This information provides you with general information which may or may not pertain to your case. Each patient is unique and you are encouraged to seek advice from Dr. Chow about any concerns. Every aspect of the surgery cannot be covered and you are encouraged to ask questions during your consultation.
The eyes are thought of as the “window to the soul” and arguably one of the most expressive features of the face. Eyelid surgery can dramatically improve one’s appearance by restoring a youthful and less fatigued look.
The procedure can correct drooping upper eyelids that tend to sag with age and time and impair vision, and reduce puffy bags that may develop below the eyes. Whether eyelid surgery is performed for medical or cosmetic reasons the aim is to improve the aesthetic appearance while retaining natural shape and maintaining or improving function. The result can be a refreshed appearance with a firmer eye area. Blepharoplasty does not alter dark circles, sagging eyebrows or fine lines and wrinkles around the eyes but it does improve drooping eyelids.
The surgery can be performed as a single procedure or in conjunction with a browlift / forehead lift, facelift /mini facelift, skin resurfacing, wrinkle relaxer (e.g. Botox) and wrinkle fillers so that any other problem areas may be addressed simultaneously.
Blepharoplasty can be performed to:
• Remove excess droopy skin from the upper or lower eyelids
• Tighten the underlying muscles and soft tissues
• Remove excess fat “bags” from under the lower eyelids or in the upper eyelids
Understanding the Procedure
Eyelid surgery involves the removal of excess skin and fat from the upper and/or lower eyelids and is one of the most common cosmetic procedures. The procedure usually takes 45-60 minutes for upper or lower blepharoplasty and 90-120 minutes for both upper and lower blepharoplasty. It can be performed as a day case in hospital using local anesthesia with or without sedation or general anaesthetic.
Stitches can be removed after 5-7 days and most patients return to work 1 to 2 weeks after surgery.
In upper eyelid surgery, incisions are made in the natural skin folds so that fine scars are less visible. Excess and loose skin can then be removed. In lower eyelid surgery the incision is normally made along the lash line or smile creases (external subcilliary incision) of the lower lid so that excess skin and fat (bags) can then be removed. Fine sutures are used to close the incisions minimising the visibility of any scarring.
Occasionally the incision can be made inside the lower eyelid. This is called a transconjunctival blepharoplasty. Sutures in this area are normally self dissolving and leave no visible scars. Not every patient can have this type of procedure so you need to ask Dr. Chow whether you are a candidate for this.
Double Asian Eyelid Surgery
People from East Asian background commonly have no or limited upper lid creases. Double eyelid is a normal variant and is considered to be aesthetically pleasing. People who would like to double eyelid surgery do not want Westernisation (high eyelid crease) but enhancement of their ethnic feature. Options are suture technique or surgical incision in the upper lid. While suture technique is less invasive the result is more variable and has higher recurrence in the long term. Surgery to form a permanent crease is more involve but provide the best long term result. It is performed as a day procedure under local anaesthetic with sedation.
Patients from East Asian background commonly request double eyelid surgery blepharoplasty and nasal augmentation/augmentation rhinoplasty together.
Revision eyelid surgery is surgery on an area that has already been operated on. Corrections normally take longer because the surgery is more complex. Also it should be noted that reduction in swelling and healing times can take a little longer with revision surgery.
Friends, relatives or coworkers who have had facial and cosmetic plastic surgery are often willing to share their experiences. It is often helpful to talk to these people before contemplating surgery.
An initial consultation gives you and Dr. Chow the opportunity to discuss your intended procedure/s in full.
Some of the questions you may wish to ask are:
• Am I a good candidate for this procedure?
• What is a realistic outcome for me after surgery?
• How long will the operation take?
• What is the recovery time?
• What are the risks involved?
• Is post-operative medication necessary?
• What is the charge for the procedure?
It is a good idea to write down the answers Dr. Chow provides so that you can review these carefully later. The consultation also provides you with an opportunity to meet Dr. Chow to determine whether your personality and hers are compatible and that you feel comfortable with her as your surgeon.
Cosmetic surgery is not a guarantee of happiness, success in life or relationships, and you need realistic expectations before embarking on surgery. Please think carefully about the reason why you are considering surgery and why at this point in your life. Suitable patients for cosmetic surgery are currently happy in their life and not obsessed about their appearance. These patients are seeking to enhance their appearance with subtle changes and realise the final result will not be perfect. If you are thinking about your appearance constantly, experiencing life problems and other stressors, you may require psychological help rather than cosmetic surgery.
MAKING A DECISION TO PROCEED WITH SURGERY
Whether your surgery is desired for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. As a Facial Plastic and Cosmetic Plastic Surgeon, Dr. Chow is trained in both Otolaryngology Head & Neck Surgery and Facial Plastic and Cosmetic Surgery, which provides you, the patient, with the highest level of training and expertise. You should be informed as much as possible before making a decision to proceed with cosmetic surgery. Cosmetic surgery is an elective procedure, which means that it is a personal choice and not necessary for maintenance of good health.
You can expect a thorough explanation from Dr. Chow regarding the various types of surgical and non surgical procedures. Dr. Chow will inform you of the best methods of anaesthesia, the surgical facility where your procedure will take place and the benefits and risks involved in surgery. Following a joint decision by you and Dr. Chow to go ahead with a procedure, photographs of you will be taken and Dr. Chow will further discuss the options available.
A good rapport between you and Dr. Chow and realistic expectations are prerequisites for successful outcome. You are most likely to be pleased with the results if you have a realistic idea of what surgery can and cannot do. Please do not hesitate to seek another doctor’s opinion if you are uncertain about Dr. Chow’s advice. You are the most qualified person to select a surgeon that is right for you. The goal is for a natural, aesthetically pleasing and balanced look.
It is important that you are candid with Dr. Chow and her staff regarding your medical history so that she can plan the best possible treatment. This information is strictly confidential. Please inform her of any:
• Previous facial and/or cosmetic surgery (nose, eyelids, breasts etc.)
• Past and current medical conditions such as heart, lung and kidney disease, prolonged bleeding or excessive bruising, blood clots in the legs or lungs, or gastric reflux.
• Current medications especially Aspirin, Plavix, Iscover, Anti-inflammatories, Warfarin, blood thinners, Insulin, and oral contraceptive pills. Over the counter products such as vitamins and herbal medications
may also be important.
• Allergies or adverse reactions to antibiotics, anaesthetic drugs or other medications.
• Psychological and psychiatric illnesses
• Past keloid scarring or poor healing
• Connective tissue disorders such rheumatoid arthritis, lupus erythematosis, scleroderma or similar
• Previous radiotherapy to the head, neck or breast areas.
Dr. Chow will then examine your features and after discussing options and specific risks and benefits will recommend the most appropriate procedure/s for you. We respect your privacy.
Risks of Surgery
Modern surgery is safe but does have risks. Complications can occur despite the highest standards and world’s best practice principles used by Dr. Chow. It is not possible to list all the risks but you should be informed of the common side effects and benefits so that you can make an informed consent. Dr. Chow will discuss these in greater detail at consultation. You should write down any particular questions or specific concerns.
The potential risks are
General risk of surgery
• Wound infection – may require antibiotics
• Bleeding, blood clots or seroma
• Chest infection
• Sore throat from the breathing tube
• Scars that become raised (hypertrophic or keloid)
• Pain and discomfort
• Bruising for usually 2 -3 weeks
• Temporary swelling causing tightness around the eyes
• Too much skin removal – may cause inability to close the eyes and corneal injury
• Rounding of the eyelid margin or retraction of the lower lid
• Asymmetry of the eyelids
• Scars at the incision site
• Temporary change in vision – usually short term, rarely permanent
• Itchiness, dry or watery eyes- may require artificial tears. Rarely permanent.
• Very rarely loss of vision- risk is 1 in 40,000. People with pre-existing eye conditions, or smoking, heavy lifting or coughing have higher risks
Final results following Blepharoplasty are not fully apparent for 3 to 6 months following surgery. We recommend that you have follow up appointments for assessment and postoperative photographs.
Whilst every effort is made to produce a satisfactory improvement in appearance and optimal result, postoperative irregularities and asymmetry do sometimes arise. Whilst such things can often be corrected, no guarantees are made in regards to eventual final results.
If you have any concerns please contact Dr. Chow’s office. Remember, we are all here to give you the best possible care.