Lower Lid Blepharoplasty

Why do patients request a blepharoplasty?
Patients are often very self conscious about excess skin and wrinkling developing in the lower eyelids. They feel that these features make them appear tired and they often complain of “bags” under their eyes. This appearance can result in comments from colleagues and acquaintances about their appearance and how tired they look.

The development of this appearance is a natural consequence of ageing. With the passage of time the skin and underlying tissue loses its elasticity and stretches. The skin becomes wrinkly and the normal fat which is present underneath the eyeball bulges forward causing eyebags to become prominent.

Are there any reasons not to have a lower lid blepharoplasty?
There are no absolute reasons not to have lowerlid blepharoplasties but relative contra indications include previous surgery to the lower eyelid, history of hyperthyoidism, and exophthalmos.

Other indications not to have surgery include smoking and a history of bleeding disorders. Medications such as aspirin and warfarin need to be considered carefully when planning surgery.

How is the operation performed?
Lower lid blepharoplasty is normally carried out under general anaesthetic but can be performed under a local anaesthetic. The skin and muscle of the lower eyelid is lifted, the extra fat is removed, the underlying tissue is tightened and the extra skin is trimmed and the wound is closed with fine sutures (stitches).

What you need to know

How long does the operation take?
A lower lid blepharoplasty takes between 60-90 minutes

How long am I in hospital?
The operation is usually done as a daycase but some surgeons keep their patients in overnight.

What happens when I go home?
Most patients are discharged from the hospital the following morning after the operation from the hospital. The sutures are removed 5-7 days after the operation when you will be reviewed by your surgeon.

Most patients are able to return to work within a fortnight of their operation. Patients are instructed with regard to application of moisturising cream and massage to help the swelling and the bruising to settle.

What are the complications of lower lid blepharoplasty?

• Lower lid blepharoplasty has the risk of the following complications
• Bleeding and haematoma formation
• Infection
• Visible scarring
• White cysts developing along the scar line (very rare)
• Asymmetry
• Need for adjustment
• Epiphora – watering of the eye
• Chemosis – swelling and inflammation of the conjunctiva (covering of the eye)
• Round eye/ectropion – the lower eyelid is pulled down and sometimes away from the eyeball
• Blindness – very very very rare.