How blepharoplasty surgery is done


Blepharoplasty surgery is usually done under local anaesthesia, with light sedation to make the patient feel relaxed and sleepy. Lower eyelid blepharoplasty is sometimes done under general anaesthetic.

Upper eyelid blepharoplasty

Typically, incisions are made in the upper eyelid skin crease where they heal well and will remain hidden. The incision is made along the eyelid natural skin crease a few mm above the eyelashes (between 6 and 8 mm in Caucasians, but less in Asian patients with a naturally low skin crease). An elliptical piece of skin and muscle is removed using a blade and a "Colorado" needle (cutting diathermy) which greatly reduces bleeding and helps keep the surgery very neat. Some underlying fatty material may also be removed. The skin incision is close using delicate sutures of glue.

At the same time as upper eyelid surgery, an eyebrow ptosis (droop) and eyelid ptosis (droop) way have to be addressed.

Lower eyelid blepharoplasty

Patients with only mild lower lid skin laxity or fine lines and discolouration may not require a blepharoplasty, but instead can get noticeable improvement from either laser resurfacing treatment or a chemical peel such as trichloracetic acid (TCA).

If there are only deep tear trough regions, injection of Hyaluronic acid (Restylane) is used in the periocular region to increase the soft tissue volume. If this is satisfactory, once the Restylane has resorbed, a further injection is offered or the patient prodceeds with fat transfer ("Coleman fat").

If lower eyelid surgery is required, the incision depends on what material is going to be removed. If only fat bags need removing or delicate repositioning into the tear trough region, this can be done via the inside of the eyelid, which causes little swelling and leaves no scar visible on the outside.

If skin is going to be removed from the lower eyelids, a fine sub-ciliary incision is positioned 1-2 mm below the lower lid eyelashes and enables the excess lower lid skin to be redraped and excised. Absorbable sutures are used to close the skin incision, which looks discreet and heals well, usually without a visible scar.