EYELID SURGERY (BLEPHAROPLASY)

What is Blepharoplasy?

Blepharoplasty is performed to remove excess skin on the eyelids (upper OF lower or both), tighten the muscle support of the eyelids and usually trim and re-distribute the fat pads under the muscle of the eyelids. Excess skin on the eyelids can be a familial trait or become apparent after many years of excessive SUN EXPOSURE and smoking.

This leads to heaviness of the eyelids with excessive skin overhang on the upper lid, transverse wrinkles on the lower lids and bagginess of the lower lids

helpful advice

General Questions

Dr. van Oudenhove and the staff work as a team professionally and discreetly to make your experience as smooth and comfortable as possible. Here are some of the commonly asked questions and answers we've put together to enable our client's in making the most informed decisions.

What is the procedure?

The operation is usually performed under local anesthetic with intravenous sedation. It is usually very well tolerated as long as the patient is calm and does not become anxious or alarmed.

The injections of local anesthetic into the eyelids at the beginning of the operation usually cause a slight burning for about a minute or so.

After the local anesthetic has taken effect the incisions are made along the lines that have been carefully explained to the patient pre-operatively. The excessive skin is then trimmed off with usually some trimming and redistribution of the fat pads behind the muscle of the eyelids.

The incision is then closed leading to tightening of the skin and muscle of the eyelid. The lids are then taped up for a few hours. Starting immediately cold packs are placed upon both eyes in order to help reduce the swelling.

We strongly encourage the use of cold packs for up to 72 hours after the procedure. At the end of the procedure, the patient may be driven home.

Are there any Complications?

The problems associated with bleeding, bruising and swelling have been discussed previously. Also take note that there may be apparent differences in shape between the 2 sides during the first few weeks. In time this usually settles.

Occasionally it appears as if the lower lid is too tight post operatively and does not rest comfortably on the globe of the eye. This usually enquires external taping for 2 – 3 weeks before settling.

There will also be some irregularity of the surface of the lower eyelid especially. This always settles in time.

It has been said in the past that blindness may occur after this kind of surgery. It is possible for catastrophic bleeding which tracks behind the eye to cause stretching of the main nerve to the eye. This is extremely rare and is for all practical purposes not a factor which should affect one’s decision.

This complication has not been witnessed in South Africa over the last 20 — 30 years.

Our pre- and post operative advice

Before surgery, please do not take any products that contain Aspirin or large doses of Vit.E for 3 weeks. If you take any form of over the counter medication please notify your doctor well before the operation.

Ideally smokers should stop smoking completely at least 2 weeks before the operation. If this is not possible we would request smokers to cut down to 3-4 cigarettes a day and abstain from smoking completely for 48 hours pre-op and 48 hours post op. Smoking causes coughing which can easily cause post operative bleeding and further complications.

Please report any signs of cold infection, boils or pustules appearing within 3 weeks of surgery.

The night before and the morning of surgery We recommend washing your hair with an antiseptic shampoo.

Once at home, it is very important to rest in bed on 3-4 pillows and continue applying cold packs to the eyes as discussed with your surgeon. It is advisable to keep the room in semi-darkness for 24 hours and avoid straining the eyes by reading or watching television for long periods of time.

Please note that it is not possible to open the eyes widely for 3- 4 days due to the presence of the tape on the skin. On the 3rd or 4th day, we remove most of the sutures. On about the 5 or 6th post operative day the last few sutures are removed. You can expect some oozing of blood from the incisions but there will not be much pain, you will be more aware of a tightness around the eyes .

The tape on the eyelids may become quite blood stained and one should not become alarmed and for the first 2 — 3 days, one may in fact look rather bruised. This will settle fairly quickly. YOU may be advised to use eye gel or eye drops post operatively. Please use them as instructed.

Your may wash your face but please do not wash the incisions. If you have kept your eyes well moistened with cold packs and using eye drops, then crusts of blood will not form on the eyelashes.

You may wash your hair with assistance + 2-3 days after surgery.

Please wear loose fitting clothes that do not have to be pulled over your head. Dark glasses will make your eyes more comfortable when you go outside and will help maintain your privacy.

Post operatively you can expect swelling and bruising around the eyes, sometimes more on the 2-4 or 3° day. Occasionally the white portion of the eye may become red and discolored. This will settle in time. It will take a few weeks for the initial swelling and discoloration to subside.

There will be temporary differences between one eye and the other. Please be patient, try to avoid comparing them since it will increase your anxiety without helping your healing. You can expect intermittent puffiness and swelling of the eyelids for up to 3 months post operatively.

You may also feel strange sensations on the eyelid skin. Please do not worry as this will all disappear. It is very important not to resume any physically strenuous activity until 3 weeks after surgery.

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