The passing of the years may result in excessive amounts of skin in the upper lids which hang down and can even obscure vision to some extent. Conversely fatty bags or loose skin may accumulate in the lower eyelid and again give the eye a very tired appearance.
Upper Blepharoplasty is usually done through an inconspicuous scar in the crease above the upper eyelid lashes. The scars are usually only visible with the eyes closed and even then they are quite fine. The scar does creep out towards the side to some extent.
Fatty bags in the lower lids may sometimes be treated by a surgical approach on the inside of the lower lids. This avoids a skin scar. However when there is excess skin as well an incision along the lower eyelid just below the eye lashes is required to remove this excess of skin.
Excision of skin from the lower eyelid must be done very cautiously. The eyelid is a frail structure and placing too much tension on it can lead itself to fall down which can leave an undesirable appearance and functional problems as well with irritation and watering of the eye. This condition, ectropion, can be seen without surgery simply as a result of aging, especially where there has been significant sun exposure.
Not uncommonly at the time of a lower lid Blepharoplasty a support procedure is done to the corner of the eye to try and prevent ectropion from occurring.
Eyelid surgery is usually done under a general anesthetic as a day patient. The main inhibiting factor for the operation is that a degree of bruising is to be expected and this may hang around for ten days or even more. In some cases the bruises are gone in five days but in others they can be severe and persist for up to two weeks. Thus while there is minimal discomfort from the operation one may feel inhibited in returning to work for this period of time.
Other treatment modalities may be suitable for you. If there are a lot of fine lines around the eyes laser resurfacing can be of benefit. If however the main problem are deep lines out to the side (“crow’s Feet”) then use of muscle relaxing injections can help to smooth these lines out. The injections usually last for four to six months and the dose required has to be adjusted to the individual.
Therefore it is wise to be carefully assessed by a plastic surgeon and the treatment options outlined and described. Whilst eyelid surgery is almost pain-free, the bruising there can be inconvenient and may interfere with your returning to normal activity for a week or more.