Adrian Richards's Blog

The eyes have it

POSTED: September 23, 2013

The eyes are one of the most visible areas of the face and consequently ageing changes in these areas are common concerns. In addition the eyes are particularly susceptible to environmental factors such as alcohol intake and smoking.

Lack of sleep, stress and inadequate fluid intake visibly affect the eye region more than any other.

Eyelid operations are called blepharoplasties and are either performed on the upper eyelid (upper blepharoplasty) or the lower eyelid (lower blepharoplasty). These operations can be performed together or separately and are often combined with face lift operations. Upper blepharoplasty

Many people have a significant fold of extra skin on their upper eyelid. In some cases this can be hereditary and appear from a young age, in others it develops with time. As this fold of skin becomes heavier the forehead muscles have to work harder to keep the eyebrows elevate and the eyes open.

Constant contraction of the forehead muscle causes fatigue and discomfort and deepens the wrinkles in this area. As the forehead muscle tires towards the end of the day some people find it particularly difficult to keep their eyes fully open. Often this effect is most noticeable when driving at night.

The extra fold on the upper eyelid makes tasks such as putting on makeup difficult. In addition tests often show that the fold reduces vision in the upper area similar to the effect of wearing a peaked cap. Following upper blepharoplasty many people notice that everything is much brighter demonstrating the reduction in their visual fields before the operation.

Upper blepharoplasty is one of the most frequently performed facial cosmetic procedures and is often performed alone. The effect is subtle and makes you look fresher and less tired. Following the operation most people will not be able to pinpoint exactly what has changed about your face but comment that you look brighter as if you have had a good holiday.

Upper blepharoplasty can be performed under local, twilight or general anaesthetics. Twilight anaesthetic is often preferred by the patient and the surgeon as it has a rapid recovery without many of the side effects of a general anaesthetic. For the surgeon it has the advantage that it is possible for the patient to open and shut their eyes during the procedure. This helps him make small adjustments to ensure exactly the right amount of skin is removed and the scar is concealed as near as possible to the upper eyelid fold.

Recovery from upper blepharoplasty is normally fairly rapid with most people returning to work within a week. Lower blepharoplasty

In a lower blepharoplasty and incision is made under the eyelashes extending out into a natural fold. Puffiness can be reduced by removing or redistributing the fat pads of the lower lid. Any skin excess is treated by direct skin excision. It is extremely important that this is performed judiciously as excess skin removal can pull the eyelid down away from the eye (ectropian).