My name is Adrian Richards. I am a consultant plastic and cosmetic surgeon and today, I'm going to be talking a little bit about the technique and recovery period following an upper blepharoplasty procedure. In a previous video, I have talked a little bit about who would be appropriate for this treatment and how you assess whether you would benefit from blepharoplasty procedure.
So what actually happens in the operation? Well, the first thing to decide is whether you want to be asleep for the operation or whether you want to have it under twilight anesthetic, which is local anesthetic with you a bit sleepy, or whether you would just like it purely under local anesthetic with being awake. There are advantages to each of these.
Sometimes for the surgeon it's easier if you are awake even in the twilight anesthetic, because I can ask you to move your eyelids up and down and then you can make minor adjustments to the position of the scar, which isn't possible under general anesthetic. So often, patients do opt for a local anesthetic and it's generally tolerated very well.
So normally the operation is performed as a day case, so that you probably would have it in the morning, you are probably pretty okay to go home by the evening. Sometimes we do like to keep you in overnight, particularly if you live a bit of a distance away because it is beneficial to use ice packs on the eyes overnight to reduce the swelling and the bruising. That's very beneficial if you can stop the bruising form and that's good, because once the bruising has formed, it's going to take sort of seven to ten days to go away. So that's the procedure.
In the operation the surgeon would decide, normally you would be marked before, so the surgeon would normally mark you awake, with you sitting up, that's very important that you are assessed sitting up. He would normally mark the lower fold, the lower eyelid fold and then assess how much skin to remove and then mark the upper portion of the skin to be removed which is really at the bottom of the upper fold where the natural upper crease is.
Things to discuss are whether you have fat pads in the eyes, the fat lies around the actual eyeball and protects it from movement within the eye socket and this fat can move forward slightly in both the upper and lower eyelids. In the upper eyelid, it tends to form in the inner aspect of the eyelid here, so you may well have a slight out pouching here.
Now the way to test whether this is fat coming forward or whether it's excess skin, is to raise you eyebrow up, this will tighten the skin up. If the fat goes, it's due to excess skin because the skin's being tightened up. If the fat doesn't go, if the bulge doesn't go, it's due to fat coming forward. The surgeon will assess that and decide whether you need removal of the fat, normally from that inner area and you need to discuss this with the surgeon beforehand.
So surgery is performed, the scar is as close as the surgeon can get to your natural eyelid fold, so it will lie normally within the fold. How far does it go out? Well, it needs to go out as far outwards laterally as you have a fold. So if you've got overhang on the side, the scar will need to go out to the side and will go in your natural crow's feet line. So the surgeon should plan it to go out in that natural line so it's concealed.
How do you look after your scar in the first week? Well, as I said, it's very important to sit upright and that reduces the swelling, so we like to get you sitting as upright as possible in the bed, ice packs on the eye to reduce the swelling and then we like to give you arnica and special creams with vitamin K in to reduce the bruising, very important to get rid of the bruising as quickly as possible.
I tend to use a running stitch on the upper eyelids, some surgeons use interruptive stitches, the advantage of the running stitch is that it's just one stitch that needs to be removed and it runs all the way along the incision, so it's just one stitch to be removed. You can use absorbable stitches but they have been shown to produce worse scaring so most surgeons don't tend to use absorbable stitches in the upper eyelids.
Recovery period, like any scar the upper eyelid scar will be a bit raised initially following surgery, but it concealed within the fold and makeup can be used to further conceal it from about ten days following the surgery. The other advantage is because it's thin skin, the scar really does heal very well and sometimes even looking at a scar two or three years old it's very difficult to actually see where the scar was. So it's a really good one for healing.
So overall, upper blepharoplasty, a very successful operation. A relatively simple operation, operation with low complications but potentially high gains in opening up your eyes and making you look brighter. I think it is one to consider if you have got that slightly heavy upper eyelid.
So thanks very much for listening and watching the video today. If you would like any more information or would like to schedule a complimentary consultation with one of our surgeons, please do so by ringing us on our office number which is 01844214362 or alternatively email us via the website which is aurora-clinics.co.uk. Thank you very much.
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