Eyes Open

By: Mr Mansoor Khan
Created on 30th May 2012

Consultant plastic surgeon Mr Mansoor Khan dissects the blepharoplasty procedure

A blepharoplasty procedure, done well, is the best anti-ageing procedure in my opinion. It completely refreshes the look of the eyes and thereby the whole face.

Isolating the problem
Although this is a relatively straightforward procedure for a competent and experienced surgeon, it is important that you don't just view the eyes in isolation. You have to assess the forehead as well as their upper and lower eyelids.

The biggest mistake a surgeon could make is to remove excess skin off the eyelids and then discover it is their brow that is drooping and not their eyelids. In that case, they would need a brow lift and I would say 40 per cent of patients that present to me for eyelid surgery actually need a brow lift or a brow lift combined with a bleparoplasty. This has to be explained to them carefully as many are convinced that it is their eyes that are the problem.

Scar no more
One great aspect of a blepharoplasty procedure is that scarring is minimal as the skin in this area is very thin. The upper eyelid incision is literally invisible within six weeks. It can be more visible in the lower eyelid for up to eight weeks but still heals really well.

Patients usually want to stay out of the public eye for seven to ten days and then - especially if they've just had their upper eyelids done - they should be able to cover up any scarring with make-up and no one will be the wiser.

An op for all ages
In terms of patient selection, I see a wide age range of patients presenting for a blepharoplasty procedure. Younger patients might be suffering for a congenital problem where the eyes droop or they suffer from bulging fat pockets under the eyes and a blepharoplasty can really help. Obviously we're all aware of the effects that ageing can have on the eyes with gravity making the upper eyelids droop and in the lower eyelid area they might be suffering from prominent eye bags or hollows under the eyes.

In combination
I often combine a blepharoplasty op with non-surgical procedures for the best results - the current vogue is for tear trough filling where you combine a lower blepharoplasty with fat redraping or with temporary fillers to get rid of that hollow look. I personally don't do much laser work myself but it is also possible to do laser treatments on the lower eyelid to tighten up the whole area.

Patient minded
The current trend is to have the upper and lower eyelids done at the same time as the price difference is not that great. Although the upper eyelid is relatively simple as it you're just removing excess skin, the lower eyelid procedure is more demanding and a skilled surgeon is a must, otherwise the lower eyelid can droop afterwards if you're not careful.

It is important to go to recognised surgeon - preferably BAAPS and BAPRAS registered - who has done a number of these procedures as there are a number of pitfalls that can be quite disastrous and difficult to fix. Ask how they manage complications as they can sometimes happen.

Your surgeon should be able to show you good before and afters of this procedure and provide a lengthy consultation that gives the patient all the information they need to know - this includes what will actually take place, post operative healing, the results they should expect.

In conclusion
Blepharoplasty is referred to as a 'cosmetic' surgery procedure and, as a result, it is often not treated with the respect it deserves. This is invasive surgery and it should be treated as such so patients need to be really careful about which practitioner they choose.