COSMETIC SURGERY
Eyelid surgery
Before considering this a careful assessment of any history of dry eyes or eye allergies should be made to avoid postoperative problems, with assessment by an eye surgeon advisable. Thyroid disease can cause bulging of the eyes and retraction of the eyelids. The management of thyroid eye disease is complex and may require surgery of the bones of the orbit as well as the soft tissues.
Sometimes, drooping of the upper eyelid (ptosis) may be caused by a problem with a specific muscle. This condition must be recognised preoperatively as it will not be improved by blepharoplasty.
Surgery to improve 'eye bags' (bilateral blepharoplasty) can be very successful in restoring a more 'open' and youthful appearance around the eyes. However, although this lid lift and tuck procedure is perceived as simple, quick and straightforward procedure there are limitations as to what can be achieved. The operation of lower and upper lid blepharoplasty generally involves removing excess skin, muscle and fat from the eyelid and can be carried out under local or general anaesthesia as a day procedure. Scars are placed in natural creases and easily concealed. Fine wrinkles in the lower eyelid are not removed and removal of too much fat can produce a hollowing effect after a few years.
There are now several alternatives and refinements to the traditional procedure of lower and upper lid blepharoplasty:
- Removal of fat through an incision on the inside of the eyelid without any scar on the skin.
- For some patients, reshaping rather than removal of the fat
- Using laser to improve the wrinkling of the skin (this can, however, result in a permanent lightening of the skin colour).
- The lower lid can be tightened or elevated as a part of the procedure. This is known as a 'Canthopexy'.
Excess skin folds in the upper lid can commonly occur when the eyebrows become lower and heavier. In these circumstances, a more natural and long lasting improvement can be achieved with a Brow lift