Understanding excess eyelid skin and drooping lashes
Introduction and Overview
The upper eyelid region can be affected by several age-related or anatomical changes that impact both appearance and vision. Two of the most common are dermatochalasis and lash ptosis. While they are distinct conditions, they often occur together and may require surgical correction. Correction of these conditions usually involves a surgical procedure called a blepharoplasty. If the upper eyelid skin abuts the upper lid lashes, this is termed a functional blepharoplasty. Often the eyes feel tired and heavy and hence the surgical procedure is medically indicated and attracts a medicare item number.
Often a milder form of dermatochalasis exists which can cause an unwanted cosmetic appearance. A blepharoplasty performed for this degree of excess eyelid skin is termed a cosmetic blepharoplasty.
Dermatochalasis
Dermatochalasis refers to redundant or excessive eyelid skin, often with underlying fat prolapse. This can create a heavy or hooded appearance of the upper lids and, in some cases, obscure the visual field.
Patients may notice difficulty with activities such as reading or driving, along with symptoms of brow fatigue from constant lifting of the eyebrows to compensate.
Lash Ptosis
Lash ptosis occurs when the upper eyelashes rotate downward toward the eye, often accompanying dermatochalasis.
This lash misdirection can cause lashes to touch the ocular surface, leading to irritation, foreign body sensation and further narrowing of the visual field. Correction usually involves addressing both the redundant skin and lash orientation at the time of surgery.
What Is Blepharoplasty?
Blepharoplasty, or eyelid surgery, is a procedure that involves the removal or repositioning of skin, muscle, or fat in the eyelid region. In some cases, treatment may be recommended for both the upper and lower eyelids. The procedure is performed using surgical excision, and when indicated, excess fat is removed at the same time.
This procedure can be functional if there are symptoms associated with the excess skin and can attract a Medicare rebate, or can be purely done for cosmetic reasons. If you are wanting a cosmetic procedure, bookings can be made directly with Prèface Cosmetic, our dedicated cosmetic clinic.
Upper and Lower Lid Blepharoplasty
Blepharoplasty is a procedure that can improve both the function and appearance of the eyelids. You may be considered for eyelid surgery if you have excess upper eyelid skin that interferes with your vision, or if changes have occurred due to trauma, sun damage, or skin cancers.
Before recommending surgery, your ophthalmic surgeon will carefully assess your eyelid health and identify any conditions that may influence the outcome. From there, an individualised plan is developed to ensure the best possible result.
Upper Lid Blepharoplasty
An Upper Lid Blepharoplasty refers to the removal of skin, muscle and fat from the upper eyelids.
Lower Lid Blepharoplasty
Lower Lid Blepharoplasty refers to removing excess tissue of the lower eyelids.
Risks and Recovery
As with any surgical procedure, lacrimal surgery carries potential risks and requires a period of recovery. At Newcastle Eye Centre, our specialists take every precaution to ensure patient safety and optimal outcomes.
Risks
Like all surgical procedures, blepharoplasty surgery carries risks. It’s important to be aware of common risks so you are able to weigh up the benefits, risks and limitations of the surgery. Below is a list of possible complications and specific risks for blepharoplasty surgery. There may be complications that are not listed here and some lifestyle factors and medical conditions can cause greater risks.
The most serious risk is visual loss due to bleeding behind the eyeball. This is called a Retrobulbar Haemorrhage and is extremely rare. If you are on blood thinners this should be stopped prior to the surgery after discussion with the surgeon and your general practitioner.
Risks of blepharoplasty surgery:
- Lagophthalmos and inability to close the eyelids
- Post-operative asymmetry
- Dry Eye Syndrome
- Transient numbness around the eyelashes
- Upper lid ptosis
- Infection
- Post-operative bleeding
- Scarring
- Allergic reactions
- Bleeding
- Swelling and bruising
Recovery
As with many procedures, surgical wounds usually take 1-2 weeks to heal. Sutures are removed at that time or are often left to dissolve and absorbed by the body, which may take up to 8 weeks.
There will be some bruising and swelling, which generally subsides about 1-2 weeks after the operation. Keeping your head elevated, posturing and applying cold compress immediately after surgery are paramount in minimising pain and swelling. It may take up to 3 months for everything to settle down and swelling can persist over this period.
At Newcastle Eye Centre we provide patients with tailored recovery programs to reduce post-operative bruising and swelling.
Swimming, physical exercise and heavy lifting is to be avoided for two weeks. Mineral makeups can commence a few days after surgery if you so desire.
Cosmetic Blepharoplasty
Often a milder form of dermatochalasis exists which can cause an unwanted cosmetic appearance. A blepharoplasty performed for this degree of excess eyelid skin is termed a cosmetic blepharoplasty.
For more information regarding Cosmetic Blepharoplasty, please visit Preface Cosmetic, our service division dedicated to high-end cosmetic eye treatments and procedures.
Suitability for Blepharoplasty procedures and the potential risks and outcomes will be discussed during a personalised consultation with Dr Hollenbach.
Clinical Disclaimer
The information provided on this page is for general educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Every individual’s condition is unique, and the details presented here may not apply to your personal situation. Always consult with a qualified healthcare provider regarding any questions or concerns you have about your health or treatment options. Reliance on this information is solely at your own risk.