If you have both excess upper eyelid skin and your eyelids are drooping that is called dermatochalasis and ptosis. In that case, blepharoplasty alone does not cure your ptosis or droopy eyelids, and you require a combination of upper eyelid blepharoplasty and droopy eyelid ptosis surgery. Fortunately, we can do both at the same time on both eyelids under local anaesthetic as a day case.
Patients who have excess upper eyelid skin causing hooding and folds and who also have actual drooping eyelids or ptosis will often get quite bad headaches. The reason for their headaches is that they are trying desperately to see out and to lift their eyebrows up using their frontal forehead muscles. This will stretch out the skin of the upper eyelids stopping the folds of skin or hooding and lifting the height of the eyelid. However, it takes a lot of effort and energy to lift your eyebrows during the whole of the day. As a result, many patients with excess skin on their upper eyelids and drooping eyelids get quite noticeable frontal headaches towards the afternoon and the end of the day.
To stop these headaches and to improve the visual field as well as the cosmesis of your eyelids, you may require upper eyelid blepharoplasty and combined ptosis surgery as a dual operation. So getting upper blepharoplasty for your ptosis involves two operations done at the same time.
The first part is where I make a skin crease incision, I find the levator muscle and move it forwards to lift the eyelid and correct the ptosis.I will have already measured and assessed the amount of upper eyelid skin and in the underlying soft tissues that require removal.
I will then as a second part of the operation (we do the first and second parts at the same time) remove that excess soft tissue. Lastly, I will close the skin with a combination of fibrin tissue adhesive and very minor stitches which are barely visible. By having the combined upper eyelid blepharoplasty and ptosis surgery, you can stop headaches that you have been getting as a result of your eyelid droopiness and ptosis.
The upper eyelid blepharoplasty and ptosis surgery are done here at Clinica London as a day case. You are admitted about an hour before the surgery for the pre-assessment, and then you go into the small operating theatre. The nurse then makes you comfortable on the couch, cleans the skin and puts in the eyedrops. After that, I come along and get scrubbed up into my gown and sterile gloves. Using a sterile pen I will measure the skin height, the amount of skin to be removed and then I will make the decisions on exactly what I need to do during the surgery. Next, I will give you a little bit of local anaesthetic infiltrated underneath the skin of the upper eyelids and proceed with the blepharoplasty and ptosis surgery. At the end of the procedure, I will either put some pads on for an hour or two or just some shields to protect the eyes. And that is it; then you go home in sunglasses about an hour afterwards. By having this surgery, you can stop the headaches that you have during the day.
Headaches during the day can be caused by other things as well. So clearly if you are in the age group of 40, we have to double check that your headaches are not caused by getting tired sight or presbyopia or that you need glasses for reading. I also have to check that you have not got undue dry eyes and that your occupation is making these worse and contributing to your headaches. So before I do upper eyelid blepharoplasty and ptosis surgery, I want to know that you have got precisely the glasses that you should be having and that you are not suffering from very dry eyes. Once those two are corrected and if you are still getting the headaches because of using the frontal muscle so much to try and lift up the eyelids then we can proceed with the surgery for functional medical reasons not just cosmetic.