Eyelid Surgery (Blepharoplasty)
Blepharoplasty, or surgery of the eyelids, removes excess skin, fat and muscle from the upper and lower eyelids. It can make you look younger by getting rid of unsightly lines and droopy eyelids.
You are a good candidate for blepharoplasty if you have puffiness, sagging or loose skin on your upper eyelids, drooping, excessive skin or fine wrinkles on your lower eyelids or bags underneath the eyes.
Eyelid surgery is often combined with other cosmetic enhancement procedures, such as a facelift and brow lift surgery.
What eyelid surgery can do for you
Eyelid surgery can be performed on the upper eyelids, lower eyelids or both, removing excess fat and skin from the eyelids. It can really help make a person look more alert, refreshed and youthful.
Droopy upper eyelids can make a person look much older than their actual age. Sometimes they can also make a person look sleepy. In severe cases they can even impair vision. Surgery on the upper eyelids can refresh the eye area, giving a much younger and more alert appearance.
Puffiness, bags under the eyes and excess skin folds can make people look tired and worn out, even when they are not. Lower eyelid surgery can remove the puffiness caused by fat deposits and remove excess skin, firming up the under-eye area.
Browse the Face Gallery for results of eyelid and browlift surgeries performed by Dr George Marcells. All photos are those of actual patients of Dr Marcells.
What eyelid surgery can’t do
Blepharoplasty cannot remove dark circles around the eyes or get rid of all the fine lines or wrinkles around the eye area, although some, like those below the eyes, may be removed as a result of blepharoplasty surgery. Fine lines and wrinkles can be treated effectively using a range of non-surgical treatments. Eyelid surgery does not correct sagging eyebrows either. For this you need a browlift.
Are you a candidate for eyelid surgery?
Eyelid surgery is performed on adult men and women with realistic goals and expectations for improving their eyelids and the area surrounding their eyes.
It is essential to have healthy facial tissue and muscles and no life-threatening conditions or serious eye problems at the time of surgery.
For your own safety, inform Dr Marcells at your initial consultation if you have any eye disease (such as glaucoma, a detached retina or dry eye), disorders of the thyroid or circulatory disorders such as heart disease or high blood pressure. Also inform him if you have diabetes.
Sometimes, although people visit Dr Marcells seeking eyelid surgery, the best treatments for them could be non-surgical cosmetic treatments to the area around the eyes. Who will benefit from eyelid surgery and who will benefit from minimally invasive non-surgical treatments can only be determined after a consultation. After your consultation, Dr Marcells may recommend volumising treatments like dermal fillers, anti-wrinkle injections, peels and specially formulated skin care products and eye creams instead of surgery. For some people, only eyelid surgery can make a difference.
How the procedure is performed
Eyelid surgery needs to be customised to suit each individual’s needs. The general goal of upper eyelid surgery is to reverse signs of ageing and to restore a youthful and vibrant look.
During upper eyelid surgery, incisions are placed in the natural crease of the upper eyelid, so that they are hidden when your eyes are open. Excess skin and fat are removed through the incisions. How much or how little needs to be taken off to give you the best results depends on your specific needs. And this must be done with care and precision; even a little excess fat removal could make your face look hollow, making you look unwell or older than you are.
The most common complaint from people wanting lower eyelid surgery is bags under the eyes and dark circles.
Lower eyelid surgery uses incisions just under the lower eyelash line and inside the lower eyelid, leaving no visible sign of surgery. Excess skin and fat are removed through these incisions.
The incisions made inside the lower eyelids are best suited for younger people who have little or no redundant skin that requires removal. The excess fat deposits and the orbital fat that have moved to below the eyelids will be removed using the incision placed inside the lower eyelids. If there is only a little excess skin on the lower eyelid, a small amount may be removed in this procedure or be treated later with laser treatments and chemical peels to tighten the skin.
Older people usually have redundant skin under their eyes. For these people, Dr Marcells performs transcutaneous lower lid blepharoplasty. In this technique, the surgical incision is placed outside of the eye, just below the eyelashes of the lower eyelids. This enables the removal of both excess fat as well as skin folds from under the eyes.
Lower eyelids can become lax with age. Usually people who are middle aged start to see first signs of this.
Dr Marcells uses a general anaesthetic when performing eyelid surgery. This means that you will be asleep for the procedure. You should be able to return home after the effects of the anaesthetic have worn off.
Upper eyelid surgery usually takes between 45 minutes and one hour. If both lower and upper eyelids are to be operated on, the combined surgery will take about two hours to complete.
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Preparing for your eyelid surgery
The preparation process this procedure involves an initial consultation. It may be necessary to take certain medications or adjust the medications you are currently taking before having the procedure.
Dr Marcells will give you a set of instruction on preparing for your blepharoplasty. Follow those instructions closely. If you have any questions or need clarification on the instructions given to you, we will be glad to help.
You will be asked to stop taking aspirin, anti-inflammatory drugs and certain other medications. Taking this step, and avoiding herbal supplements during this time, helps control the risk of excessive bleeding.
After the surgery
Your eyes will be loosely covered with gauze immediately after surgery. Expect lubricating ointment and cold compresses to be applied.
Eyelid surgery is usually a day procedure, so you will need someone to drive you home after the surgery.
The natural healing process during the first one or two weeks may involve some swelling, bruising, dry eyes or eye irritation and irritation around the incision site.
During your recovery, follow the post-operative instructions given to you by Dr Marcells. If anything appears out of the ordinary, or if you experience severe pain, call us immediately.
Your instructions will include contact numbers to use in an emergency. Do not hesitate to use those numbers. Having your mind at rest is important for uneventful and speedy healing. If a call can put your mind at ease, go ahead and make that call.
You may be able to see the results of your eyelid surgery within several weeks of the procedure. However, complete healing of the incision lines could take up to a year. Avoid exposing your eyes to the sun until the healing process is complete. Using dark glasses and even a hat is recommended.
Potential risks and complications
Every surgical procedure carries some level of risk, including the risk of infection and adverse reactions to anaesthesia.
Although they are rare, potential risks and complications that can arise from blepharoplasty include:
- Temporary numbness of the skin on the eyelids
- Dry eyes or eye irritation
- Temporary vision changes, such as double vision
- Impaired eyelid function
- Injuries to the muscles of the eye
- Abnormal discolouration of the skin on the eyelids
- There is a very small risk of blindness if there is bleeding behind the eye
Carefully choosing your facial plastic surgeon, checking the accreditation of the facility used by the surgeon and a thorough discussion of your medical records prior to surgery can avert a lot of unnecessary risk. However, it is impossible to entirely eliminate risk of a surgical procedure.
Now it’s your call
Every year over a hundred thousand people around the world have blepharoplasty. Its popularity may be explained by the fact that no medical alternatives can reshape or reposition the eyelids.
Eyelid surgery is most in demand among people in the 35 to 64 age group. But over 65s also account for a sizable portion of candidates each year.
Blepharoplasty is elective cosmetic surgery and is not typically covered by Medicare Australia or by private health insurance companies. However, some of the costs of eyelid surgery may be covered if the procedure is performed for medical reasons, such as in the case of droopy eyelids impairing your vision.
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Meet Dr Marcells
MBBS (Syd), FRACS (ORL-HNS)
Past President – Australasian Academy of Facial Plastic Surgeons
Dr George Marcells is known for excellence in facial plastic surgery and is considered a true master of rhinoplasty. He performs advanced surgical techniques to restore balance and harmony to the face and can also resolve functional issues such as breathing difficulties.