Eyelid Surgery At A Glance
- Best Results1 treatment
- Treatment Recovery8 days
- Procedure Time30 - 60 min
- Skin SpecialistDavin Lim, Dermatologist
- Duration of ResultsVariable - years
- Back to Work7 days
Blepharoplasty - Eyelid Surgery
Loose eyelid skin can lead to eyelid surgery. Some patients have variable amounts of excess upper eyelid skin plus droopy brows that contribute to this condition. Treating both the upper & lower eyelids will give the best results. Depending on the amount of excess skin and laxity, together with factors such as the state of your surrounding skin, laser resurfacing, eyelid surgery, injectable or a combination, can make a significant difference.
FactsFacts on Eyelid Surgery
- Droopy eyelids can range from mild to severe. In severe cases vision can be blocked
- Excess skin on upper lids can be due to excess upper eyelid skin, an abnormal position of the margin or brow ptosis
- Excess skin and laxity can be due to a combination of genes, age, sun & smoking
What is the cause of Eyelid Surgery?
Droopy eyelids are inevitable, however some people age prematurely. This can be due to genetics, however, lifestyle factors such as UV exposure, coupled with smoking can accelerate skin laxity.
Genetics plays a significant role in the formation of eyelid skin laxity.
What type of droopy eyelids are there, and why is it important to know?
There are 3 different conditions that can cause loose, lax and droopy eyelids. Some patients may only have one factor, some all 3 contributing to this condition.
- Excess laxity – this is termed dermatochalasis, and can present as upper or lower lid laxity. Most people who exhibit upper lid laxity over the age of 40 will also have lower lid laxity. This can result in patients looking tired, and wrinkled, especially under the eyes.
- Eyelid margin repositioning – this is known as ptosis. Ptosis most commonly presents in adult life, but can be present at birth. Abnormal eyelid margins can give a heavy and tired look.
- Brow positioning. Eyebrows that move downwards with time as gravity can also contribute to droopy eyelids. This is called brow ptosis.
Patients in the 40s upwards will have varying degrees of all 3. Balancing laxity, eyelid margins and the position of the brow will give optimal results.
What treatments are available to treat excess eyelid skin?
For patients that exhibit marked or severe laxity, surgical excision of excess skin gives the best results- this is called surgical blepharoplasty.
How do I know what treatment is best for me?
An examination will give me a guide as to the best treatment for you. Some patients may only require laser resurfacing whilst others surgical. In cases where by upper and lower eyelid laxity is associated with poor skin texture and tone, I may recommend surgery, followed by resurfacing.
It is extremely important to take note of the surrounding skin before advising on what is the best treatment. For example, if laser resurfacing for eyelids is planned, then feathering to the surrounding skin is essential to prevent any sharp ‘cut offs’.
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Are the treatments painful and what are my anesthesia options?
Treatments are well tolerated and pain is minimal. We use a mix of local anaesthetic cream plus injections to the treated areas. If a case extends beyond 20 minutes, I may add light sedation to help decrease both pain and anxiety of the procedure. Pain is not an issue as this is addressed well before surgery.
How long is the recovery time following the procedure?
It depends on what is performed.
Eyelid surgery heals the fastest– downtime is usually less than one week. Sutures are out within 5 days, and swelling last for a day or two post surgery.
Laser resurfacing has a downtime of 5-10 days. The more laxity you exhibit, the longer the downtime as more energy levels are needed to stimulate collagen.
What should I expect after the treatment?
Surgery is different from laser resurfacing. After surgery, you can expect swelling for up to 2 days. You will have sutures that come out at day 5. We then tape the area for another week with strips. Mild swelling may persist for a week or two, but the results will be instantly noticeable. The scar line will fade within 8-10 weeks, depending on the location of surgery (upper or lower lids).
Laser resurfacing is associated with weeping & swelling for up to 3 days. You will be required to clean the area twice a day, and use a special healing balm for up to 10 days. The healing time of laser is variable, as this depends on the laxity of your eyelid skin. I usually perform a mix of both erbium and CO2 laser resurfacing for optimal skin tightening and wrinkle removal.
How long will the results last?
Surgical blepharoplasty last longer than laser belpharoplasty. Expect 6-15 years following surgical, and 4- 8 years following laser eye lid surgery. Genetics play the most important role in longevity of the procedure.
Are there less invasive options?
For mild cases of laxity, other options are available. RF or HIFU maybe indicated in some. Very mild cases can respond to Tixel (best for wrinkles rather than actual lifting). Non surgical modalities such as above give variable results & should only be considered in some.
Can other areas of the face be treated at the same time to minimise downtime?
Yes. If you exhibit altered skin texture & poor skin tone, laser resurfacing of your face can be combined with resurfacing of your eyelids. In fact 90% of my eyelid resurfacing is combined with face resurfacing, as most patients will also have associated facial skin laxity.
I also combine upper eyelid surgical excision of lax skin WITH laser resurfacing of the face. In many cases patients exhibit marked upper eyelid laxity with only moderate lower lids laxity- this combination of surgery and laser gives optimal results.
Does Medicare or Private Health insurance cover treatment?
No. This treatment is considered cosmetic in nature and not covered under Medicare/ Private Health. The exception is if eyelid skin laxity is so severe that it covers the field of vision and obstructs or impairs sight. This is exceptional rather than the rule.
Davin’s Viewpoint on treating eyelids
Treating eyelids and the surrounding areas can give tremendous results & markedly decrease perceived age. Have a look at the before and after photos and you can see why. I believe that the ‘eyes are the window to the soul.’ Eyes are the very first thing people look at when they meet and greet you. Saggy and droopy lids can convey tiredness and sadness as well as age.
My treatments are aimed at opening up the eyes, tightening excess skin, however I look beyond that. Eye rejuvenation goes beyond removing or tightening loose eyelid skin. Reducing wrinkles around the eye can decrease perceived age, whist addressing volume loss around the orbit can support the eye area. Fat transfer or dermal fillers can make a tremendous difference.
Last but not the least, I have a professional brow specialist that works with me- this is icing on the cake, having your brows waxed and shaped professionally can give lifting and complete the process of eye rejuvenation.
Eye rejuvenation is one of my favourite procedures as it involves not only surgical techniques, but injectables & lasers.
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