Upper Lid Blepharoplasty
Most commonly this procedure is performed to rejuvenate the appearance of the eyelids, however there may also be visual benefits if overhanging skin from the upper eyelids are obscuring the uppermost part of the field of vision. This is achieved by removal of redundant skin from the eyelids and some fat may also be removed from their inner corners.
Important considerations
The eyes, lids 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.
Brow Position
Some people unconsciously reduce the hooding effect of the excessive skin on their upper eyelids by using the forehead muscle (frontalis) to lift it out of the way. This is known as a
compensatory mechanism and is common but not universal.
The skin for removal is carefully marked before the anaesthetic is administered in an upright position, relaxing the forehead as much as possible, in order to decide on the amount of skin
which can safely be removed without compromising eyelid closure. This is vitally important for the health and comfort of your eyes. Those whose compensatory brow lift is strong may find that
once the overhanging skin is removed, their forehead muscle relaxes, the eyebrows descend and a fold of skin may reappear in the upper lid. It will be possible to tell if this is the case within 3 months of the surgery (prior to this, the appearance can be due to swelling). Should this apply to you, further removal of this skin will be offered, inclusive within the surgical fee paid at the time of your original procedure.
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.
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.
Scarring
Surgery will always result in some degree of scarring; this is unavoidable but the scar will be placed in the natural skin crease, where it is most discrete. If your skin hooding 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 as
advised and accept that failure to do so may compromise your surgical outcome.
Skin Quality
A surgical blepharoplasty will not change the quality of the upper lid 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.
Anaesthetic
The procedure is usually performed under local anaesthetic as a day case procedure. Once the skin for removal has been carefully marked, you will receive local anaesthetic injections into the upper eyelid(s). These sting momentarily but are very effective. The anaesthetic can be topped up during the procedure if necessary. If a general anaesthetic is preferred this may also be possible, assuming there are no concerns about your fitness for general anaesthesia. 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 and no jewellery or make up 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 approximately 1 hour 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.
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 your vision. There may be some numbness in the operated area which may take several weeks to resolve. There will be
stitches in the skin. These are usually dissolvable but if not, arrangements will be made for you to attend for their removal. You will be given written post-operative information and an emergency number to call in case of any concerns.
Postoperative Care
Regular simple painkillers (ibuprofen 400mg 3 x daily +/or 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.
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.
Price: From £3,400 for bilateral upper lid blepharoplasty (inclusive of post-operative appointments). Consultation fee for the above procedure is an additional £245
I have now been for my last check up and everything with my upper blepharoplasty procedure has been perfect from start to finish. The whole team are very professional, warm and welcoming, and Julia is amazing at what she does. I am so pleased with the final result, and no longer look tired all the time. I would highly recommend anyone thinking about having this procedure to go and see Julia, you will not be disappointed.
Before & after upper lid blepharoplasty | Dr Julia Sen
I had upper blepharoplasty three months ago and am over the moon with the results, both my vision and appearance have improved massively and I could not be happier. Julia was extremely professional.
I had upper blepharoplasty, totally painless and I felt safe in Julia's hands, and her nurses were lovely too. Would highly recommend Julia and her nurse. Felt totally at ease.
Before & after upper lid blepharoplasty | Dr Julia Sen