Lower Lid Blepharoplasty
Lower lid blepharoplasty is a procedure performed to rejuvenate the appearance of the lower eyelids. This is usually achieved by trimming of any redundant skin +/- redistributing +/or removing of fat to improve the contour of the lower eyelids.
Important considerations
The eyes, eyelids and brows constitute an important area of the face with respect to our identity and social interactions. Changing the appearance of this area will inevitably change the way you
look.
Anaesthetic
The procedure may be performed under local or general anaesthetic as a day case procedure. Local anaesthetic injection is administered in both instances as it helps to reduce post-operative discomfort in the first few hours. If you are awake, it will sting momentarily but is very effective. It can be topped up during the procedure if necessary.
Pre-Operatively
Certain medications may need to be discontinued prior to the procedure. Foods and supplements such as ginger, garlic, ginseng, gingko biloba and vitamin E should be avoided for
two weeks prior to surgery since they may have a similar effect.
Arnica may be taken following your surgery if you wish. The evidence that Arnica reduces postoperative bruising is weak but many of patients report perceived benefit. It should not be
taken in advance of surgery as it may promote bleeding.
If opting for a general anaesthetic, you will be required to fast prior to admission and will be advised about the details of this at your pre-operative assessment. In the case of local anaesthetic, you may eat and drink as normal prior to your arrival. On the day of surgery it is advisable to wear loose fitting clothes. Please wash your face but do not apply any creams or make up. No jewellery should be worn.
Operation
Your face will be cleaned with an antiseptic solution and drapes will be wrapped around your face. The procedure usually takes 2 hours during which if your procedure is undertaken under
local anaesthetic, you will be able to talk freely and let us know how you are feeling. At the end of the procedure a dressing is usually applied to one side.
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What To Expect Post-Operatively
The local anaesthetic will wear off over the next few hours. There will be swelling and some bruising, the majority of the bruising will resolve over the next 2 weeks; the swelling may take several months to resolve completely. The eyelids may feel somewhat stiff and difficult to fully open or close in the early post-operative period. There may be watering and stickiness which may initially blur vision. There may also be some numbness in the operated area which may take several months to fully resolve.
There will be stitches in the skin. These are usually dissolvable below the lash line but in some instances non-absorbable sutures will be used to help maintain the position of soft tissues which have been “re-draped”. If this is the case, arrangements will be made for you to attend for their removal, usually after 1 week.. You will be given written post-operative information and an emergency number to call in case of any concerns.
Postoperative Care
Regular simple painkillers (e.g. paracetamol 1g 4 x daily).
Cold compresses (bag of frozen peas or an ice pack wrapped in a clean linen) 5 x daily for the first 3 days. Additional pillows overnight to raise your head and discourage further swelling.
Clean your face using a clean, damp flannel, cotton wool pads or baby wipe; avoid immersing your face in water.
Healing
A healthy healing response is dependent on the quality of your tissues which is, in turn influenced by your lifestyle choices. Smoking and poor nutrition reduces the chance of an
optimal outcome. If you smoke, it is strongly recommended that you stop as soon as possible and that you avoid highly processed foods and those high in sugar. If you are diabetic, it is
important that your blood sugars are optimised in advance of your surgery to facilitate your body’s healing response. Certain medications may need to be discontinued prior to the
procedure. You will be advised if this is the case.
Scarring
Surgery will always result in some degree of scarring; this is unavoidable but the scar will be placed immediately below the lash line, where it is most discrete. If the skin requiring removal
extends out towards the temple, the scar will extend within one of the existing “laughter lines”. Massage of this area once the stitches have dissolved will help to make this scar increasing discreet. It takes a full 12 months for a scar to mature and diligent massage is vital to obtain optimal results. By consenting to this procedure you are committing to undertake the postoperative instructions and failure to do so may compromise your surgical outcome.
Skin Quality
A surgical blepharoplasty will not change the quality of the skin, which becomes thinner and somewhat “crepey” with age. If this is a concern, there are non-surgical ways of addressing these changes which can be discussed for consideration prior to or following blepharoplasty surgery.
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Risks of Blepharoplasty
Bleeding
Incomplete eyelid closure
Exacerbation of dry eye
Double vision
Scarring
Asymmetry
Change in brow position
Need for further treatment, including surgery
Visual loss (very rare)
Failure to meet aesthetic expectations
Further questions
It is important to ask any questions you may have once you have received this information and a second consultation will be offered to you without further cost to discuss all aspects of your care in advance of your procedure. Please feel free to ask any questions you may have at any point prior to the procedure.
Price: From £3,600 for bilateral lower lid blepharoplasty (inclusive of post-operative appointments). Consultation fee for the above procedure is an additional £245.
Before & after lower lid blepharoplasty | Dr Julia Sen
