Upper Eyelid Surgery
Droopy upper eyelid is a common sign of facial aging. The upper eyelid appears thick, heavy and saggy, with a tired and sad impression. In severe cases, the upper eyelid can cover the upper part of the eye and affects vision. This condition is due to laxity and excess of upper eyelid skin and excess eyelid fat. This condition is medically called dermatochalasis of the upper eyelid. In some cases, the upper eyelid may appear sunken. Upper lid blepharoplasty is a surgical procedure to correct this condition and rejuvenate the upper eyelid.
Another cause of droopy upper eyelid is a condition called ptosis (short for blepharoptosis). Instead of due to the laxity of the upper eyelid skin, ptosis is due to the weakness of the levator muscle. The main function of the levator muscle is to elevate the upper eyelid and open the eye. An abnormal levator muscle is unable to lift the upper eyelid properly, and the upper eyelid appears droopy and the eye half-opened. Ptosis can occur in young children (congenital ptosis) as well as in the elderly (involution ptosis). Ptosis repair generally is accomplished by strengthening the levator muscle, or in more severe cases, replacing the levator function with other muscle. (Go to read Correction of Ptosis)
Preparation
1. Inform the doctor about any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.
2. Stop smoking at least one week before surgery. Smoking negatively affects wound healing and increases risks of other post-operation complications.
3. Stop the following one week before surgery:
a. All supplements that contain vitamin E, ginseng, ginkgo, garlic, fish oil and other ingredients that increase bleeding during surgery
b. Medicine that increases bleeding during surgery such as aspirin, NSAIDs and warfarin. However, you may need to consult your physician who prescribed the medicine before you stop them.
4. On the day of surgery, wear simple and comfortable clothing. Do not wear any jewelry and metal objects on the face and body.
5. Bring a pair of sunglasses on the day of surgery for use after surgery
6. Don’t wear contact lens on the day of surgery
Surgery
Duration: 1-2 hours
Anaesthesia: Local anaesthesia
Hospitalization: Not required.
Recovery*: Back to work in 3-7 days, light exercise after 7 days, heavy exercise after 2-3 weeks.
*The speed of recovery and duration of rest may vary from person to person and also depends on the physical burden of the work and exercise the patient is going to resume.
Surgery Technique: An incision is made on the upper eyelid skin. Excess skin and fat are removed. The levator muscle is repaired or tightened if required. The incision is located in the double eyelid crease itself and not visible when the eye is open. Most of the scars on the upper eyelid heal very well and would not be noticeable.
Post-operative Care**
1. What to expect: Swelling usually peaks on the second to third day after surgery and then gradually subsides. Post-operative pain is usually minimal.
2. General care:
a. Apply cold pack during the first 3 days and warm pack thereafter. Elevate the head during sleep to reduce swelling.
b. Avoid smoking for at least one month. Smoking increases the risk of wound complications.
c. Use sunglasses for protection when going outdoors.
d. Get a good rest and enough sleep to speed up recovery.
e. Be relaxed and calm. Contact the clinic if there are any queries.
f. Don’t use contact lens for at least 1-2 weeks.
3. Medicine: Finish the oral antibiotics as prescribed. Take the painkiller when necessary.
4. Wound care: Clean the wound with a clean cotton tip soaked with sterile water/saline. After that apply antibiotic ointment. No dressings are required.
5. Physical activity: Avoid heavy physical activities and exercises for at least one month.
6. Follow-up: Come back one week after surgery for suture removal and review.
7. Emergency: If there is heavy bleeding, rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.
**The instructions in this section are not meant to be exhaustive and are only for general references. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for specific advice.