Patients often present to us with “bags under their eyes”. These bags occur in both women and men and occur predominantly around or after the age of 50. What causes these bags is a combination of both g...Continue Reading
Eyelid Surgery Sydney
Female Image Gallery Eyelid Surgery Sydney
Male Image Gallery Eyelid Surgery Sydney
About The Procedure
Upper and Lower Eyelid Surgery (Blepharoplasty) Sydney
We have all heard the saying “The eyes are the windows to your soul”. The signs of premature ageing, such as dark circles, sagging upper and lower eyelids, fine lines and wrinkles, can make you look tired and older.
Eyelid lift surgery (or blepharoplasty) is the recommended and most often preferred treatment for removing bags under the eyes or improving droopy eyelids. These ageing eye conditions can add years to your appearance and even impair your vision.
If you have either or both drooping eyelids or bags under your eyes, Sydney cosmetic plastic surgeon, Dr. Darryl Hodgkinson, can enhance your appearance and give your face a more youthful appearance with an upper, lower or combined double eyelid surgery. To achieve the best overall facial rejuvenation result and a look that is uniform each patient is assessed based on their individual needs and desires It is not uncommon for patients seeking eyelid surgery to have other facial rejuvenation procedures performed at the same time including facelift, browlift, skin resurfacing and often even Infini or anti-wrinkle injections and injectible fillers.
Eyelid Surgery Need To Knows
Excessive skin folds in the upper eyelid can cause hooding, while herniation or protuberance of the fat surrounding the eye globe can cause the upper and lower eyelids to bulge, resulting in a tired or ‘worn out’ appearance. For either condition, there are treatment options available. An upper eyelid blepharoplasty removes excess skin and muscle and redefines the supratarsal fold, while a lower eyelid blepharoplasty smooths out wrinkles of the lower eyelid by removing excess skin and muscle and removes bulging fat or restores it to the orbit.
There are also an additional treatment option for lower eyelid wrinkling, if the case is not too severe, that can be smoothed out using a carbon dioxide resurfacing laser, or chemical peeling.
Is Eyelid Surgery Right For You?
To confirm that blepharoplasty surgery is the right path for you, a pre-operative examination and consultation will be conducted, which will include a review of your medical and surgical history along with a physical exam. We will discuss your issues and goals to determine if you are, indeed a good candidate for eyelid surgery.
The specific problems that you are facing may not be solved by blepharoplasty surgery, in which case an alternate recommendation may be offered. Our medical staff will work with you to ensure that we understand your wants and desires, and that we have provided you answers to any questions that you may have. Making sure that you are comfortable with the procedure, feel fully informed, and confident that it is the right way forward for you, is of the utmost importance to Dr. Hodgkinson and our team.
How Is Eyelid Surgery Performed?
Eyelid surgery or blepharoplasty and other facial rejuvenation procedures are all is performed in our fully licensed and accredited day surgical facility located in Double Bay. Dr. Hodgkinson will make tiny incisions along the natural lines of your eyelids, which results in minimal scarring in the upper eyelid. For the lower eyelid, the transconjunctival approach is often used which is inside the eyelid resulting in no visible scarring. The procedure involves the removal of excess skin from the upper and/or lower lids and Dr. Hodgkinson may remove fat and tighten muscle to help you attain a fresher, more alert yet completely natural eye expression.
Upper and Lower Eyelid Blepharoplasty
While there are surgical options available for both sections of the eye, the intention and issues rectified differ. In both procedures though, balance is the key. The procedure should not be overdone; it should restore the tissues to where they were when the patient was in his or her early 30s. For this reason, Dr. Hodgkinson uses past photographs as a reference point.
The biggest issue and reasoning for upper eyelid surgery is excessive skin, which gives an older and tired look while also causing tired eyes and in some cases, headaches or impaired vision. Upper eyelid surgery involves an incision in the upper eyelid crease and the removal of excess skin or a small amount of fat, creating a more desirable contour in the upper eyelid.
This procedure is quite simple and does not require any post-surgical dressings or result in noticeable scarring. And you will likely experience improved vision as a result of the procedure.
In some cases, this may be combined with a lower eyelid procedure, known as a ‘double’ blepharoplasty. Lower eyelid surgery looks to treat the puffiness below the eyes. Slightly more complex than the upper eyelid procedure, the lower eyelid process targets the fat under the eyes which can create a bulge or bags giving a tired looking aesthetic, even when the person is well rested. This is usually caused by a weakening of the support structures under the eyelids.
The lower eyelid procedure involves the removal or redistribution of the fat to tighten and smooth out the skin under the eye. This is performed via an incision inside the lower eyelid or under the eyelash area. The severity of this procedure will be dependent on the level of puffiness experienced by the patient, ranging from minimally invasive to standard surgery.
In most cases, a local or general anaesthetic is used with a total duration between one and two hours, depending on the size of the operation.
Recovery After Eyelid Surgery Sydney
Usually, you will be ready to return to work or normal activities in 7 to 10 days. Most patients are back to their normal routine within days, although complete recovery may take a few weeks. Swelling, bruising and some discomfort are part of the recovery process, and can be alleviated with cold compresses and appropriate medication.
If you notice how your drooping eyelids and puffy or hollow under eye areas may be adding years to your age, ask Dr. Hodgkinson how a blepharoplasty (eyelid lift) can help you. We can reassure you by showing you our patients’ before-and-after pictures that Dr. Hodgkinson will take an artistic approach and will personalise the eyelid surgery, as well as non-surgical services that is right for your unique face.
Combining Eyelid Surgery With A Brow Lift
In some cases, patients have shown an interest in the brow lift procedure when the position of the eyebrow is arched above the bony orbit. The brow descends with age, which can result in a stern or unhappy facial expression.
A brow lift now commonly uses the endoscopic approach, and eyelid surgery and brow-lifts are often considered complementary to each other. It’s essential to identify the cause of the problems; drooping brows can cause a fold of loose skin to hang beyond the lid margin. Gravity’s effect on the forehead and eyebrows may actually be the cause of fullness in the upper lid and would best be treated by brow-lift surgery rather than eyelid surgery. The results of eyelid surgery are often longer lasting when done in conjunction with a brow lift. Blepharoplasty may not wholly remove crows feet and other wrinkles around the eyes; anti-wrinkle injections or injectable fillers might also be needed.
Often patients seeking eyelid surgery or a brow-lift express fear of an over-operated appearance. They are right to be concerned because the removal of too much skin and fat from the upper and lower eyelids can result in a gaunt, even sickly look. A high lateral arch is a desirable feature of a youthful face, but if the brow is lifted too much, the patient can end up with a startled, ‘rabbit in the spotlight’ appearance.
An endoscopic brow-lift is less invasive than the traditional procedure but requires a high level of skill and technology. Keyhole incisions are made behind the hairline; the endoscope is inserted, projecting an image onto a screen which guides the surgeon in the procedure to tighten tissue and muscle. Dr Hodgkinson has been performing the endoscopic browlift for over 20 years.
The operations involve minor discomfort and incidence of complications is very small. It takes about a week to ten days for the swelling and bruising to dissipate. The eyelids are very forgiving, and scars become invisible quite quickly.
More Than Just Cosmetic
In some cases, blepharoplasty can be more than just a cosmetic procedure. This popular surgery can also tend to the genetic tendency for eyes to droop as we age, which can impair vision.
As we age, our skin loses elasticity, and the muscles supporting the eyelids begin to weaken. These are not the only causes of heavy eyelids, as exposure to the sun, and genetics can also be factors. If this is something you are currently experiencing, and particularly if your sight is impaired, blepharoplasty can help restore uninterrupted vision while also enhancing the rejuvenated look of your eyes.
Further to loss of vision, extreme sagging or puffiness can make it difficult to wear contact lenses or glasses. Severe drooping eyelids can cause overuse of the muscles in the forehead and eyebrows, creating forehead tension, which can lead to regular headaches. A review by an optometrist can assess the amount of “visual field” loss and if significant, there are Medicare & private health rebates available.
Does Dr. Hodgkinson do Asian Double Eyelid surgery?
Yes! Dr Hodgkinson has thirty years’ experience in Asian eyelid surgery and a large percentage of Asian patients in his practice. He has also been a frequent member of the faculty at the Oriental Society of Aesthetic Plastic Surgery (OSAPS) conferences. Dr. Hodgkinson often has the privilege of lecturing in Asia at cosmetic surgical meetings, as a guest lecturer in China, Taiwan, Thailand, the Philippines, Malaysia, South Korea, and Singapore.
These opportunities have exposed him to Asian aesthetic surgery, and the top Asian aesthetic surgeons and about 15% of his patients in Sydney are of Asian or of Oriental extraction, or Eurasian. Dr. Hodgkinson enjoys working with these different ethnic subgroups and customising their eyelid and facial surgery to their particular aesthetics while making sure that the operation approximates to their ethnic ideals.
He uses advanced techniques with permanent results, not the simpler stitch through the eyelid which might be less expensive but is less predictable and does not last long. Dr Hodgkinson is very careful to make sure that the fold/crease in the eyelid is at the correct height and has a natural and attractive Eurasian look. The procedure is usually performed under twilight sedation to enable the patient to open their eyes during the procedure to ensure that the folds are absolutely symmetrical.
Oriental Eyelid Blepharoplasty
How can I have younger looking eyes?
The procedure to rejuvenate the eyes (eyelids) is called blepharoplasty. Blepharoplasty involves a surgical procedure, performed as an outpatient under twilight sedation or light general anaesthesia, where the excessive skin and bulging fat of the upper and lower eyelids is removed and the youthful stance of the eyelids restored. Care must be taken not to overresect tissue but to create a crisp fold in the upper eyelid and not 'hollow out' the lid. This outpatient surgical procedure requires precision and experience to rejuvenate your 'look'.
Eyelid Surgery (Blepharoplasty)
What procedures do you use for droopy eyelids?
When thinking about facial rejuvenation, it’s important to consider your eyes as well. “Droopy”, “sleepy” upper eyelids and excessive “baggage” on the lower lids are quite common complaints by many patients seeking cosmetic improvement around their eye area. Racial characteristics, excessive expression, allergies and sun exposure all contribute to “droopy” lids where loose skin bends down the eyelashes. Removal of the excessive skin above the eyes and readjustment of crows’ feet can be achieved through eyelid surgery known as blepharoplasty.
It is important that the surgeon has experience in this procedure as it is of critical importance to remove just enough excess skin and tissue to create a crisp and appealing appearance. If too much tissue is removed, there is the risk of the patient having too startled a look and worse yet not being able to properly close their eyes which can lead to dry eyes and other ophthalmological issues. In the lower lids, bulging fat is removed alleviating the baggage and reducing the dark rings under the eyelids.
Facelift with Blepharoplasty (Eyelid lift)
If I have my eye lids done, will I be able to close my eyes properly?
An upper lid blepharoplasty should remove just enough redundant skin from the upper lids to reveal a nice lid fold. If excessive skin is removed, patients may be unable to close their eyes properly. A well done blepharoplasty will leave enough skin on the lids to allow normal eyelid closure and showing a natural fold on which to apply eye makeup.
Upper Eyelid Blepharoplasty
What can be done to improve baggy lower eyelids?
As we age, it is common, in both women and men to not only develop droopy upper eyelids but baggy lower eyelids as well. Eyelid surgery, which is technically know as upper or lower blepharoplasty is used to improve the appearance of the upper and lower eyelids. For the lower eyelids, a transconjunctival approach is usually used, whereby the incision is placed inside the eyelid and to remove the excess tissue. This means that there are generally no visible scars whatsoever with lower eyelid surgery. It is critical that the surgeon has extensive experience in eyelid surgery as if too much tissue is removed or the incision is not appropriately placed, the patient may have resulting problems such as drooping of the lower eyelids known as ectropion.
Upper and Lower Blepharoplasty
What should I expect post-surgery?
Each patient is different, but some post-surgery outcomes can include;
- Swelling for an extended period of time
- Dry eyes
- Blurring of vision
- Small scarring of the upper or lower eyelid area
- Minor asymmetries in eyelid position
Are there any potential risks?
Complications with this procedure are very rare, and Dr. Hodgkinson has many years of experience performing these surgeries on an extensive range of patients. However, as with any surgical procedure, there are risks that we make our patients aware of. These can include;
- Bleeding (very rare)
- Infection (very rare)
- Blurred or double vision (exceptionally rare & transitory)
- Loss of vision (exceptionally rare – Dr Hodgkinson has never had a case.)
- Lid sagging in the upper or lower region (exceptionally rare)
Are There Other Factors To Consider?
Several factors may require a different technique or render a patient ineligible for this procedure. These can include dry eye syndrome, uncontrolled medical conditions like hypertension, or prominence in the eyeball. The anatomic conditions of eyelids and the quality of the skin can also play a role when selecting this procedure as the best surgical option for a patient.
It is also important to note that eyelid surgery is not the same as a facelift, despite using a similar technique. Blepharoplasty is only concerned with the eye region, whereas a facelift works with the lower part of the face. These treatments can be combined if that is necessary for achieving the overall goals of the patient.
The slightest pulling down of the lower eyelid tissues can cause the white of the eye to be over-exposed, resulting in a ‘round eye’ or a severe, ‘hound dog’ appearance. Dr. Hodgkinson will determine who is at risk of developing this problem and use surgical procedures, such as canthoplasty or canthopexy, and temporary tarsorrhaphy to prevent the dragging down of the eyelid. A lazy eye (ptosis of the eyelid) is caused by a weakening of the lid-opening mechanism and can be repaired at the same time as blepharoplasty. It is important to recognise the lazy eye pre-positioning.