Blepharoplasty Melbourne

Surgery of the upper and lower eyelids can result in a changed appearance. The specialist plastic surgeons of NorthEast Plastic Surgery Melbourne have expertise in blepharoplasty surgery and can correct visual obstruction from an excess of upper eyelid skin in addition to changing the appearance of upper and lower eyelids

Why consider a blepharoplasty?  |  Blepharoplasty surgery consultation  |  Blepharoplasty surgery  |  Recovery period  |  Book a Consultation

NorthEast Plastic Surgery, has changed the layout of the educational information about this
procedure to outline the risk and recovery information at the top of the page in order to be
compliant with the advertising guidelines of the Australian Health Practitioner Regulation Agency
(Ahpra).

As we appreciate that this may impact your understanding, the surgeons will answer any related
questions at your consultation.

Risks

Though uncommon, there are risks associated with every surgical procedure. Risks most commonly associated with blepharoplasty include wound complications such as infection, haematoma formation including visual impairment due to retrobulbar haematoma, scarring and wound breakdown. Further surgery to address any complications will incur its own risks.

Most patients experience seven to 10 days of bruising and swelling and your surgeon will advise you on the likely post-operative recovery time based on the extent of your surgery. Patients are able to drive once their vision is normal and unobstructed, which is typically about five days post-surgery.

You may also experience asymmetry, drop in the eyebrow complex resulting in the appearance of excessive upper eyelid skin and lower eyelid droop, which may require revisional surgery.

The eyelids and in particular, lower eyelids, can sometimes be subject to swelling, which is addressed with massage and taping. You will be advised of such treatments during your post-operative visits.

Recovery Period

It is important that access to medical attention is available by telephone once you have been discharged. Issues about which your surgeon needs to be made aware urgently include any change or issue related to your vision, pain uncontrolled by medication, bleeding to the extent that the dressings soak through with blood, temperatures exceeding 38 degrees Celsius, redness of the skin or any concerns related to the surgery.

After a period of visual acuity observation, patients are typically discharged on the same day into the care of a responsible adult or following overnight hospitalisation. At the time of discharge, appropriate pain medication and antibiotics will be dispensed. It is important these be taken to minimise discomfort and potential wound complications.

Ice packs are used for 48 to 72 hours post-operatively and patients are encouraged to maintain their head in an elevated position with pillows at night to minimise bruising and swelling.

In general, soft tissue swelling and bruising improves over the first week to the extent that patients can return to work and resume normal activities. Whilst improvement in appearance can typically be appreciated within one to two weeks, the swelling continues to improve for six to eight weeks and may take several months to subside completely.

During your post-operative visit one week after surgery, your dressings and sutures will be removed as appropriate. Wound healing will generally takes a week and during this period movement should be undertaken with care. Driving a motor vehicle can typically commence once patients have ceased pain medication and when vision is unimpeded, which is usually five days after surgery.
Strenuous exercise can be resumed at around four to six weeks. It is important to avoid trauma from being knocked or accidentally hit for six weeks after surgery.

While your surgeon will strive to achieve an optimum result with minimal scarring, the degree of scar formation varies from patient to patient. The aim of swelling management and scar maturation strategies is to achieve the best possible result as safely as possible.

Why Consider Blepharoplasty?

1.   Upper Blepharoplasty

Typically, patients seek upper blepharoplasty surgery to reduce upper eyelid skin that can lead to visiual obstruction or changes in appearance. Fatty tissue may also need to be reduced.

Blepharoplasty can lead to definition of the upper eyelid crease and the visibility of the upper eyelid skin between the eyelashes and the upper eyelid crease.

In circumstances where the eyebrow complex has descended, elevation of the eyebrow with a forehead or brow lift operation may be required to reposition the eyebrow and optimise the results of blepharoplasty. This can be performed in conjunction with blepharoplasty or as a separate procedure.

2.   Lower Blepharoplasty

Patients typically request lower blepharoplasty surgery to manage lower eyelid soft tissues including skin, cartilage and ligamentous structures in addition to fatty tissue.

Lower blepharoplasty surgery involves a combination of minimal removal of skin, management of fatty tissue and optimisation of structural support of the lower eyelids.

Blepharoplasty Surgery Consultation

The decision to undergo upper or lower blepharoplasty surgery is significant and adjustment to change in appearance must be considered in addition to the process of post-operative recovery.

Consultation Aims

Before consenting to surgery, you will undertake a detailed consultation with your surgeon. The aim of the consultation is to assess your expectations and identify potential limitations to achieving those expectations.

Such limitation relate to skin quality and extent, structural integrity of the lower eyelid, fatty tissue positioning and eyebrow position. Your surgeon will discuss surgical management options of the eyebrow complex and upper and lower eyelids during the consultation.

Issues which need to be considered include:

• Management of eyebrow ptosis (descent). Upper blepharoplasty procedures need to be considered in relation to eyebrow position. This will be discussed with your surgeon as it will be a factor which can impact the ultimate outcome.
• Management of the upper eyelid. The degree of surgery required will be discussed with your surgeon in addition to the extent of surgery which can be performed safely and any limitations to achieving your expectations.
  Your surgeon will discuss the relative merits and surgical techniques involved in removal of skin, fatty tissue and reconstruction of the supra tarsal crease (upper eyelid crease).
  You will have access to pre- and post-operative images to illustrate the potential cosmetic outcomes achievable.
• Management of the lower eyelid. During your consultation, your surgeon will assess the quantity and quality of your lower eyelid skin, the position of fatty tissues and the structural integrity of your lower eyelid. You will be advised on the impact each of the elements will have on your expected outcome. Your surgeon will also assess your potential risk of ectropion (exposure of the conjunctiva below the limbus or coloured part of the eye) and may recommend corrective surgery to optimise lower eyelid tone. Discussion will also take place regarding placement of scars which are typically under the lower eyelashes where eye liner is applied or internally within the lower eyelid.

Patients who have a tendency towards dry eyes or tearing may experience temporary exacerbation of these conditions after surgery and it is advisable to avoid contact lenses for two weeks after surgery.

Past Medical History

It is important your surgeon is made aware of any previous surgery and history of scarring, along with significant medical history including visual problems, as well as a tendency for easy bruising and excessive bleeding, and deep venous clots involving the legs.

Your surgeon should also be made aware of all prescription and non-prescription medication you may be currently taking, as well as any allergies to anaesthetic agents, antibiotics and dressings, history of smoking and psychological or psychiatric issues.

Such issues are important as they have the potential to affect your surgery, anaesthesia, and recovery.

Pre-operative Management

Further medical consultation is necessary to be fully informed about the procedure and to minimise complications including consultation regarding blood thinning agents, which may need to be either ceased or modified in preparation for surgery.

You may also be required to undergo a series of diagnostic tests, including blood tests, to assist your surgeon in gaining a complete assessment of your bleeding tendencies and to optimise your fitness for general anaesthesia.

If advised by your surgeon, it may also be necessary to cease medication such as the oral contraceptive pill. It is important to avoid aspirin, Disprin and non- steroidal anti-inflammatory medication such as Nurofen, as well as some herbal medications two weeks prior to and after surgery.

It is essential that smoking ceases six weeks prior to and after surgery to minimise the risk of surgical wound complications and potential complications from anaesthesia. Products containing Nicotine can also affect wound healing and should be ceased two weeks prior to and after surgery.

Informed Consent

Only after your surgeon has thoroughly assessed your situation and informed you of the surgery process and all associated risks should consent to surgery be given. Ensure you have asked your surgeon any necessary questions, including questions related to cost and the potential for corrective surgery after your initial operation.

Cost

At NorthEast Plastic Surgery, we want to make sure you have the most accurate information before moving ahead with surgery. As such, we do not advertise set prices for any of our procedures on our website. This philosophy adheres to the guidelines for advertising of regulated health services, provided by the Australian Medical Board.

Once you have undertaken an extensive consultation at our clinic, your surgeon will be able to discuss the cost of your procedure with you. We can also provide approximate out-of-pocket costs before your initial consultation, including any applicable Medicare rebate, over the phone via 03 9088 5000 or via our website.

Consultation Cost

There is a cost for an initial consultation at our Melbourne clinic, with the potential to receive a portion of this back via Medicare where eligible for rebate, provided you have a referral from your GP. You can call our Melbourne office on (03) 9088 5000 to enquire about any out-of-pocket costs before your initial consultation as well. All consultations are made by appointment and you should allow one hour for your consultation to ensure adequate time for examination and any necessary questions.

Blepharoplasty Surgery

Whilst the procedure is occasionally performed under local anaesthetic with sedation, it is most commonly performed under general anaesthetic administered by specialist anaesthetists in an accredited hospital.

Your surgeon will discuss your requirements in this context along with the nature and placement of the incisions required prior to undertaking the surgery which will determine where scarring occurs.

Your surgical wounds will be repaired with internal stitches which are removed one week after surgery. At the completion of surgery, tapes and dressing are applied which can be worn whilst showering.

Second Opinion

Mr Patrick Tansley MD FRCS (Plast) and Dr Sugitha Seneviratne FRACS (Plast) provide second opinion to patients seeking to address problems following plastic surgery performed elsewhere and revisional or corrective surgery. If you would like a second opinion on previously undertaken surgery, book a consultation to discuss this with one or both of our surgeons.