The eyes are the dominant feature of the face and the windows to the soul. They also play a major role in how attractive the face is viewed, as well as mood and character. The upper and lower eyelids are greatly affected by ageing in both men and women. Dr. Gerarchi performs procedures to rejuvenate the eyes and restore a more youthful and rested appearance to patients whose heavy or baggy eyelids make them seem sad, tired or old. A blepharoplasty is a surgical procedure to address changes to the eyelids that occur naturally with age.
Upper Eyelid Blepharoplasty
The most common concern among both men and women with their upper eyelids is excessive skin. This can make the face seem older and tired and the extra weight can also cause tired eyes and even headaches. In some cases, excess skin of the upper eyelids can even impair vision when it folds over the eyelashes.
This excess skin and fat around the eyes may be corrected through upper eyelid surgery. This procedure is performed through an incision that is hidden in the upper eyelid crease. Excess skin and sometimes a small amount of fat will be removed to restore the original contour to the upper eyelids.
Most patients have little discomfort after this surgery. No post-surgical dressings will be necessary and the incisions, once healed, will be almost impossible to see. This procedure can improve vision and lighten the eyes by exposing the eyelashes.
While some patients require only rejuvenation of the upper eyelids, this procedure may be performed as a ‘double’ blepharoplasty to correct both the lower and upper eyelids for total rejuvenation of the eyes.
Another issue to consider is that ‘heaviness’ of the upper eyelids is not always only due to excess eyelid skin. Sometime the eyebrows have descended, contributing to the aged appearance of the upper eyelids. In this case a browlift may be recommended for ideal rejuvenation of the eyelid area.
Lower Eyelid Surgery
Lower eyelid surgery treats the lower eyelids, and it may be performed with several techniques depending on the cause of the puffiness below the eyes. This procedure is a bit more complex. The lower eyelids may develop pouching or puffiness when fat under the eyes bulges, which may be due to weakening of the supporting structures under the eyelids. This is often responsible for the under-eye bags that can develop with age.
Dr. Gerarchi will remove or redistribute the underlying fat and/or tighten the skin of the eyelids to smooth out the under-eye area. This involves an incision under the eyelashes or inside of the lower eyelid.
Depending on the cause of the puffiness under the eyes, the procedure may be done in a minimally invasive manner. Patients who have severe puffiness due to wrinkling, excess skin or excess fat will require a standard surgery.
Surgery is performed under local or general anaesthesia, depending on the technique that will be used, and takes between one and two hours to complete, depending on whether just the lower eyelids will be addressed or both. Incisions will be very well concealed once healed and almost invisible.
After surgery, bruising around the eyes is common but typically fades within one to two weeks. At The Face Institute, we recommend applying Hirudoid cream available at our practice to help resolve bruising. Some patients experience redness of the eyeballs, which results from bruising to the soft tissue.
Swelling is also normal following surgery, and this swelling may be uneven. Swelling reaches a peak two days after surgery and gradually subsides on its own. You may notice forward or downward displacement of your lower eyelids, which is temporary and a result of poor muscle tone or swelling. Gentle massage and exercises can help. Some patients experience swelling of the whites of the eyes, which can take weeks to resolve.
Scars usually appear pink for the first few weeks, although they will resolve into nearly invisible, thin white lines over time. To improve healing and help reduce the visibility of scars, applying Dermatix gel into the scars twice a day for six weeks can help. This gel is available at our practice.
You may experience drying of the eyes. It can help to use lubricating eye drops for the first two weeks. You may also experience blurred or double vision, sensitivity to light and excessive tearing, which is normal during the first few weeks. Watching too much television, reading too much or staring at a computer screen may also make your eyes feel tired during the first few days.
The Face Institute will provide detailed care instructions to follow after your surgery. It is very important to follow these instructions for a successful surgery and an easier recovery.
Avoid any activity that may interfere with healing, including smoking and drinking alcohol. Plan to take a one or two week break from your normal routine to heal. The eyes should be protected during the healing stage so avoid rubbing or touching them. You may wear dark glasses when you are outside if you feel sensitive to bright sunlight or wind. Avoid driving for the first 24 hours.
Medication and Pain relief
Most patients experience only mild pain or discomfort following blepharoplasty, but Dr. Gerarchi may prescribe oral pain medication to make your recovery more comfortable. Avoid medication that contains ibuprofen or asprin, which increase bruising and the risk of complications.
Your eyes should be kept dry for at least one week. Dr. Gerarchi will prescribe Chlorsig, an antibiotic ointment, which should be applied around incision sites to keep them from drying out and improve healing.
Dr. Gerarchi’s staff will help you schedule follow-up appointments before your surgery. The first follow-up appointment will be about one week after surgery, at which point Dr. Gerarchi will check on your healing and remove non-absorbable sutures. If you experience bleeding, excessive pain, fever or abnormal swelling do not hesitate to contact us immediately.
Follow-up appointments depend on the procedure and patient. In most cases, expect your appointments to take place one week, six weeks, three months, and six months post-surgery
Am I a candidate for this procedure?
Men and women in good physical health who want to improve sagging of the upper eyelids or puffiness under the eyes may be good candidates for this surgery.
What type of anesthesia will be used?
Dr. Gerarchi typically performs blepharoplasty with local or general anesthesia.
How long will the surgery last?
This procedure is typically completed in one to two hours.
Will there be visible eyelid surgery scars?
While the procedure will result in scars, once healed they will be very well hidden and difficult to notice. Like all incisions, these scars will appear pink to start with, but will fade. For an upper eyelid procedure, incisions will be placed in the crease of the lids. For the lower eyelid procedure, incisions will be placed inside the lower lids or just below the eyelashes.
How soon can I return to work?
The recovery takes between one and two weeks. Most patients return to work within 7-14 days, depending on the extent of surgery.
Are there any risks to the surgery?
Possible rare risks associated with this procedure include infection, scarring, bleeding, ectropion (a condition in which the lower eyelid turns outwards) and blindness.
The before and after photographs shown are of Dr Gerarchi’s patients. They are for illustrative purposes only. They depict the results achieved by individual patients and are no guarantee of the outcome to be expected by any particular individual considering surgery. Reputable surgeons do not guarantee outcomes. Unexpected events and individual healing characteristics can affect the outcome of any surgery.
The before and after photographs shown are of Dr Gerarchi’s patients and the surgery has been performed by Dr Gerarchi. They are for illustrative purposes only. They show the results achieved by individual patients and are no guarantee of the outcome to be expected by any particular individual considering surgery. Surgeons of good reputation do not guarantee outcomes. Unexpected events and individual healing characteristics can affect the outcome of any surgery.
Please feel free free to call us on (02) 9412 4599 or email if you would like any additional information about this procedure.