye, and you will be able to open and close your eyes. You will need regular lubricating eye drops, eye ointment to the suture line and ice packs over your eyes. 

It is desirable to stay overnight for regular monitoring because during the first 12 hours after eyelid surgery, there is a risk of bleeding, pain, nausea and vomiting due to the anaesthetic and general drowsiness due to a slow recovery from the anaesthetic leading to an increased risk of bleeding. In addition, the blurred vision following surgery can make the patient anxious.  Staying in hospital where you will be monitored, and your eyelids looked after.

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Types of eyelid surgery

Upper eyelid surgery – both functional and cosmetic benefits

Upper eyelid surgery or upper blepharoplasty is performed to address the commonly seen eyelid ageing changes namely excess eyelid skin and hooding of eyelids, droopy or weak eyelid eyelids and double eyelids. The less common causes for which upper eyelid surgery is performed include creating an eyelid crease in patients who don’t have one and fixing an uneven eyelid crease. People often seek upper eyelid surgery to correct asymmetrical or uneven eyelids. A browlift is usually combined with upper eyelid surgery

Lower eyelid surgery – the main benefit is cosmetic

Lower eyelid surgery or lower blepharoplasty removes eyebags and reduces loose and excess skin. It can be done from the inside of the eyelid (transconjunctival blepharoplasty) or from the outside. Lower eyelid surgery can be done at the same time as the upper eyelid surgery and is usually combined with a midface lift or fat grafting. 

Droopy eyelid surgery or Ptosis surgery – improves your field of vision

Droopy eyelid is caused by weakness in the muscle that is responsible for opening the upper eyelid. Some are born with a weak muscle while most patients notice gradual weakening as a result of the ageing process. The muscle gets overstretched similar to an overstretched rubber band that loses its tension. The net effect is a droopy eyelid that causes a decrease in your field of vision. Some of the symptoms you may experience as a result of the droopy eyelid are heaviness in the eyelids and headaches at the end of the day, reading in a dim light is hard and reading restaurant menus require a torch. Surgery is the only effective way of fixing the droopy eyelid.

Double-eyelid or Asian Eyelid Surgery – defines the crease for brighter eyes

The Double eyelid operation creates an upper eyelid crease and an eyeshadow space. It is commonly requested by people of east Asian heritage. Often an epicanthoplasty is performed at the same time to make the eyelid fold or epicanthic fold less prominent. This operating required meticulous technique and an artistic flair.

 

Procedures that can be performed at the time of your eyelid surgery 

Brow Lift – often combined with upper eyelid surgery for a better outcome

Brow lift is a surgical operation that precisely repositions the eyebrow with aesthetic finesse using sophisticated techniques. The benefits of a browlift are it elevates the droopy eyebrow, may improve forehead lines and gives a brighter refreshed look. The brow lift has to be customised to every individual depending on whether the patient is a male and female, whether the person has a receding hairline or not, and whether the ageing changes are mild or severe. The browlift scars are minimal and cleverly hidden from view. 

Midface lift –combined with lower eyelid surgery to blend the eyelid cheek junction

Midface lift is a surgical procedure that precisely lifts and repositions the midface that is the part of the face immediately under the eyes using precise surgical techniques and artistic finesse. A midface lift is done at the same time as a lower lid blepharoplasty and helps to minimise the deep grooves in the under-eye area, blend the lower eyelid and cheek junction and improve the cheek contour.

Fat Transfer

Fat from the tummy is removed using very fine microcannula, processed to make it ready for transfer and injected into areas of the face where there is a volume deficit to plump up the face. The fat transfer is done using fine specialised cannulas with precision. 

 

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Risks of eyelid surgery

Eyelid surgery is not a ‘risky’ surgery but has certain risks. It is a bit like travelling overseas in an airplane. While the expectation is that of a safe journey and a safe arrival, there is an understanding that there is a remote chance of things going wrong. The choice of the airline based on its safety record and flight path are important elements that determine risk. Similarly, for your eyelid surgery, the experience and expertise of your Surgeon, the skill of your anaesthetist and the standard of the hospital will determine the risk.

The Surgical risks are infection, bleeding, scarring, blurred vision, a very small risk of blindness, uneven eyelids, excess scar or keloid scar formation ( rare), asymmetry of your eyelids or eyebrow, asymmetrical level of the crease, bunched up skin in the upper corner that may need revision are some of the risks. 

Reducing risks of eyelid surgery

Healthy patients who choose a registered Specialist Surgeon in Plastic Surgery for eyelid surgery, instead of a low-priced doctor who is not registered as a specialist, can reduce some surgery risks by:

  • Making sure the Surgeon is experienced with significant expertise in eyelid procedures
  • Carefully following instructions before and after surgery
  • Not trying to do too much too soon
  • Avoiding driving, and not wearing contacts or eye makeup, until your Surgeon has cleared you to do so after surgery

How does low cost eyelid surgery increase risk of eyelid surgery – cutting costs and cutting corners.

Low-cost eyelid surgery options more often means corners are being cut in the surgery clinic. These may give you a discount but may impact your surgery result.  Low priced eyelid surgery can leave you with some serious eye lid problems after a botched Blepharoplasty procedure; it’s just not worth it and will cost you more in the long run. The cost of fixing the complication is significantly more than the cost of the original surgery.

How long is the healing process and how bad is the scarring after eyelid surgery?

Healing and recovery after eyelid surgery vary from patient to patient but typically the healing process can take up to two weeks. It is important that you follow all the post-operative instruction. Please ensure you allow adequate healing time after eyelid surgery and don’t try to do too much too soon you will need to rest your eyes a lot during those 2 or more weeks of healing.

Scars on the upper and lower eyelid heal very well. It is normal for the scar to be visible and noticeable for the first 3-6 months and then it will begin to fade. By 12-18 months you can expect good resolution of the scars and it will be barely visible. 

An integrated skincare regime helps maintain results from eyelid surgery

To get the best results of surgery, it is important to have a proper skin care regime integrated into your surgical plan that you can start before eyelid surgery and continue after surgery to ensure the skin is healthy and well maintained. 

The results of eyelid surgery depend on how eyelid skin redrapes after surgery, so having healthy and thick the skin is important. So, using a medical grade skin care to improve the health of the skin pre surgery can help. Similarly, maintaining skin health after the surgical procedure helps to prolong the effect of surgery. 

Medical grade skin care products that use concentrated creams and serums 

are prescription only products available in medical practices. These are a lot more powerful and effective than the products you find in retail stores, salons or spas thereby producing better results.

 
Final Comment from Dr Naveen Somia, Plastic Surgeon and ``Sydney’s eyelid surgery expert:

“I believe eyelid surgery and various blepharoplasty techniques are particularly transforming, and yet these surgeries are very complex. I have made my surgery practice in Sydney strongly focused on eyelid surgery and facial rejuvenation. That’s because I know how much positive change they can make on a person’s overall facial appearance, and because I know they can go wrong in the wrong hands of a less-trained doctor.  

It’s much better to get it right the first time. That’s not to say some complications do not occur, occasionally they do; but at least when you choose a Plastic Surgeon who is focused on eyelid surgery, you’re in far better hands in terms of experience, expertise and precision.”

 

All surgery carries risk.   A second opinion from an appropriately qualified health practitioner is recommended before proceeding

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or call: 02 9387 2110

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Royal Australasian College of Surgeons

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Plastic Surgery Research University of Louisville

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Royal College of Surgeons of Edinburgh

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PACES Plastic Surgery Atlanta USA