Eylid surgery

1. Who will benefit from eyelid surgery?

The age is not important. Younger people may have bothersome fat bags. Older people, maybe those over 70, can have skin folds that in addition to be disfiguring, also interfere with the eyesight and cause symptoms of fatigue.

Heavy smokers ought to cut drastically down on their consumption of cigarettes at least two weeks prior to the operation. You also need to stop using medicine that contains acetylsalicylic acid (Dispril, Albyl and so on) at least two weeks prior to surgery. Patients with eye diseases need an approval from an eye specialist before we can operate on them. If you have normal vision (with or without glasses) and no problems with your eyes, you can assume that your eyes are healthy.

2. Before the operation

You can come to our clinic for a consultation before the operation, or you can send us photos of your eyes. The photos must be close-ups, both from the front and from the side. It is best to have the photos taken by a photographer. Anyone who have problems with their eyes, eyelids or tear ducts must see an eye specialist before such an operation.

During the consultation, the skin, eye muscles and fat bags are examined. In particular, it is interesting to see if a forehead lift will provide a better result. The photos that are taken during the consultation serve as a ”guideline” for the surgeon during the operation. Then you will be informed of what happens during the operation, where the incisions are made, what happens after the operation, which results to expect and possible side effects

3. The day of the operation

- is always performed under local anesthesia. At first, a sedative is injected into a blood vessel in your wrist. Then the local anesthetics are injected into the skin on each side of the eyes. We also use eye drops that inhibit the blink reflex. This makes the operation less uncomfortable. The incisions themselves are painless.

The surgical incisions are placed where they will be least visible after the operation. On the upper eyelid, they are placed in the crease of the eyelid. On the lower eyelid, they are placed right below the lash line. The scars will disappear in a few months. During that first period they can easily be covered up with make up.

On the upper eyelid, excess skin, fat and muscle tissue are removed. When the precise amount is removed, there will just enough skin left to allow you to close your eyes. On the lower eyelid, excess skin, fat and muscle tissue are also removed, but only small amounts. In younger patients, only fat is removed from under the eyes.

After the operation, you will remain in our clinic, resting, for a couple of hours. Out of town patients are recommended to spend the first 24 hours after the operation in the Oslo area.

4. After the operation

Usually the patient’s eyes are covered with a bandage for a couple of hours. You need to keep completely still for the first 24 hours. Sleep with your upper body raised until the stitches have been removed. The swelling, which is at its worst after the first day, begins to subside after to 3-4 days. The stitches are removed after 3 to 7 days, depending on the technique used. You can read and watch television after 2-3 days. You can start using your contact lenses again 14 days after the operation.

You will experience bruising around the eyes for the first one or two weeks. The discoloration can easily be concealed with sunglasses or a concealer. Regular eye makeup can be used again once all the scabs have fallen off – after about 2 weeks. Be careful when you remove makeup during the first month – use oil or a mild cleansing cream. We recommend that you purchase a pair of large sunglasses beforehand. Using sunglasses has the following advantages: They minimize the irritation on the eyes and protect the wound against sun, wind and dust. The best types of glasses are with wide, convex lenses to protect the eyes from the sides as well as from the front. We recommend that you use sunglasses for about two weeks after surgery.

Do not remove the scabs from the wounds. Instead, massage them gently off with baby oil or let them fall off when you shower. A few patients are bothered by itching in the eyes a days after surgery. An eyebath (can be purchased in a pharmacy) or rinsing your eyes with cold water, usually helps.

At nights during the first week, it is best to use yellow eye-ointment in the eyes. The ointment is to be applied on the inside of the eye, not on the scar around the eye. However, do not use the eye ointment on the day when the stitches are to be removed. Pain is very rarely experienced after an eyelid surgery. A burning feeling combined with redness on the white of your eye may occur, but it is completely harmless and only lasts a short period. During the first few days, some patients experience some unpleasant ”tightness” of the skin around the eyes. Persisting pain or feeling of pressure is not normal and should be examined by a doctor as soon as possible.

Activities: Expect about one week of absence from work after surgery. Avoid heavy lifts the first couple of weeks. The same goes for physical exercise. Sunbathing should also be avoided for a couple of months. Short periods in the sun should be no problem, but for longer periods in the sun, your eyes need to be covered with something that blocks out the sun. You can most likely proceed with a normal social life after two weeks.

5. What kind of results can I expect?

You will usually look younger after surgery, feel more awake and look refreshed. The result is certainly permanent, yet many want another operation after 6-8 years. This is because ageing is a continuing process, which cannot be stopped with an operation, only delayed. The procedure will not totally change the way your eyes look, though they may become rounder and more open. The vision will remain unchanged and it is not possible to change the shape of the eyes with an operation like this.

It is limited how much of the lines will be removed with this procedure. The procedure removes excess skin and fat bags. The eyebrows have a tendency to droop with age. It is important that you know that eyelid operations do not raise the brows. In such cases, a forehead lift is the best alternative. In cases where both an eyelid lift and a forehead lift are needed, the forehead lift is done first and then the eyelid operation is performed later. Sometimes, the two operations can take place during at the same time.

Even the most perfectly performed eyelid operation cannot guarantee the perfect result, the result depends on the patient’s age, skin surface, skin color and hereditary factors. Cheek bags (festoons) below the lower eyelid cannot be corrected with an eyelid lift. In addition, deep lines around the eyes cannot be removed with eyelid surgery alone. It seldom that an individual has eyes that look the same. Thus, you need to accept some difference between your right and left eye also after the operation. Some people have a thickening right below the eyelash line. This is a muscle, which can be made a bit thinner, but not removed completely.

6. Possible complications

The operation of the eyelids is a very safe procedure – problems associated with this operation are extremely rare. Yet, we need to mention some of the problems that may happen: Should the surgeon remove too much skin from the upper eyelid, the patient may find it difficult to close the eye. The problem usually only lasts for a couple of weeks. Should this problem arise, it is important to use eye ointment in the eye at night. If too much skin is removed from the lower eyelid, the eyelid will be pulled down quite a bit. This will cause the eyes to appear rounder than before -”too much of the white is visible”. In most cases, massaging the area will help, and otherwise it must be corrected with another operation. Such problems are very rarely seen with experienced cosmetic surgeons. Bleeding and infections, which are sometimes seen after other types of operations, practically never occur in the face. Should they appear, we have efficient methods of treatment available.

Impaired vision after eyelid surgery has been reported abroad. However, there are very few known cases known worldwide. These cases probably had to do with patients who had suffered from eye disease prior to the operation. With all the hundreds of thousands of eyelid operations that have been performed with no consequences of the patients’ vision, it is clear that the risk of reduced eyesight is extremely small.