Eyelid Surgery

Rejuvenation of the eyelids can be divided into 4 separate areas with 4 different types of surgery
1. Upper eyelid – Upper blepharoplasty, Double eyelid surgery
2. Lower eyelid – Lower blepharoplasty, Removal of Eyebag
3. Epicanthus – Medial Epicanthoplasty
4. Eyebrow – Direct Brow lift, Sub-brow Upper Eyelid Lift

1. 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 incisional method.

Non Incisional Method / Stitch 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. For those with thick upper eyelid due to fat, the excess fat may be removed at the same time through an additional small incision.

Open Incisional Method

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.

 

2. 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 eyebag and rejuvenate your eyes. The most reliable and effective 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 re-drape to give a nature look without any external scar. This method is extremely useful for patients who have no or minimal excess skin. When there is laxity of skin in some older patients which requires removal, the excess skin is trimmed at the same time through a sub-ciliary incision. Our approach to lower eyelid surgery has almost eliminate 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, scarring or weakening of the lower eyelid. Together with the use of laser as an incisional tool, the recovery time is significantly shortened.

3. Medial Epicanthoplasty

Many Asian upper eyelids are almond shape with the presence of thick epicanthic fold. Epicanthoplasty is an ancillary procedure that reduces the prominence of epicanthic fold by releasing the medial web-like fold with modified z-plasties, It makes the eye look rounder and wider. The procedure can be done at the same time as the double eyelid surgery.

 

4. 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 position is high. An ellipse of skin below the brow is excised below the brow to lift the upper eyelid.

 

FAQs

What is the downtime?
– swelling for the first 1-2 days; advised to do cold compress
– warm compress after 2 days to help in resolution of bruise.
– recovery time about 1 week

What is the cost?
– Ranges from $2500 to $3500 per procedure.
– Medication: $100- $200
– 7% GST

What are the risks?
– Immediate risk: bleeding, haematoma and infection.
– Longer term risk: dry eye, change in the shape of the eye or ectropion, asymmetry and scarring, hollowness of eye, loss of double fold (<5% to minimal)

How long does it last?
– Effect of surgery is long lasting, usually more than 5 years.

Insurance?
– Usually a cosmetic surgery; not covered by insurance.
– Exception: Severe ptosis which obstructs the visual field.

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If you are interested in having any of the above eyelid surgeries performed by Dr Hong, please contact us via this link.