Blepharoplasty (eye bag removal) is a popular procedure requested both by women and men. Some of them feel their eyelids to be excessively heavy but others may be concerned about the ‘hooding’ of the upper eyelid skin. In most cases the definition of the upper eyelid above the eyelashes is taken up by the loose skin. Concerns about the lower eyelid may be due to excess skin or due to the puffiness of the lower eyelid. In some patients this may be the result of other medical conditions like: under active thyroid or renal diseases. It is therefore important to seek a professional opinion which takes into consideration the general medical problems of the patient and not just focusing on the excess skin on the lids. In a proportion of patients the downward droop of the eyebrows may also contribute to the heaviness of the upper lid. This may require a ‘brow lift’ in addition to the eyelid bag removal.
Excess skin in upper eye lid can be removed with or without any fat removal. This can be performed under a local or a general anaesthesia. If there is a need for removal of fat excess from the lower eyelid it is best performed under a general anaesthesia. The resulting scars are placed such that they blend with the skin crease lines around the eyelids. Routinely patients would be advised to have cool eye masks to minimise the bruising. It is best to avoid any strenuous activities for a few weeks after the surgery. Patients would be advised to keep their heads propped up for up to a week after the operation. The eyelid sutures are usually removed in five days.
Bruising is a common occurrence following eyelid surgery. If the upper and lower lids are operated together it is likely that the eye area would feel tight. It is best to avoid wearing contact lenses for up to two weeks after the operation. Patients would be advised to avoid any eye makeup for that period as well. There have been reports of rare, but devastating loss of vision following cosmetic eyelid surgery in the world literature.
If too much skin is removed from the lower lid during surgery the eyelid may not close properly and may appear slightly out-turned (ectropion). In extreme cases the patient may require further reconstructive procedures to solve this problem.