Upper eyelid blepharoplasty is often a much-maligned operation, as it is cosmetic and only to be done by people who are possible, may I say, vain or self-obsessed. In the UK, people often do not want their family or friends to know that they had an eyelid blepharoplasty done because they are concerned that they may be misconstrued as just seeking an improvement of their appearance.
I want to tell you about one case I saw last week in the clinic which ultimately illustrates the opposite; namely how having upper lid blepharoplasty and ptosis surgery can completely transform somebody’s life.
The patient in question was a 55-year-old lady who had bilateral upper eyelid excess skin and droopy eyelids. She was not completely aware of the droopy eyelid; she just knew that she was lifting her eyebrows a lot throughout the day and that her eyelids felt hefty and then her forehead felt exhausted. In fact, she had been raising the eyebrow so much that she had developed very thick horizontal lines on her forehead.
She had been very anxious about having the surgery, and so, unusually, we did do the surgery with local anaesthetic and intravenous sedation, which is known as twilight anaesthesia. That is always a little bit more difficult because I do not then have full co-operation of the patient to look up and down, and I am not able to sit them up during the surgery to test the height.
However, everything went very well, and at her first visit, which was ten days after eyelid blepharoplasty surgery, she came in with an enormous smile on her face saying that the surgery had transformed her life. She had got rid of the heaviness, in other words, the feeling across the top of her forehead above the eyes. She felt incredibly different. She had a full vision all round. She says one of the first things that she had noticed was that she had lost the dark lines on her forehead. This was because she no longer had to use the tremendous effort of her forehead muscles to lift her eyebrows and hence try and get the secondary effect of lifting the skin off the lashes and raising the height of the eyelids.
This somewhat small operation in some respects of operating on the upper eyelids, which is done for cosmetic reasons, can have a real functional change on people’s lives. In fact, my patient said it had transformed her life. Also, she looks a lot younger! She no longer has the horizontal lines on her forehead. She no longer has that tired, strained appearance that she had before when she was trying to lift her eyelids up using her forehead muscles. She looks relaxed with gorgeous eyes and can now wear her make-up. She is delighted at the transformation. Even though she is only ten days after surgery and there is still a small amount of swelling to settle, and the bruising is only just going along the eyelid, she can see the improvement and knows, as I do, that in the long term this has been a very successful operation for her. Despite her nervousness, she is pleased she went ahead with it.
I am happy to say she did the operation with the full knowledge of her family, her husband and children and that they have been very supportive of her and helped her through the early post-operative phase, with all the uncertainty and putting in the eye drops and seeing some small amount of bruising. I believe she has done this right by involving the loved ones around her in her quest for improvement of the function of her eyelids with blepharoplasty and ptosis surgery. Not for vanity.
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