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Under the knife: drooping eyelids surgery

Oculoplastic surgeons operate on eyelids, and one of the main areas that we specialise on is removing excess upper eyelid skin which is hanging or drooping.
This is done under local anaesthetic as a day case. Light oral sedation can be used in drooping eyelids surgery if required. It is important that the patient can sit up at the beginning of the surgery so the surgeon can mark the amount of skin to be removed. The skin needs to be marked before the local anaesthetic has been given.
It is advantageous for patients to be alert but relaxed, and to be able to sit up at the start and later during the surgery when the eyelids are numbed, for the surgery to be set at the right position for their eyelids.
Again, the amount of skin removed is checked several times during the surgery. This gives the optimal results, all because the patient is helping the surgeon.
At the end of surgery, the skin incisions are closed with small stitches and a combination of ‘glue’. The “glue” is called Tisseel fibrin adhesive and is used in the central part of the lid to seal the skin edges. The adhesive gives a natural post-surgical look. However, there will always be the risk of some bruising and swelling and redness for 5 to 10 days after drooping eyelids surgery.
The alternative to surgery for drooping eyelids is to raise the eyebrows a little bit with a small amount of Botox™ injected to the lateral brow. This does not push the brows up but prevents gravity pulling them down, as it works on weakening the muscle that pulls down the outside edges of the eyebrows. Then, the muscle that pulls the eyebrows up can work more efficiently, open up the eyebrows and reduce small amounts of drooping

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