Upper Blepharoplasty / Double Eyelid Surgery
About 50% of Asians do not have a double fold. The presence of a double fold will give the perception of a bigger and more attractive eye. There are generally two ways to create a double fold namely the stitch method and the open cutting method.
The stitch method involves putting 3 stitches to hold up the fold through small puncture holes. It has the advantage of faster recovery and almost unnoticeable scar. It is suitable for the young people who has thin upper eyelid without excess skin.
The open method involves making an incision along the intended fold, cutting away some skin, muscle and fat and anchoring the skin to the levator to create a double fold. For older patients who have excess skin or fat that is drooping and covering the fold, it may be removed to reveal the double fold and give a more youthful appearance.
We use a laser-assisted technique in the open method to reduce bleeding and swelling, thus shortening the recovery time. The procedure takes about 1 hour under local anaesthesia. The recovery time is about 1 week.
Anciliary procedure like Epicanthoplasty may be done at the same time to enhance the double eyelid fold. Epicathoplasty reduces the prominence of epicanthic fold by releasing the medial web-like fold with modified z-plasties.
Lower Blepharoplasty / Eyebag Removal
Eyebags appear with aging as a result of fat bulging from the orbit due to septum laxity. In the older patients, it is accompanied by skin excess and appearance of wrinkles. They make you appear tired. Lower eyelid surgery can remove the eyebags and rejuvenate your eyes. The most common method used is the transconjunctival approach whereby a small cut inside the lower eyelid to remove excess fat that is bulging. The lower eyelid skin and muscle will fall back and redrape to give a nature look without any external scar. With the use of laser for the surgery, the swelling and bruising are minimized, thus shortening the recovery time.
This method is extremely useful for patients who have no or minimal excess skin. It almost eliminates the risk of complications like ectropion, scleral show and change in the shape of the eyes, which is more commonly associated with conventional external approach due to excess removal of skin and muscle or weakening the wall of the lower eyelid. However if there is excess skin in some older patients which requires removal, the excess skin may be trimmed in the same time through a subciliary approach.
The procedure takes about 1 to 1.5 hours under local anaesthesia. The recovery time is about 3-7 days.
Direct Brow Lift or Subbrow Upper Eyelid Lift
With ageing of the upper eyelids, there is frequently an associated brow droop which accentuates the hooding of the upper eyelid laterally. In the presence of brow droop, upper blepharoplasty alone to remove excess skin will not be enough to fully brighten up the upper eyelid. A simple method to complement the upper eyelid surgery is to do a direct brow lift. An ellipse of skin is removed just above the brow to raise the brow position higher. There will be a resultant linear scar on the upper edge of the brow, which is not noticeable after a few months. It can also be camouflage with eyebrow liner or tattoo.
The lateral upper eyelid droop may also be corrected or lifted with using a sub-brow approach if the brow postion is high. An ellipse of skin below the brow is excised below the brow to lift the upper eyelid.
These procedures take about 1 hour under local anaesthesia and the recovery period is about 1 week. This is suitable for patients who prefer a simple surgery with quick recovery to more complex surgeries like endoscopic brow lift or forehead lift which has longer downtime.