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We regret that medical advice cannot be provided outside the context of a consultation and NHS referrals can only be made through a General Practitioner.
With age the skin looses elasticity and muscles tend to become floppy. This change is most obvious in the face particularly around the eyes. This excess skin forms folds in the upper lids and deepening creases in the lower lids. Loss of muscle tension results in prolapse of fat from the eye socket producing bags. In some people there is an inherited tendency for eye bags to develop in early adult life. Rarely medical conditions such as thyroid disease may results in similar problems.
Most changes are worse in the morning and can be particularly bad during periods of stress or lack of sleep. Additionally if forehead skin loses its elasticity the eyebrows may also droop and make the excess skin in the upper eyelid appear worse.
Eyelid surgery (blepharoplasty) can correct droopy, puffy eyes, rejuvenate a tired appearance and create a more youthful look. Both upper and lower eyelid surgery can be carried out under local anaesthesia, intravenous sedation or general anaesthesia. The procedure takes up to two hours.
In upper eyelid surgery cuts are made along natural skin folds to remove excess fat, muscle and loose skin depending on what is required. In lower eyelid surgery cuts are made either inside the lower eyelid or in the skin to remove or reposition excess fat causing puffiness. If the lower eyelids have bags without any skin excess then fat can be removed using a cut on the inside of the lower eyelid (transconjunctival blepharoplasty) that avoids an external scar.
Following surgery the incisions are put back together with fine stitches that are removed after around five days. As all incisions are made along natural folds scar visibility is minimal.
It is important to understand that blepharoplasty will not eliminate dark circles, fine lines and wrinkles around the eyes, change sagging eyebrows or remove festoons - the puffiness that sometimes occurs in the upper cheeks.
A variable amount of swelling and bruising is to be expected around the eyelids. Occasionally the whites of the eyes may become bruised with a red appearance. Slight blurring may also be noticed. Contact lenses are best avoided in the first few days. All these changes are most noticeable in the first 24 hours after surgery and settle in 3-4 weeks. These effects can be minimised by using cold compresses and sleeping propped upright for the first 3-4 days after surgery.
Depending on the nature of your work it may be necessary to take a fortnight or so off work and avoid strenuous exercise for this time. It is important to remember that you will not be able to drive or operate machinery for 48 hours after a general anaesthetic and 24 hours after intravenous sedation.
Bleeding can occur but is usually slight and is likely to stop by applying pressure over the area for about 10 minutes with a rolled up handkerchief or swab.
Infection is uncommon and can be minimised by the use of antibiotic eye drops or ointments
Closure of the eyelids may occasionally appear tight after surgery because of the swelling
Any incisions made on the face will produce a scar but these fade with time.
The eyelids may feel itchy and numb for several weeks after surgery
Rarely the outside corner of the lower eyelid may pull down slightly (ectropion). This tends to settle on its own but may need further surgery
Changes in vision are very rare
