SINGAPORE ASSOCIATION OF PLASTIC SURGEONS

Eyelid Surgery

EYELID SURGERY

Dr Chia Hui Ling
Eyelid surgery, or blepharoplasty, is surgery to enhance the appearance of the eyelids. Asian blepharoplasty, or double eyelid surgery, a form of upper blepharoplasty unique to the oriental population, is discussed separately here. 

The surgery may be performed on the upper eyelids, lower eyelids or both. Apart from improving the appearance, eyelid surgery may also be carried out to restore your visual function, such as ptosis correction and ectropion or entropion correction.

Eyelid surgery can address the following concerns:
  • Loose or sagging upper or lower eyelid skin
  • Puffy upper eyelids
  • Eyebags
  • Retracted lower eyelid that expose the lower white of the eye
  • Medical conditions (may be claimable under Medisave or insurance): 
    Ptosis (droopy upper eyelids), Entropion (infolding) or Ectropion (outfolding) of the eyelids
Loose or hooded upper eyelid skin may be due to brow ptosis, in which case your plastic surgeon may recommend that a brow lift procedure is more suitable for you.

TREATMENT

Have a thorough discussion with your plastic surgeon, including your surgical goals, medical conditions, drug allergies, medications and previous surgeries. For upper eyelid surgery, discuss your preferred crease type (parallel or tapered) and height too. Expected outcomes, risks and other treatment options should be explained to you.
  • Preparing for Surgery

    Do inform your plastic surgeon of previous eye conditions and surgeries, any medical conditions and medications. Stop eyelid tape if this is in use. Avoid blood-thinning medications, anti-inflammatory drugs or herbal supplementations as they can increase the risk of excessive bleeding during surgery, unless indicated by your doctor.



  • Surgery

    The surgery is performed under local anaesthesia, with or without sedation. Ensure that the surgery is performed in an accredited surgical facility.  



    UPPER EYELID SURGERY

    Incision: Along the supratarsal (double eyelid) crease

    Procedure: Depending on your condition, the surgery may involve removing excess fat and skin, and lifting the eyelid (ptosis correction).



    LOWER EYELID SURGERY

    Incision: Along the lower lashline (subciliary) or at the inside of the lower eyelid (transconjunctival)

    Procedure: Techniques to improve the appearance of the lower eyelids include eyebag fat removal, correction of the tear trough, canthopexy (tightening of lower eyelid), mid-cheek lift, and in the case of using the subciliary approach, excess loose skin can be removed. If you suffer from lax or retracted lower eyelids, additional procedures to tighten the lower lid (canthoplasty) is needed.



  • Post-Surgery Care

    Bruising and swelling are expected after surgery. Major swelling should subside by 1 to 2 weeks for incisional upper blepharoplasty and less for SUB. The stitches are removed within a week. The final results is often apparent after 3 months. Cold compress is recommended for the first few days after surgery to reduce swelling. Antibiotic and lubricating eyedrops may be prescribed.

COMPLICATIONS AND MANAGEMENT

Risks of Eyelid Surgery include:
  • Dryness to the eyes
  • Bleeding 
  • Infection
  • Sensitivity to bright light
  • Difficulty closing the eyes
  • Ectropion
  • Lid retraction
  • Skin numbness (temporary or permanent)
  • Asymmetrical results
  • Unfavorable scarring
  • Need for revision surgery
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