Blepharoplasty - My Form My Beauty

Why consider a Blepharoplasty ?

You may notice that your upper eyelids sit lower over your eyes than they used to, this is known as eyelid ptosis. Ptosis is when the upper eyelid covers too much of your eyeball (limbus). Eyelid ptosis can have many causes, such as age, genetics or trauma, and can be corrected by a procedure to lift the droop. Eyelid ptosis may not only interfere with vision, it may also give the impression of tiredness.

Perhaps you have excess skin in your upper lids (dermatochalsis) and you feel the skin dragging and folding when you open and close your eyes. Your field of vision may even be limited, if you have a large amount of excess upper eyelid skin. For women, excess skin in the upper eyelid can make putting on eye-make up very difficult. If you feel that any of the above issues are affecting you, you may be a suitable candidate for an upper blepharoplasty procedure.

An Asian Blepharoplasty, or a Double Eyelid procedure is usually performed for Asian patients who have no upper eyelid crease. If you would like to have an upper eyelid crease, or wish to open up the eyes more, or make the eyes appear more Eurasian, a double eyelid procedure is the blephroplasty of choice.

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What is an upper blepharoplasty ?

An upper blepharoplasty removes excess tissue from the upper eyelids and can correct minor ptosis. The eyelid has many components, such as skin, orbicularis muscle, fat, the septum, levator muscle and attaching ligaments. For some patients, a blepharoplasty may be a medical necessity, if excess skin hangs down and covers the upper lid to an extent that vision is impaired. A blepharoplasty is sometimes accompanied by other cosmetic procedures of the face, such as a browlift, or a facelift.

How is an upper blepharoplasty performed ?

In upper blepharoplasty usually a sliver of skin is removed first; how much skin, will depend on the amount of excess skin present and the desired outcome. If need be, a small amount of fat is removed or re-draped to create a defined smooth arc of the upper eyelid crease. Similarly, the crease can be made deeper by removing a very a small piece of muscle and a new crease can be created if there’s little or no crease in the first place, as is often seen in the Asian eyelid.

As mentioned before, an upper blepharoplasty may be accompanied by other ancillary procedures, such as an internal browpexy, a lacrimal gland resuspension or the correction of eyelid ptosis.

Asian Upper Blepharoplasty/Asian Double Eyelid Surgery

Asian blepharoplasty is the technique of creating a double eyelid. In a patient who has no upper eyelid fold, it is possible to create a fold in the upper eyelid. Dr Wetton has been taught various techniques in double eyelid surgery by internationally acclaimed surgeons, such as Dr Moon Seop Choi from South Korea, Dr Lok Huei Yap from Malaysia and Dr Matthew Yeo from Singapore, as well as leading Occuloplastic surgeons in Australia.

The new fold can either be created by a suture method, or an incisional method. The suture method involves a few tiny punctures in the skin and the insertion of stitches to create the fold. The advantage of this method is that it does not require an incision, and so scarring is minimal. The disadvantage of this method, is that if the sutures come undone, and sometimes the fold can ‘unfold’ and the eyelid will revert back to being a single lid. The incisional method is more popular, because this involves creating a double lid, by making a small cut in the upper eyelid at the desired point of the new fold. The excess fat and muscle is trimmed away and a fold is successfully created with sutures. The incision is then neatly closed. The incision is placed in the crease of the upper eyelid, where it is not obviously seen, and this technique is usually permanent. As the asian upper eyelid may have excess fat, the incisional method allows for removal of this fat, which ultimately results in an aesthetically optimal outcome.

There are many techniques that are common in Asian countries to either open up the eye, or create a more rounded and bigger eye shape. These procedures are delicate and complex to perform, with a risk of scarring around the eye area. There is a spectrum of eye shapes for Asian blepharoplasties, and the final ‘look’ will be determined by where the patient would like the crease positioned and what ultimate aesthetic results they are after.

Lower Blepharoplasty

Why consider a lower blepharoplasty ?

If your lower eyelids are a source of concern, you may consider a lower blepharoplasty. Perhaps you have noticed that you look more tired, you may have ‘bags’ under your eyes, or you may have developed dark circles under your eyes. A lower blepharoplasty can potentially address all of these issues.

What is a lower blepharoplasty ?

A lower blepharoplasty is a complex procedure, which is made up of many steps. It is used to address the specific areas contributing to an ageing lower lid.

Sometimes a patient may be concerned about under-eye wrinkles and or eye bags (fat protrusion), obvious deep lines (tear troughs) or dark circles. With ageing, the septum and orbicularis oculi muscle may become lax, which means that the fat bulges forward, creating an under eye bag. This bulging fat stops at the orbitomalar ligament (tear trough ligament), where the bag abruptly ends in a deep sunken arc. This arc or depression may be evident just under the eyebags. There is often excess loose skin around this area, causing lines or crepey areas. Each of these unwanted characteristics can be addressed effectively by a lower blepharoplasty procedure.

How is a lower blepharoplasty performed ?

There are two main approaches to a lower blepharoplasty, one is through an incision on the inside of the lower eyelid (transconjunctival approach) and the second is through a fine incision just under the lower eyelash line (subciliary approach)

Unless you are having a mid-facelift at the time of your blepharoplasty, Dr Wetton’s preferred method is the transconjunctival approach. In this procedure, she can remove some of the fat from the lower-eyelid and remove it, or redistribute it to cover the orbital rim so that the fat comes down into the upper cheek area to create a smooth appearance, and decrease the lower eyelid bag.This technique helps to smooth out the eyelid to cheek junction.

If your concerns are also related to excess skin, or creepy skin under the eyes, a small amount of skin removal can be done, by simply cutting a few millimeters of skin under the eyelash line. In effect, the skin around the eye appears smooth and tight.

If you have loose ligaments around the eye, or you are having a mid-facelift, Dr Wetton will often perform a canthopexy which is a ligament tightening procedure. A canthopexy uses stitches to strengthen and stabilise the lateral canthal tendon, it repositions the outside corner of the eye where the upper eyelid meets the lower eyelid. The corner of the eye is uplifted. If a patient’s skin is very lax in that area, as can happen as we age, a triangular wedge of tarsus plate, which is a thin sheet of fibrous connective tissue, may need to be excised.

Dr Wetton has a special interest in blepharoplasty and has had the privilege to be taught lower blepharoplasty techniques from leading Occuplastic and Blepharoplasty surgeons in Australia and overseas.

Frequently Asked Questions

How long will my procedure last?

A Blepharoplasty is a permanent procedure, however our faces continue to age. As we age, we lose collagen and our connective tissue can become more lax over time. There is a possibility, depending on genetics and lifestyle that you may need to have more than one blepharoplasty in your lifetime if you wish to maintain a certain aesthetic.

Recovery

All blepharoplasty procedures are performed in an accredited hospital and you can go home on the same day. An upper blepharoplasty can usually be well healed in two or three days, but a lower blepharoplasty usually takes a week or two. Most likely, you will have some swelling and bruising and you will need to rest and take it easy the first day to two. Depending on the incision, the swelling can last anywhere from a few days to a few weeks. Some patients are out and about the next day after an upper blepharoplasty, but Dr Wetton recommends that you take one week off work after an upper blepharoplasty and 1-2 weeks off work after a lower blepharoplasty. Each and every patient is an individual and depending on your general health and usual lifestyle some people will recover more quickly than others. If you are female and like to wear make-up, it will be at least a few weeks before you go back to wearing full eye make-up.

One week later

After a week, your sutures will be removed and Dr Wetton will review your progress in person. You will notice that the swelling and bruising will begin to subside, and you will have more energy again. You should already notice the beginnings of a positive difference in your eye area.

Complications

Too much skin removal
Too little skin removal
Infection
Bleeding
Damage to underlying structures
Poor scar
Protracted swelling
Dry eyes
Excess tears
Asymmetry

How much will my Blepharoplasty cost ?

The Surgical Fee for a Blepharoplasty is $4000- $8000 depending on the type of blepharoplasty required and any ancillary techniques which may need to be utilised. This fee does not include the Hospital or the Anaesthetic Fee.

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Blepharoplasty: Upper and Lower Eyelid Surgery