Purpose

Eyelid surgery may be called for in reversing changes in the eyelids from ageing to give a more youthful look. Congenital problems like ptosis or absence of the supra-tarsal crease (single eyelid) may also be corrected. Occasionally trauma or surgical resections may involve the eyelids.

Details

The eyelids may be infiltrated with fat producing a baggy look with ageing. Skin redundancy may be accompanying and may sometimes be severe enough to affect eyesight. These could be ameliorated surgically through approaches along the supra-tarsal crease for the upper eyelid and the conjunctiva (the red mucosa) or the skin below the lashes of the lower lid.

Ptosis can be due to different causes. In congenital ptosis, a number of techniques are available depending on the severity of the condition, either the intrinsic tendinous mechanism of the upper eyelid is shortened or a tendon graft is employed to enable upper lid movements via its attachment to the forehead muscle.

The oriental eye sometimes comes with an absent supra-tarsal crease and creation of such a crease can be achieved by re-establishing the connection between the skin at the desired crease to the tendinous mechanism of the upper lid responsible for opening the eye.

It is becoming more common lately for patients to ask for "opening the angles" of the eyes. These are local skin resections of various designs performed on the inner and outer angles of the eyes to produce a "bigger eyes" look.

The eyelids easily swell and post-operative recovery may take time. Strenuous activity is to be avoided and sleeping with the head end elevated is helpful. Eye ointment is often applied and this may impair vision for the time being. Cold compress on the eye is often recommended. Patients often bring along a pair of dark glasses to surgery to put on when they leave the clinic or hospital suite.

Caution

Corrected ageing changes may recur with time. Correction of congenital ptosis may sometimes fail or correction may not be full, requiring a second surgery. Some methods of the double eyelid operation may have a higher rate of recurrence. Eye swelling takes time to subside.