LOWER BLEPHAROPLASTY INFORMATION
is the medical name for the operation which removes eye bags. The prefix "lower" simply refers to the lower eyelid, and hence lower blepharoplasty
is also known as lower eyebag removal. With advancing age many people
develop redundant skin on the lower eyelid, and some of the fat from within
the eye socket prolapses (moves forward) making the situation worse. This
operation removes the loose skin and excess fat which appear below the
eye, generating a younger, fresher look to the eyes. Blepharoplasty is
a relatively common procedure performed in both men and women, and can
be performed in combination with other cosmetic procedures.
Before the operation
There is nothing
special or complicated to be done by the patient. If you are on the oral
contraceptive pill or HRT you should continue to keep taking it, and inform
the surgeon or anaesthetist in the hospital. It would be advisable to
stop any herbal medicines and avoid aspirin or ibuprofen-like drugs for
2 weeks before and after the operation.
The operation itself
come into the hospital on the morning of surgery. The operation is usually
performed under general anaesthetic and takes between one and two hours.
There are two main types of operation to remove lower eyebags. In the "traditional" operation there is a small incision just below
the eye lashes, and the excess skin and fat are excised, removing the
eyebag appearance. This type of operation is used in 90% of cases. In
some young people, the main problem is of excess fat prolapsing forward
rather than loose skin. Such patients benefit from the "trans-conjunctival"
operation which is only suitable for younger patients who have no extra
skin on their lower eyelids. The "trans-conjunctival" operation
uses an internal approach to excise the fat and remove the eyebag appearance.
There will be no big dressing at the end of the operation but there will
be small steristrips (paper stitches) over the lower eyelids. Patients
are advised to stay overnight and go home the following day.
Post-operative follow-up and after care.
dressing should be left alone and not interfered with. You will be given
eyedrops to take home with you and it is important to use them as prescribed.
It is vital that you rest and take it very easy for at least 2 weeks after
the operation and it is essential to avoid all strenuous activity during
this period - this includes all sexual activity. You wound be advised
to take 10 days off work to allow any swelling and bruising to settle.
It is critical that you do not bend down and lower your head as this increases
the possibility of bleeding and bruising. Vigorous sport such as jogging
or the gym should be avoided for 4 weeks.
At between 5 and 7 days you will be seen in the clinic and the steristrips
and stitches removed. A check-up clinic appointment at 3 months after
the surgery will be arranged for you.
carry a risk of complications, and in lower blepharoplasty is no exception.
If the "traditional" operation is performed there will be small
scars just below the eyelashes which heal extremely well and with time
become almost invisible. Very occasionally the scars may be red for a
few months but they usually settle down by themselves without any treatment.
They can be easily covered by make-up during this time. The "trans-conjunctival" operation uses no external incisions and therefore no scar is made.
The risk of infection is very low, about 1 %, and responds well to antibiotics.
Many patients will notice that there is bruising of the lower eyelid area,
the amount of which varies between individuals. This bruising resolves
by 10 days. The most serious complication is of severe bleeding behind
the eye itself after surgery. This is called a "haematoma" (collection
of blood) and can interfere with vision. Great care is taken to avoid
this extremely rare problem.
Some patients complain of dry or gritty eyes after the operation. This
is related to changes in lubrication of the eye or swelling of the lining
of the eye. Fortunately, these changes are temporary and resolve spontaneously.
If the dryness or grittiness is a problem during this period simple lubricating
eye drops can be prescribed.
One of the problems associated with lower blepharoplasty is of pulling
down of the lower eyelid after surgery. In mild cases this is called "scleral
show" when the white of the eye is visible above the lower eyelid,
with the eye in its resting position - (some patients have this appearance
naturally before any surgery has taken place). In more severe cases the
pulling down of the eyelid is known as "ectropion", which is
fortunately rare. At the time of surgery special stitches are used under
the skin to avoid this happening.
is a procedure designed to reduce the extra skin and fat of the lower
eyelid, and remove the eyebag. It gives good, predictable results and
improves the appearance of the eyes.
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