Christopher Thomson F.R.A.C.S
Ear, Nose and Throat & Facial Plastic Surgery
Phone: +64 (03) 356 0274
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Patient Information on Eyelid Surgery - Blepharoplasty

This information is important regarding your eyelid surgery. Please discuss any issues you do not understand with Chris before surgery.

The eyes show our expression. Eyelid surgery is requested to improve a tired, angry or sad expression which does not reflect our true self. This is accomplished by removal of skin and/or fat from the upper and/or lower eyelid. It is a sophisticated operation which usually heals quickly. Modern techniques reduce recovery time and swelling.

Most of the upper eyelid incision is hidden in the upper eyelid crease, but the ends may be visible above the outer eyelid. For the first few weeks the scars may be pink and slightly thickened. This may require some cosmetic camouflage until it has settled down over the first few months. Incisions can never be made completely invisible, and the final appearance depends upon your pattern of healing and reaction to surgery.

Bruising occurs around the eyelids for about a week, sometimes slightly longer. Occasionally it spreads onto the white part of the eye. To minimise bruising and swelling, avoid Aspirin and similar pain killers for 3 weeks before the operation and avoid overactivity and bending over for 2 to 3 weeks after the operation. Dark glasses are helpful during this early period.

The upper eyelid is often slightly overcorrected to obtain a better long term result. This may cause slight dryness of the eyes. Should this happen, the use of a lubricating eye ointment during this phase is important when asleep to prevent the eye drying out and becoming sore. Rarely a prolonged reduction in tear formation may necessitate the use of artificial tears.

Although many patients have an ideal result, it may not be possible to completely remove all wrinkling or fullness of the upper and lower eyelids in every patient with safety. Mr Thomson will endeavour to provide the best cosmetic result, while performing safe surgery.

Mr Thomson is careful to preserve the eyelid support structures. One potential complication is "ectropion" where the lower eyelid appears pulled down too far. The lower eyelid is a very weak structure and accordingly, to avoid this problem, Mr Thomson is careful not to pull too hard here. For this reason the skin below your eye may not be as smooth as you may wish. Also note that this surgery will not remove the fine wrinkling called "smile lines" at the outer edges of the eyelids, nor deep creases ingrained into the eyelids themselves.

Swelling and ointment in the eyes cause slight blurring of the vision for the first few days in many cases. Very rarely there is a temporary impression of double vision for a day or two after the operation but this recovers spontaneously and is associated with the bruising, not with any serious complication of the operation. Temporary irritation and abrasions of the outer surface of the eye itself may occur. These usually resolve with specific eye drops.

Longer lasting change in vision is a remote possibility. If you have glaucoma or if you have any ocular problems that impede vision or tear formation, be sure to tell Mr Thomson before surgery. Longer term problems with dryness can occur in any eyelid surgery and this may require further surgery or use of drops or ointments or referral to an ophthalmologist (eye specialist) for further management.

Asymmetry is normal in nature and exists in every person although this is often not recognised. Due to variations in healing, underlying tissue structure and surgery, asymmetry may be present after any operation. This means that one eyelid may have slightly more fullness or wrinkling than the other. Mr Thomson always endeavours to identify and minimise asymmetry in every case.

Eyelid surgery is not a painful operation. However there may be "discomfort" because of the "tightness", the swelling and the ointment etc. There may also be excessive tear formation and sensitivity to bright light for the first few days. Be sure to report any postoperative pain to Mr Thomson.

Variations in healing occur in every patient. Bleeding, infection, tissue reactions and contractions can affect the final result. Mr Thomson will provide professional care to coordinate management of any problems which arise.

It is important not to over exert during the recovery period (1-2 weeks). This will reduce the risks of bleeding and reduce swelling.

Should there still be any questions regarding this surgery, be sure to get them answered in advance by Mr Thomson. Well-meaning friends are not a good source of information! Find out everything you want to know before the operation - a well informed patient is a happy one!

Finally, obviously there can be no guarantees with any surgery. Remember improvement not perfection is the realistic aim. A further operation may rarely be required to improve the result.

Postoperative Instructions after Blepharoplasty

The eyes may be swollen and bruised for a week after surgery. Cold compresses and resting with the head elevated will reduce swelling and discomfort.

Regular Postoperative Care

Apply antibiotic ointment to the suture line 4 times per day for 5 days.
Eye drops may be prescribed for lower eyelid surgery.
Cold compresses on the eyes (a bag of frozen peas on a tea towel) are useful for 2 to 3 days after surgery.
Dark glasses provide eye protection and camouflage.
During the first week cleanse the face carefully, avoiding the eye region.

Pain

Severe pain should not occur after blepharoplasty - contact the office.
Mild pain should respond to paracetamol and codeine combinations e.g. panadeine.
DO NOT USE ASPIRIN or products CONTAINING ASPIRIN as they may produce a haemorrhage.

Events after 'external' blepharoplasty

The table below serves only as a guide. Feel free to discuss specific problems with Chris. Contact the office should there be any unexpected problems.

Make up After day 3, (initially water based).
Bruising Variable - Usually resolved at 1-2 weeks.
Contact lenses After 10 days
Return to work Usually at 1 to 2 weeks.
Strenuous exercise 3 weeks.
Wetting the incision After day 3, then immediately apply ointment.
Sun protection Direct sunlight may cause skin markings. Use sunscreen regularly for 3 months.

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