What are Common Questions About Eyelid Surgery (Blepharoplasty) and Browlift?

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Hi! I am Dr M Szalay and I have performed over 300 eyelid surgery procedures. I am going to answer some common questions about eyelid surgery. Prior to doing this, it is worth summarising the changes around the eye that occur as we age.

As we get older, the skin and muscles around the eye can loosen. (see diagram).

eyelid ageing

Eyelid Ageing

This can cause the tissue of the upper eyelid to droop, possibly hanging over the  eyelashes or even interfering with the vision. Patients often tell me that their symptoms are worse at the end of the day as they get more tired.
In the lower eyelid, wrinkling of the skin can be present or bags can occur due to fat pushing forward. (see diagram).

eyelid bags

Eyelid Bags

The most common questions I am asked by patients are:

Where are the incisions? 
In the upper eyelid, the incision is made mostly in the natural fold of the upper eyelid in order to be as inconspicuous as possible.(see diagram).

diagram-upper-eyelid-incision

This incision allows me to remove the excess tissue in the upper eyelid. In the lower eyelid, the incision is made on the inside of the eyelid so that no scar will occur. (see diagram).

lower eyelid incision

Lower Eyelid Incision

This incision allows me to remove the excess fat that is causing the bags. Here is a photo of 2 patients I performed both upper and lower eyelid surgery on.

Upper and lower eyelid

Upper & Lower Eyelid

Upper and lower eyelid

Upper & Lower Eyelid

How long will I need off work? 
Because of swelling and bruising, with the upper eyelid it is best to have 7 to 10 days off work. With the lower eyelid you will need 14 days off. We will give you a detailed list of things to avoid prior to surgery (eg alcohol, aspirin) to minimize bruising and it is important to read this. After the surgery, ice is very helpful for 72 hours and it is important to avoid significant exercise for 2 weeks.

When is a browlift necessary in addition to upper eyelid surgery?
A browlift might be required if it has dropped low. If this happens, it causes sagging on the outer part of the eyelid. It might be best to illustrate this by referring to some images of some of my patients.

Upper eyelid

Upper Eyelid

Upper eyelid

Upper Eyelid

These images (above) show 2 patients who had hooding of their upper eyelids but their eyebrows are in good position. and not contributing to their problem. They only required upper eyelid surgery.

Browlift & Upper Lid

Browlift & Upper Lid

This image (above) shows a patient whose brow was low and contributing to her loose skin so she required a browlift in addition to upper eyelid surgery.

How do you improve loose skin on the lower lid?
As explained above, the incision on the inside of the lower eyelid for lower eyelid surgery allows me to remove the fat which causes the bags. In order to improve loose skin on the lower eyelid, I use the fractional CO2 laser because it safely tightens the skin. Here is an image of a patient who had lower eyelid surgery and laser.

Lower eyelid

Lower Eyelid

What types of browlift do you do?
I perform 3 types of browlift. One relies just on fine sutures to lift the eyebrow (“The Lift”). Here is an example of a patient I used that technique on.

browlift

Browlift – Type 1

Another type relies just on the removal of skin along the hairline to lift the brow and is useful for subtle browlifts. Here is an example of a patient I used this technique on.

Browlift

Browlift – Type 2

The final type relies on both sutures and skin excision and is helpful when a significant browlift is needed. Here is an example of a patient I used this technique on.

browlift

Browlift – Type 3

Results can vary among individuals. Any procedure has risks and it is wise to seek a second opinion. For more information visitwww.precisioncosmetic.com.au