More about Aesthetic eyelid surgery
Surgical eyelid lifts and eyebags removal: Ptosis and Blepharoplasty
Ptosis surgery is eyelid lifting surgery for drooping eyelids, performed under local anaesthetic as a Daycare at Clinica London. Conducted by an experienced oculoplastic surgeon we aim to give a good symmetry in eyelid height and a pleasing contour and appropriate skin fold height and depth.
Blepharoplasty is the correction of hooded eyelids and eye bags, done on either the upper or lower eyelids or both, under local anaesthetic as a day case. In the upper eyelids, a small amount of skin and underlying muscle is removed. Sometimes the medial fat pad causing a media eye bag is reduced, and the lateral lacrimal gland repositioned using internal stitches where it may have prolapsed, giving the appearance of a lateral bag.
In the lower eyelids there are several different types of lower eyelid blepharoplasty depending on whether fat is required to be removed transconjunctivally (from the inside of the eyelids) or skin only from the front in a below eyelash line incision, or both. Often a stabilising lateral canthoplasty is done where there is eyelid laxity or deemed to have a risk of eyelid sag post lower eyelid blepharoplasty surgery.
Aesthetic medical treatments include:
- Anti-wrinkle treatments with botulinum toxin A (e.g., Botox®, Dysport®, Azzalure®) for vertical frown lines, horizontal forehead lines, crow´s feet smile lines, bunny lines on the side of the nose, and poppy chin.
- Hypertrophied calf muscles are also treated with Botulinum Toxin A (Botox®).
- Excess sweating of armpits, palms of hands or soles of feet, called hyperhidrosis, is treated with botulinum toxin A, Dysport®
- Dermal fillers for tear trough and cheek hollowing such as hyaluronic acid gel filler (e.g., Restylane® and Juvederm® ). Miss Olver specialises in TearFill® using Restylane and Lidocaine introduced via cannula single port entry in the periorbital area for rejuvenation. She builds up the cheeks, zygomas, temples, tear troughs as well as filler in the lower face, lips, nasolabial folds, marionette lines, chin and jaw. She specialises in canula administered lip liner which has very reduced discomfort for the patient compared to direct injection with a needle.
- Restylane Skinboosters Vital and Light for light dermal hyaluronic acid-boosting on backs of hands, under eyes and around mouth
- Biostimulation injections of poly-L-lactic acid by cannula (Sculptra® ) for tear troughs (dark circles under the eyes) as SculptEyes® and SculptVisage® , facial grooves (nasolabial lines) and other areas of cheek and facial volume loss.
- Intraceuticals peri-orbital rejuvenation, which is hyperbaric oxygen and hyaluronic infusion, is used for rehydrating the root layers of the skin.
- Ultherapy uplift is used for face and eye rejuvenation. Also known as Ulthera®, this is micro-focused thermocoagulation of the dermis which stimulates collagen biosynthesis and skin tightening and lifting. Ultherapy is used for the upper neck and tightening jowls and is FDA approved for a non surgical facelift. It can be used around the eyes for a brow lift, on the neck and decollete for tightening, all as non-invasive non-surgical lifts with microscopic downtime.
- Other aesthetic treatments: Dermaroller, phFormula, cosmetic skin care advice, TCA peels
- Hyaluronidase enzyme reversal of hyaluronic acid gel filler, HyaloFix®, in lips, cheeks, tear troughs.
Miss Olver, the Oculoplastic Surgeon, assesses all patients for aesthetic surgery and treatments. She does the eyelid ptosis and blepharoplasty surgery as well as the TearFill, and other fillers and stimulatory injections. Miss Olver does the anti-wrinkle treatment, and her nurses will do some anti-wrinkle glabella, forehead and crow´s feet botulinum injections, TCA peels. The Clinica London nurses the Intraceutical facials, Dermaroller, Ultherapy non-surgical face and eye lifting, phFormula facials and gentle peels, and advice on skin care with the Clarisonic brush, Heliocare and phFormula, La Roche Posay Anthelios sun protection and their other eye and skin products.
The Hyaluronic acid gel reversal with hyaluronidase, HyaloFix®, is done by Miss Olver as it is an off license medical prescription and treatment.
Initial Assessment For functional or cosmetic ptosis and blepharoplasty surgery
- Lifting the upper eyelids – upper blepharoplasty for hooded eyelids
- Remove lower eyelid bags – Lower blepharoplasty
- Raise drooping eyelids – Ptosis surgery
Each patient has a 30-minute assessment with the Oculoplastic Surgeon Miss Olver, then the findings and planned treatment are discussed, with the benefits and risks explained. A full medical report is dictated and sent to the patient a few days later, outlining the condition and recommended aesthetic surgery or treatment.
The history of the eyelid problem, whether a medical functional problem or aesthetic cosmetic problem is ascertained. Photographic documentation is made and if necessary visual fields plotted to see the medical impact of the hooded or drooping eyelids. Eyelid measurements are taken, the amount of eyelid function in elevation, in horizontal laxity and snap back test are assessed. The surface of the eye and the eyelid margins are determined using the slit lamp for the presence of blepharitis and dry eyes.
A full written report is prepared after the consultation outlining the findings and recommendations. If the patient is having surgery done under their private medical insurance, the surgical codes are provided. If the patient is a self-payer, a written prepared quote of the proposed costs is sent.
Initial Assessment For Medical Aesthetic Treatment (non-surgical)
A half hour aesthetic assessment is carried out by the Oculoplastic Surgeon with the Aesthetic nurse present as well. This can be a general Aesthetic, Ulthera or a Hyaluronidase “reversal of filler” consultation.
During the meeting the oculoplastic surgeon will want to know the main aesthetic concerns, whether there have been previous aesthetic treatments with filler, Botox or other. The oculoplastic surgeon will want to know the expectations the patient has and what they hope will be recommended, and what treatments they do not want to consider. The periorbital area, face and neck are examined.
Three layers are considered, in the upper, middle and lower face.
- Skin: condition and sun damage
- Soft tissue: volume and distribution
- Underlying bony skeleton shape
The surgeon will look and feel the skin and subcutaneous soft tissue and bone, show you what areas are causing the problem and how they can be treated.
Once identifying the problem, the aesthetic medical treatment options are discussed, and the best one or combination thereof are recommended. It is important that the patient knows the possible complications of any proposed treatment, so these are discussed as well as their benefits.
A full report is prepared, outlining the problem, the findings and aesthetic medical recommendations plus the potential risks of undergoing treatment. A quote for the cosmetic medical care is sent.
Aesthetic Eyelid Surgery
Ptosis and Blepharoplasty
These operations are carried out by the Oculoplastic Surgeon Miss Jane Olver, at Clinica London, under local anaesthetic as a day case. Miss Olver has over 20 years experience as a Consultant Oculoplastic Surgeon in the NHS and privately. She specialises in ptosis and blepharoplasty surgery both for medical and aesthetic indications.
Botox and Fillers
Botox®, TearFill®, SculptEyes® and SculptVisage®
These medical cosmetic treatments have been perfected by the practitioners over many years, to give you the best possible results.
Reversal of hyaluronate fillers “HyaloFix®”
Hyaluronidase “off licence” use for reversing hyaluronate
Many patients come to Clinica London wanting a reversal of the filler they have had elsewhere, whether it be for overfill, wrongly filled with asymmetry or lumps, or just not liking the appearance and wishing they had never had the filler.
Ulthera is an outpatient treatment which takes between 45 mins and 2 hours, depending on whether just a small area or full face and neck are being treated. Bespoke treatment is tailored to your needs.