Contemplating eyelid surgery: What to expect

My friend just had a double eyelid surgery, and I'm contemplating it myself. However, I never had plastic surgery before. I am naturally apprehensive as to what to expect. What does upper eyelid surgery entail?

Upper eyelid surgery is also known as upper blepharoplasty. There is also lower eyelid surgery, which is known as lower blepharoplasty.

Upper blepharoplasty does not only give you a double eyelid, if you so wish.

It can also improve the appearance of your eyes, making them "open up" or seem bigger and brighter.

Naturally, for plenty of Oriental women, this involves the formation of a double eyelid, or making the double eyelid seem deeper.

Many people, not only women, complain of "tired eyes" when they get older because the skin around the eyes sags and loses its elasticity.

Blepharoplasty can rejuvenate your appearance. The thing is to manage your expectations. Don't go into the doctor's office asking to look like Anne Hathaway!

How does upper and lower eyelid surgery perk up my eyes?

Upper eyelid surgery can remove excess fat from under your skin, which makes your eyes appear puffy in the upper eyelids.

It can also tighten loose or sagging skin that creates folds, which can sometimes cover the outsides of the eyes, impairing your vision as you get older. This is called an eyelid lift.

Lower eyelid surgery can remove excess skin and fine wrinkles from the lower eyelid. It can also remove eye bags and correct any droopiness that causes the whites (sclera) of the eyes to be revealed under your irises.

Is this surgery done under general anaesthesia?

It can be, but most of the time, plastic surgeons prefer to do it under local anaesthesia. This is because they prefer you to be an active participant in opening and closing your eyes when they need you to, so that you can achieve a better look.

I will be very scared if this surgery is done under local anaesthesia! Isn't it painful?

There is an initial pain when the doctor injects the local anaesthetic into the areas that need numbing. But this is no more painful than an ant bite, or when you go for a facial that involves the (rather painful) squeezing of blackheads and comedones, and the plucking of oil seeds (milia).

Thereafter, your skin will be numb and you won't feel any pain. You will, however, feel some minor discomfort as your tissue is manipulated, but this discomfort is that of skin tugging and pulling.

If you still feel pain in your deeper tissues, your doctor will be able to top up your anaesthesia with more injections, which you won't feel because your skin is already numb.

Do I need to prepare anything before surgery?

Arrange for someone to drive you to the surgery, which is an outpatient procedure, and back. You may think you can drive yourself, but there will be considerable swelling of your eyes after the surgery, so don't risk it.

Eat something before the surgery. You will be given some antibiotics, and you need something in your stomach.

You are advised to stop taking aspirin or any analgesic that may cause you to bleed more profusely during surgery.

And do stop smoking well in advance.

What can I expect after the surgery?

You can expect a lot of swelling around your eyes and bruising. This will get worse the day after the surgery, but will eventually subside. There will be some oozing around the sutures as well, and you may shed excessive tears, which may be bloody.

But all this is to be expected.

Meanwhile, you have to avoid carrying heavy objects or exercising during the first week, as this can increase your swelling. You should consult your doctor if you have any questions.

When can I expect to see the results of my surgery?

The results will appear after several weeks, but it may take up to a year for the incision lines to fully refine.

Eyelid surgery usually only needs to be done once in a lifetime. The results will last you for many years, although you will continue to age naturally.

Can I expect complications?

As with any surgery, there is always the risk of complications. But it doesn't mean any of these will happen to you.

You may get scarring, temporary blurred or impaired vision, dry eyes, difficulty in closing your eyes, a lag in pulling down your eyelid, bleeding and the formation of a haematoma, infection, fluid accumulation, blood clots, numbness or changes in skin sensation, eyelid disorders, and the worse possible complication, loss of eyesight.

But again, these are merely risks, and they are rare.