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Blepharoplasty (eyelid surgery)

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Eyelidsurgery,orblepharoplasty,isatypeofsurgerythatalterstheappearanceoftheupper
eyelids,lowereyelidsorboth.Theaimistoimprovetheappearanceoftheareasurroundingthe
eyesandtoimprovevisionobscuredbydroopingeyelids.
Blepharoplastycanalter:

drapingskinthatobscuresorblocksyourvision
looseorsaggingskinthatcreatesfoldsordisturbsthenaturalcontouroftheuppereyelid
thiscansometimesaffectapersonsvision
excessfattydepositsthatappearaspuffinessbeneaththeeyelidskin
bagsundertheeyes
droopinessofthelowereyelidstoavoidshowingwhitebelowtheiris
extraskinandfinewrinklesofthelowereyelid.

Ifyouareconcernedaboutthewayyoulook,orarethinkingaboutcosmetictreatmentstoboost
yourconfidence,therearealternatives.Thesemayincludelifestylechangesorlearningtoaccept
yourselfthewayyouare.

Before choosing blepharoplasty surgery

Beforeyouoptforblepharoplasty,someoftheimportantissuestokeepinmindinclude:

Uppereyelidsurgeryisoftencarriedoutseparatelyfromlowereyelidsurgery.Beprepared
fortwoseparateoperations.
Blepharoplastycannotremovedarkcirclesundertheeyes,liftsaggingeyebrowsorgetrid
ofcrowsfeet.
Thinkaboutthefinancialcost.Cosmeticsurgerydoesnotusuallyqualifyforrebatesfrom
Medicareorprivatehealthinsurancecompanies.However,yourdoctorcanadviseifyour
conditionmatchesarelevantMBSitemdescriptorandisthereforecoveredbyMedicareand
privatehealthinsurers.Somecostsofblepharoplastymaybecoveredifitisperformedfor
medicalreasonsforexample,iftheeyelidsdrapeontotheeyelashesandblockyour
vision.Askyoursurgeonaboutanyout-of-pocketcostsyoucanexpect.VisitPrivateHealth
formoreinformationonprivatehealthinsurance.
Smokersareatincreasedriskofcomplications.Ifyouareseriousaboutundergoing
surgery,youshouldtrytoquitsmoking.

Finding a blepharoplasty surgeon

Youmaywanttoaskyourdoctorforadviceaboutfindingasuitablespecialistsurgeonorhospital
whereblepharoplastyisperformed.Atyourfirstconsultation,youshouldaskthesurgeonabout
theirtrainingandexperience.Itispreferabletohavethisproceduredonebyasurgeonwhois
speciallytrainedtoperformblepharoplastyandwhohasalotofexperienceincarryingoutthis
typeofsurgery.

Medical issues related to blepharoplasty

Beforetheoperation,youneedtodiscussarangeofmedicalissueswithyourdoctororsurgeon.
Theywilltalktoyouaboutyour:

Physicalhealth anexaminationwillhelpyourdoctororsurgeontodecideifthetreatment
isappropriate.

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Medicalhistorysomepre-existingmedicalconditionsandsurgeryyouvehadinthepast
mayinfluencedecisionsaboutthisoperation,includingthetypeofanaestheticthatisused.
Inparticular,youmusttellyoursurgeonifyouhaveanyeyeconditionssuchasglaucoma,
dryeye,weteyeoradetachedretina,anythyroiddisorderssuchasGravesdiseaseand
underactiveoroveractivethyroid,anycardiovasculardisease,highbloodpressureorother
circulatorydisorders,orwhetheryouhavediabetes.
Eyeexam youmayneedtobeassessedbyanophthalmologist(eyespecialist)before
yoursurgery.
Risksandpossiblecomplicationsitisimportantthatyouunderstandtherisksand
complicationssothatyoucanweighupwhetherblepharoplastyisrightforyou
Medication tellyourdoctorandsurgeonaboutanymedicationthatyoutakeregularlyor
haverecentlytaken,includingover-the-counterpreparationslikefishoilsandvitamin
supplements.
Pastreactionstomedicationtellyourdoctorandsurgeonifyouhaveeverhadabad
reactionorasideeffectfromanymedicationincludinganaesthesia.
Preparationforsurgeryyoursurgeonwillgiveyoudetailedinstructionsonwhatyou
shoulddoathometoprepareforsurgery.Forexample,youmaybeadvisedtotakea
particularmedicationoralterthedoseofanexistingmedication.Followallinstructions
carefully.

Blepharoplasty operation
Youmayhavealocalanaestheticandsedation,orageneralanaesthetic.Yoursurgeonwilladvise
youonwhichisthebestoptionforyou.
Theoperationdiffersaccordingtothedetailsofthesurgery,butgenerally,thesurgeonwill:

makeanincision(cut)intheskinfoldacrosstheeyelid,totreatsaggingoftheupperlid
makeanincisioneitherjustbelowthelashesorontheinsideofthelowerlid(a
transconjunctivalincision)totreatthelowereyelid
removeexcessskin.excessfatisrepositionedorremoved
tightenunderlyingtissue(suchasmuscle)withsutures(stitches),ifrequired
attempttohideallincisionswithinnaturalskinfoldsandcreases
closeincisionswithstitches,surgicaltapeortissueglue.

Tissue glue in blepharoplasty surgery

Tissueglue,orfibrinsealant,canbeusedtoholdtissuelayerstogetherduringsurgeryandto
reducebruisingaftersurgery.Itismadefromelementsofhumanbloodthatareproducedfrom
donorbloodplasma.Theplasmaisscreenedforhepatitis,syphilisandhumanimmunodeficiency
virus(HIV)beforeuse.Thebloodcomponentsarealsoheat-treatedtopreventanypossiblevirus
transmission.
Tissuegluehasbeenusedsafelyformanyyearsasasealantincardiovascular(heart)andgeneral
surgery.

Immediately after blepharoplasty

Aftertheoperation,youmayexpect:

mildpainordiscomfort
numbness
useofcoolcompresses,gauzeanddressingsovertheeyes
swellingandbruisingaroundtheeyes
possiblebruisingonthewhitesoftheeyes
asensationofwetordry,irritatedeyes
extremesensitivitytolight.

Complications of blepharoplasty
Allsurgerycarriessomedegreeofrisk.Someofthepossiblecomplicationsofblepharoplasty
include:

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risksofanaesthesiaincludingallergicreaction,which(rarely)maybefatal
surgicalriskssuchasbleedingorinfection
bloodclotsthatmaycausepotentiallyfatalcardiovascularcomplicationssuchasheart
attack,deepveinthrombosisorstroke
temporaryorpermanentareasofnumbness
temporarilyblurredorimpairedvision
dryorwateryeyes
difficultyclosingyoureyesforexample,theuppereyelidmayremainopenwhileyouare
asleep,whichcandryouttheeyesurfaceandcausescarring
lidlag,whichisapullingdownofthelowereyelidthatisoftentemporary
ectropion,whichisaslackandoutward-rollinglowereyelid
eyeliddisordersthatinvolveabnormalpositioningoftheuppereyelids(eyelidptosis)or
looseeyelidskinthesedisorderscancoexistwithsaggingforeheadandeyebrow
structures
thedevelopmentoflumpsinsidethelowereyelid,whichcanirritatetheeyesurface
sunkenorunnatural-lookingeyes,iftoomuchfatisremoved
inflamed,itchyscars
bleedingbehindtheeye
visionloss,includingcompleteblindness
furthersurgerytotreatcomplications.

Thisisnotacompletelist.Forexample,yourmedicalhistoryorlifestylemayputyouatincreased
riskofothercomplications.Youneedtospeaktoyoursurgeonformoreinformation.

Self-care at home after blepharoplasty

Beguidedbyyoursurgeon,butgeneralself-caresuggestionsinclude:

Followallinstructionsonlookingafteryourwounds.Applytheeyeointmentasprescribed.
Expecttohavesorenessandswellingaroundtheeyeforafewweeks.
Avoidanytraumatotheeyesforexample,donotrubatthem.
Usecoolcompressestohelpmanageshort-termirritation,discomfortandsensationsof
dryness.
Protectyoureyesfromsunlightuntilthehealingprocessiscompletethisisvery
important.
Reportanybleeding,severepainorunusualsymptomstoyoursurgeon.

Long-term outlook following blepharoplasty

Post-surgicalswellingwillreduceovertime.Manypeoplefindthatblepharoplastymakesareal
differencetotheirappearance,especiallyiftheyhadverylooseupperlidskinorlargebags
underneaththeireyes.Yourfinalresultswillshowwithinseveralweeks,butitmaytakeuptoa
yearforincision(cut)linestofullyheal.
Whileblepharoplastycanbeexpectedtocorrectcertainconditionspermanently,youwillcontinue
toexperiencetheeffectsofageing.

Alternatives to blepharoplasty
Therearenoothermedicalalternativestoblepharoplastythatcanrepositionorreshapethe
eyelids.Talkingtoacounsellororpsychologistmayhelpyouovercomeyourconcernsaboutyour
appearanceandyoumaydecidethatyoulikeyourselfthewayyouare.

Where to get help

Yourdoctor
AustralianSocietyofPlasticSurgeonsInformationHotlineTel.1300367446
RoyalAustralasianCollegeofSurgeonsTel.(03)92491200

Things to remember

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Eyelidsurgery,orblepharoplasty,aimstoimprovetheappearanceoftheuppereyelids,
lowereyelidsorboth.
Blepharoplastycannotliftsaggingeyebrowsorgetridofcrowsfeetordarkcircles.
Specificrisksofthesurgeryincludeabnormalpositioningoftheeyelids,bleedingbehind
theeyeandpermanentblindness.
Talkwithyoursurgeonabouttherisksandbenefitsofblepharoplastyandwhatresultsyou
canexpect.

This page has been produced in consultation with, and approved by:

AustralianSocietyofPlasticSurgeons
Contentonthiswebsiteisprovidedforeducationandinformationpurposesonly.Information
aboutatherapy,service,productortreatmentdoesnotimplyendorsementandisnotintendedto
replaceadvicefromyourdoctororotherregisteredhealthprofessional.Contenthasbeen
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