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Blepharoplasty makes the world a brighter place

One of my patients had upper eyelid blepharoplasty and ptosis surgery for hooded and drooping eyelids. A few weeks later when we were chatting in the clinic, she said to me “My daughter told me I had no spatial awareness before the surgery and I used to bump into people all the time, now I do not.”
“The world is a much brighter place, I see a lot more light, and it is not in my imagination, more light definitely gets in my eyes. It is a very dramatic change. It is much more than I thought it would be. Also, I do not feel so tired now because the weight has been lifted off my eyes.”.
It came as a surprise to me after over 20 years of doing upper lid blepharoplasties that my patients noticed so much visual improvement. If I took the time to talk and listen to my patients, I learnt a lot about how they had benefited regarding their quality of life from their eyelid surgery. Many of them had come to see me originally at Clinica London for a blepharoplasty ptosis eyelid assessment, concerned about their cosmetic appearance and looking tired. It is so often a surprise both to the patient, and to me that after surgery, not only do they look less tired, but they FEEL less tired, and their visual function is very much improved.
Upper eyelid blepharoplasty is most commonly done on men and women from the age of about 50 to 55 years onwards. At that age they have also become presbyopic, meaning they need reading glasses to see, so they are aware of a general diminishing of the function of their vision. They are very accepting of this, and so it’s a great surprise when they find they can actually see better after their eyelid surgery. They still require reading glasses for their presbyopia, but their vision is generally brighter and has better contrast.
Blepharoplasty treatment is indicated for drooping eyelids and eye bags, either for cosmetic, aesthetic reasons or to improve vision. The drooping folds of skin on the upper eyelids are removed surgically with delicate Oculoplastic surgery. Upper eyelid blepharoplasty surgery is done under local anaesthetic as a day case with the patient fully awake, but with the eyelids completely numbed. This way, at the beginning of surgery, we can sit the patient up and look at the eyelids in their normal position. I mark the eyelids with a pen to define the skin crease and amount of excess upper eyelid skin that is going to be removed.
It is not always just skin that is causing the droopiness, but also heaviness from soft tissue descent, and sometimes actual ptosis. I often have to remove a small amount of fat and even a little bit of muscle to get rid of the heaviness and help the eyelid skin edges close again. If the eyelid has actually dropped as in a ptosis, which means to fall down, then at the same time I operate inside the lid. I will gently advance the levator aponeurosis to the tarsal plate to correct the ptosis. At the end of surgery, I put in a few very fine stitches into the skin at the two corners and usually the rest of the eyelid skin is closed with TISSEEL fibrin adhesive.
The aim of blepharoplasty surgery is to give a pleasing aesthetic result with good functional outcome by improving the visual function, so the visual field is bigger and more light can get in. This way the world can be a brighter place for the patient after eyelid surgery.


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