Eyelid surgery (blepharoplasty)

What is eyelid surgery (blepharoplasty)?

Eyelid surgery includes a range of procedures to treat a various conditions of the eyelid. It is normally carried out to remove excess skin, tighten droopy eyelids or remove any benign lesion or cysts.

Preparing for eyelid surgery

Surgery is usually carried out as a day case procedure under local anaesthetic. This means that you will be awake throughout the surgery but will not feel anything. Occasionally, some eyelid procedures such as tear duct surgery are performed under general anaesthetic or sedation.

What does eyelid surgery involve?

There are a range of procedures used for eyelid surgery which can be used to treat your condition. They include but are not limited to:

• blepharoplasty – when excess skin is cut away and the wounds are then closed with stitches. The procedure may also involve strengthening the natural eyelid crease in the eye
• entropion or ectropion repair – this procedure is when the eyelid is tightened, and lower eyelid muscles are repositioned
• ptosis – in ptosis the muscle in the upper eyelid is tightened to improve eyelid opening. This may be combined with an upper eyelid blepharoplasty
• reconstruction of eyelid – required after surgery to remove eyelid cancers and can involve the use of flaps or grafts
• surgery for watery eyes – includes procedures to tighten the eyelid, open the entrance to the tear duct or form a new tear duct and can involve temporary placement of a plastic stent in the tear passageway
• lesion excision – is the removal of benign eyelid lesions such as cysts or skin tags are often removed in the treatment room. Suspicious lesions can be biopsied and more definitive surgery planned once the results are back from examination

Benefits of eyelid surgery

Depending on the type of surgery, benefits may include:

• improved field of view and brightness of vision
• reduced discomfort to the eye
• reduced watering from the eyes
• reduced brow ache or headache if caused by eyelid droop
• confirmed diagnosis of a suspicious lesion before further treatment
• restoring eyelid function after trauma or surgery to remove eyelid cancer
• improved eye symmetry

Risks of eyelid surgery

Eyelid surgery is generally safe and successful but, as with any surgery, there are some risks associated with it. They include:

• bruising and swelling of the eyelid
• infection, bleeding and scarring
• under or over correction – this may need re-evaluation and further surgery
• ocular discomfort
• watery or dry eyes
• worsening of vision – this is extremely rare, and you should report any loss of vision to the hospital immediately

Depending on the type of surgery, there may be other risks you need to be aware of. Your consultant will discuss these with you in detail.