In our last blog we talked about lower eyelid blepharoplasty, or eye bag removal. This week we’ll take a closer look at the upper eyelids and what can be done about the hooded appearance eyes often acquire with age.
‘Droopy’ eyelids, known medically as ptosis, can be caused either by an excess of eyelid skin or by weakening of the levator muscles - the muscles that allow the eyelids to lift. This most commonly occurs with age, however, some people may be born with weaker-than-normal levator muscles, thereby developing ptosis at a young age.
Whichever type you have, upper eyelid surgery (blepharoplasty) or levator surgery can correct the issue, making you look younger and fresher. Read on to find out more or call us for a consultation.
Why have I developed droopy eyelids?
Throughout one’s lifetime, the muscles responsible for eyelid closure tighten and relax millions of times – every time we blink.
Over the years, this use can stretch the delicate skin and result in an excess collecting on the upper eyelid. This skin laxity causes the eyelid to droop down and allows fat deposits to protrude forward, giving a pouchy appearance (sometimes called upper eye bags).
However, it's not only older people who suffer from excess eyelid skin; unfortunately, some people are genetically predisposed to developing this condition earlier in life.
In some more rare cases the tendon-like tissue that helps the levator muscles to lift the eyelid can atrophy and lengthen leading to a true eyelid ptosis. Although both eyes are usually affected by ptosis, drooping may be worse in one eye. In severe cases, it can also interfere with vision.
It’s worth noting that sudden onset of ptosis, especially only on one side, can be a symptom of an underlying health condition, such as muscle disease or nerve damage caused by stroke, tumours or diabetes, so it’s advisable to see your GP in the first instance.
What can be done to correct upper eye bags?
Sadly, weakened levator muscles – even in the young - cannot be targeted through facial exercises or medications. The only effective treatment for ptosis is surgical levator muscle repair. Likewise, the appearance of sagging, crêpey excess skin on the upper eyelids will not be significantly improved with topical creams.
Fortunately, both issues can be corrected with an eyelift. An eyelift is a simple surgical procedure that involves the removal of excess fatty tissue and skin.
If the underlying cause of the droopiness is a weakness of the levator muscles, additionally a repair/shortening of the levator tendon maybe necessary.
If you are also suffering with a drooping and wrinkled brow, you may benefit from a brow lift. This will restore your eyebrows to their youthful position and can be performed in conjunction with eyelid surgery.
How is upper eyelid surgery performed?
Blepharoplasty is generally performed under local anaesthesia with sedation. The eyelids and surrounding areas will be numb and you will be relaxed, but not asleep.
The surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. An incision is made in the upper eyelid and a pre-determined amount of excess skin is carefully removed.
Next a small amount of orbicularis muscle is removed and an incision is made in the orbital septum. This allows the surgeon access to the orbital fat, which can be conservatively removed to reduce a puffy appearance.
In a case of levator muscle repair the surgeon will identify and prepare the even deeper lying levator muscle and its tendon and surgically shorten it.
Finally, fine sutures are used to close the incisions and small bandages are applied to protect the stitches.
The entire procedure takes no more than 2 hours and you will be able to go home afterwards, although you will need to arrange for another person to drive you. You should also have someone stay with you the night of the procedure.
How long is the recovery process?
After eyelid surgery, you will have stitches that will remain in for around 7 days. It is not an especially painful treatment and you can use pain medication to control any discomfort.
You may have trouble opening and closing your eye immediately after surgery, but as you recover, this function will return.
You will likely have some swelling and bruising, but you can speed up the recovery process by sleeping with your head elevated for the first few days after surgery and applying cold compresses.
If you go out, wear sunglasses to protect your eyes from the wind and to help you avoid squinting in the sunlight.
Your eyelids should look more or less normal within a week or two; however, you will not see the full results for 1-2 months.
It is advisable to book at least a week off work and avoid using a computer during this time, as it can dry the eyes. You should also avoid any activity that increases blood flow to the eyes (bending, lifting, crying and exercise).
After one week it is safe to wear makeup and contact lenses, while glasses can be worn immediately. That said, the skin is still very delicate, so one must be very gentle when applying or removing makeup, or touching the eye area.
Are there any possible side effects from upper eyelid surgery?
Complications and unwanted results from an eyelift are rare, but sometimes they do occur. These can include bleeding and infection, the inability to close the upper lid and dry eye syndrome. If patients currently have dry eyes, blepharoplasty surgery can make the eyes drier.
Will I be pleased with the results and how long will they last?
It is said that our eyes are the windows to our souls. They can say so much about our health, wellbeing and mood. Because they are such an important feature, a well-performed eyelift can produce a dramatic rejuvenating effect, literally taking years off of a person's appearance.
Even more importantly, in cases where ptosis is obstructing vision, an eyelid lift can usually restore normal sight.
The eyelids heal remarkably quickly and, because the incisions are made in the natural creases of the eye, scars are usually quite inconspicuous.
Upper eyelid surgery is generally long lasting – 7 to 10 years can be reasonably expected, although as many as 15 years is not uncommon. If it’s performed correctly, you are unlikely to require another upper eyelid blepharoplasty for many years. When your eyelids do start to sag again after that time the procedure can be easily repeated or maybe you will require a forehead lift/lateral brow lift.