Excess skin on the upper eyelids can cause a reduced visual field, eyelid irritation, infections and headaches due to the constant activity of the forehead muscles trying to elevate the heavy excess skin.
Similar to fatigue of any muscle in the body, ocular and brow muscles are very active during the day and are prone to muscle overuse. This can be due to long hours of focusing on a specific activity such as staring a computer monitor for hours. Chronic allergies, sinus infections, and sun exposure may also exacerbate the heaviness of the eyelid causing swelling and increasing the probability that the excess skin will interfere with vision and will affect the individual's appearance.
Please note that individual results will vary depending on the individual, their genetics and lifestyle factors, and all surgeries have associated risks. Before proceeding with any surgery, it is advisable to seek a second opinion from an appropriately qualified medical practitioner such as a Plastic Surgeon. Dr. Gary Avery (MED0001633092) a registered medical practitioner, with specialist registration in Surgery – Plastic Surgery. Dr Avery is also a member of the two leading professional associations for plastic surgeons in Australia, Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and Australian Society of Plastic Surgeons (ASPS). Their websites provide additional information regarding plastic surgery in Australia that you might find useful, please visit ASAPS and ASPS.
Patients considering any form of face surgery will need to come in for a consultation with Dr Avery to discuss your expectations, along with the surgical options for how these can be achieved. During your consultation with the Avery team, we will ensure that the surgery you are considering is the appropriate choice for you.
At Avery, we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with surgery. Our patients’ stories matter a great deal to us.
Wherever you are on your personal journey, we would like to assist you. Your reasons for having surgery and your expectations from surgery are important conversations to have before undergoing surgery. Dr Avery will also assess your health and medical history to ensure any surgical procedure you are considering is a safe and appropriate choice for you.
Your Upper Eyelid Surgery
Your GP or another specialist that knows you well must make a referral to Dr Avery. The decision to have a consultation may be made after talking with family or friends or following your own research into plastic surgery and Dr Avery.
The purpose of your initial consultation with Dr Avery is to discuss your motivations for surgery and expectations from surgery. It is an opportunity to openly communicate what you want to change, alleviate or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.
When you arrive at Avery, you will check in with our Care Team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation.
The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.
Plastic surgery procedures can impact physical appearance and there may be a psychological response to the changes in your body after surgery. Besides the reasons for having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes the risks of having surgery and all of the possible complications that can occur after surgery, and what can be done if these occur.
We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are, and then decide if having the surgery is a safe and appropriate choice for you as an individual.
Your consultation will also include a discussion of the estimated financial implications of having this surgery or surgeries that were discussed with Dr Avery.
After your consultation, our Care Team will be there to talk through any further questions you have, including the cost of the surgery.
At Avery, our goal is to ensure you are equipped with the knowledge needed for you to feel empowered throughout the decision-making process, surgery and post-surgery.
Blepharoplasty or upper eyelid surgery aims to remove excess skin and in some cases, fat tissue from the upper eyelids to correct any unevenness.
Once a local or general anaesthetic has been administered, a small incision is made within the natural eyelid crease, where scarring will generally be well hidden. Excess skin and fat are trimmed away and if necessary, the muscles may be repositioned. The remaining skin is then lifted and the incision closed with sutures.
Upper eyelid surgery generally takes less than one hour, this surgery may also be combined with other surgery to the face and body. If upper eyelid surgery is performed without other surgery after a short time in recovery, you can be taken home by a responsible adult.
As with all surgical procedures, blepharoplasty surgery does have risks, despite the highest standards of practice. It is not usual for any surgeon to outline every possible side effect or rare complication of a surgical procedure. However, it is important that you have enough information about the most common risks to fully weigh up the benefits, risks, and limitations of surgery.
The following possible complications are listed to inform and not to alarm you. There may be other complications that are not listed. Smoking, obesity, and other significant medical problems will cause greater risk of complications.
Some general risks and possible complications of surgery include, but are not limited to the following:
- Heavy bleeding from an operated site. This may require a blood transfusion.
- Infection that may require treatment with antibiotics or further surgery in some cases.
- Allergic reaction to sutures, dressings or antiseptic solutions.
- The formation of a large blood clot (haematoma) beneath an incision site may require further surgery.
- Complications such as heart attack, pulmonary embolism or stroke may be caused by a blood clot, which can be life threatening.
- Pain, bruising and swelling around the operated site(s).
- Slow healing, often related to smoking or diabetes.
- Short-term nausea following general anaesthesia and other risks related to anaesthesia.
- Tissue cannot heal without scarring and that how one scars is dependent on individual genetic characteristics. Dr Avery will do his best to minimise scarring but cannot control its ultimate appearance.
- Smoking or using nicotine products during the 3–4-week pre-operative and post-operative periods is prohibited as these could dramatically increase the chances of complications.
- All medications I am currently taking, including prescriptions, over the counter remedies, herbal therapies and supplements, aspirin, and any other recreational drug or alcohol use can affect the safety of my surgery.
- There can be no guarantees about the results of any surgery.
Some specific risks for blepharoplasty surgery include, but are not limited to the following:
- Allergic reactions
- Permanent scarring
- Asymmetry in healing or scarring
- Temporary blurred vision
- Temporary difficulty in closing eyes completely
- Decrease in sensation of eyelid skin or impaired eyelid function
- Pain and discomfort
- Need for more surgery for surgical corrections (revision surgery)
- Further recovery time if further surgery is required
- Dryness, irritation, burning, itching of the eyes
- Tightness of lids
- Formation of whiteheads
- Temporary excessive tearing, sensitivity to light
- Hematoma, blood clot collection
- Dissatisfaction or disappointment with result
The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) has further information about blepharoplasty surgery including the possible risks for this surgery.
There will be some bruising and swelling, which generally subsides about 1-2 weeks after the operation. Frequent application of a cold compress and keeping your head elevated can help to minimise the pain and swelling following surgery. Exercise and other strenuous physical activities should be avoided in the first few weeks.
As with any operation, it is recommended that you have another adult stay with you during your first night after surgery and is able to drive you home.
A customised pain relief program will be created and issued before leaving the hospital. If circumstances change at any stage during the recovery period, pain medication can be adjusted accordingly.
Scars from upper eyelid surgery are generally well hidden within the new crease of your eyelid. They will generally fade to almost invisible, although this can vary depending on how well your skin copes with scarring.
The financial aspects of your surgery are as important as the medical elements when planning for surgery. At Avery, the surgeries we offer fall into three different financial categories: Self-funded – aesthetic surgery; self-funded – plastic and reconstructive surgery; and health insured – plastic and reconstructive surgery.
To make sense of these three financial categories, we have created a detailed price guide to help you understand what may or may not be covered by your health insurer/Medicare and your out of pocket expenses.
For more information or to book a consultation, please contact our team on 02 4002 4150.
Upper Eyelid Surgery FAQs
Visual obstruction, scarring from previous trauma, skin irritation or functional issues related to certain nerves in the face, may make you eligible for Medicare rebate. The most common reason for surgery is to correct visual obstruction, which usually progresses with time once it becomes symptomatic. To qualify for a Medicare rebate and have some coverage from your health insurance based on obstruction, you will need to have an assessment by an optometrist or ophthalmologist to determine if the excess skin is obstructing your visual field.
Upper blepharoplasty removes excess skin from the upper eyelid. Excess upper eyelid skin can lead to visual filed reduction or obstruction, skin irritation and possible infections.
Typically, a week off work is sufficient however, you may still have some visible bruising.
A goal of upper blepharoplasty may be to address some limitation of the upper visual fields and in this context, they may be improvement in the visual fields.
Skin is removed during upper blepharoplasty surgery, which means there will be scars following this procedure. Generally, the scars are partially obscured at the site where a skin crease often exists on the eyelids. Like all scars, individual results will vary depending on a variety of factors including genetics and skin quality.
A brow lift elevates skin on the forehead but does not directly impact the eyelid skin. An upper eye lift removes the skin of the lids by reducing the amount of skin between brown and lash, but it does elevate the brow position or change its shape.
Pain following surgery will vary depending on the extent of surgery. Pain immediately after surgery may be reduced by the use of local anaesthetic at the surgical site given during the surgery. The pain will also be managed with tablets or injections as required. Physical measures such as the dressings and for some surgeries, supportive garments, as well as limited movement and possibly ice packs will all help minimise any pain. Pain is usually well tolerated within a few days after surgery with all these measures. If your pain is increasing following surgery this is usually a sign that you may need a review to ensure your recovery is proceeding as expected.
Dressings and in some cases surgical garments will offer support to the wounds and the areas of your body that are still recovering. You will be also be advised to restrict excessive movement of the surgical area in the first two weeks after surgery. A good general rule throughout your recovery is if an increase in movement or activity does not increase any discomfort or swelling, then it is probably safe and this gradual progression back to ‘normal’ will be encouraged.
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Your initial consultation
During your initial consultation we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with your surgery and talk through any concerns or specific goals you may have.
Your initial consultation will include an examination of the area of concern and we'll work with you to determine if plastic surgery can achieve what you hope it will, and which specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.