Double Eyelid Surgery & Eye Bag Removal (Blepharoplasty)

What is blepharoplasty?

Blepharoplasty, or eyelid surgery, is a surgical procedure to:

• Repair droopy eyelids
• Improve the appearance of eyelids

It may involve the removal of excess skin, muscle and fat around the eyes.

Upper blepharoplasty

Performed on the upper lids, upper blepharoplasty removes excess skin or muscles from the upper eyelids. It may be used for double eyelid surgery and ptosis correction.

Lower blepharoplasty

Performed on the lower lids, lower blepharoplasty aims to improve the appearance of the lower eyelids. An example of lower blepharoplasty is eye bag surgery, which removes skin and fat from the lower eyelids.

Why do you need blepharoplasty?

As you age, excess fat may gather above and below your eyelids, resulting in sagging eyebrows, droopy eyelids and eye bags.

Besides making you look older, saggy skin around your eyes can reduce your side vision and parts of your field of vision.

Blepharoplasty can help to improve your vision and make your eyes appear younger. Consider blepharoplasty if you:

• Have baggy or droopy upper eyelids (ptosis)
• Have excess skin on your upper eyelids that interferes with your side vision
• Have excess skin on the lower eyelids or eye bags
• Would like to create or enhance your eye crease (double eyelid)

Who should not undergo blepharoplasty?

The following groups of people may be less suitable for blepharoplasty:

• Smokers
• Individuals with medical conditions
• Individuals with serious eye conditions

Your doctor will advise you if blepharoplasty is suitable for you and your goals.

What are the risks and complications of blepharoplasty?

Eyelid surgery may lead to the following conditions:

• Dry, irritated eyes
• Difficulty closing your eyes
• Temporarily blurred vision or, rarely, loss of eyesight
• Infection and bleeding
• Injury to eye muscles
• Noticeable scarring
• Skin discolouration

It also carries general risks associated with surgery, such as adverse reactions to anaesthesia and blood clots.

How do you prepare for blepharoplasty?

Before your eyelid surgery, you will need to undergo:

• A physical examination, to test your tear production and measure parts of your eyelid
• A vision assessment, to test your vision pre-surgery
• Eyelid photography, to help your surgeon plan the surgery and assess the possible outcomes

Your surgeon will also ask you about your desired results and discuss whether blepharoplasty can meet your expectations.

Once you have been cleared for blepharoplasty, you will need to:

• Stop taking certain medications which may interfere with the surgery and your recovery.
• Quit smoking for several weeks before your surgery, to facilitate your recovery post-surgery.
• Make transport and care arrangements immediately after the surgery as you will need assistance getting around.

What can you expect in blepharoplasty?

Blepharoplasty is typically performed as day surgery with no hospitalisation involved.

Estimated duration

Blepharoplasty may take up to 2 hours.

Before the procedure

You will receive local anaesthesia into your eyelids and possibly sedatives to help you relax.

During the procedure

In general, your surgeon will work on the upper lids first. They will cut along the fold of the eyelid and remove excess skin, muscle and fat. They will then close the cut.

On your lower lid, the surgeon will make a cut just below the lashes. They will remove or redistribute excess fat, muscle and saggy skin before closing the cut.

After the procedure

You will spend time in a recovery room so that the medical team may monitor you for any complications. You will be discharged a few hours later.

Care and recovery after blepharoplasty

It is normal to experience the following temporary effects after your surgery:

• Watery eyes
• Puffy eyelids
• Double vision
• Sensitivity to light
• Pain or discomfort
• Swelling and bruising around your eyes
• Blurred vision from the lubricant applied to your eyes

To speed up your healing and reduce discomfort, apply ice packs on your eyes for 10 minutes every hour on the night after the surgery. The following day, apply ice packs 4 – 5 times throughout the day.

Your doctor will prescribe eye medication to help your eyes recover.

Activities to avoid

To facilitate your recovery, you should avoid the following post-surgery:

• Smoking
• Rubbing your eyes
• Heavy lifting and swimming for a week
• Wearing contact lenses for the next 2 weeks
• Strenuous activities including aerobics and jogging for a week
• Consuming medication that may increase bleeding
• Being in direct sunlight for too long

When to call your doctor

Alert your doctor immediately if you experience any of the following:

• Bleeding
• Chest pain
• An unusual heart rate
• Severe new eye pain
• Shortness of breath
• Vision problems

Most people resume their normal lifestyles 7 – 10 days after blepharoplasty. Most of the bruising and swelling should resolve after 10 – 14 days. Any scars from surgery may take months to fade.