SURGICAL PROCEDURES (EYE SOCKET, EYELIDS, TEAR DUCTS)
PAO SUBSPECIALTY SOCIETY: PHILIPPINE SOCIETY OF OPHTHALMIC PLASTIC & RECONSTRUCTIVE SURGERY
1. How do I know if I need cosmetic eyelid surgery?
Cosmetic eyelid surgery is also known as blepharoplasty. You may need it if:
- 1. You have prominent fat pads or bulges in your eyelids (eyebags)
- 2. You have an excess of skin in your upper eyelids, draping down and covering your lid crease, reaching your lashes, or impeding your central or peripheral vision.
- 3. You have drooping upper lids (ptosis)
- 4. You have sagging lower lids
- 5. Your eye brows are drooping down (brow ptosis)
- 6. You have asymmetry in your eyelids or eyebrows.
2. What is usually done during cosmetic eyelid surgery?
In an upper lid blepharoplasty, excess skin, muscle and fat may be removed. The upper eyelid crease may be enhanced. In the lower lid, fat responsible for the bulging, and sometimes a small amount of excess skin is removed. It is important that only a conservative amount of skin is removed, to avoid outward turning of the lower eyelids (ectropion) and retraction of the upper eyelids which may result in the inability to close the eyelids. (lagophthalmos). In younger individuals, a lower lid blepharoplasty may be performed through a transconjunctival approach. This means that in the lower lid, the bulges of fat may be removed from the inner aspect of the eyelid, to avoid external incision of the eyelids.
3. Will there be a scar? What about stitches?
Anytime an incision is made on the eyelid skin, a scar may result. However, fine incision lines can usually be hidden in the lid crease for the upper lid, and under the lashes in the lower lid. Keloid or hypertrophic scarring is quite uncommon in the eyelid and periorbital area, and can be modified with medications if necessary from 3-8 weeks after surgery. Scarring can also be avoided by good surgical technique and placement of fine sutures. Placement of sutures (stitches) depends on the preference of each individual surgeon. Absorbable sutures may be used inside the wounds to keep them from opening. These do not need to be removed, and absorb in time. Skin sutures may also be used, and they are generally removed in the clinic anywhere from 3-7 days.
4. How long does the procedure last?
The procedure may last from 15 to 30 minutes per eyelid, or a total of 1-3 hours depending on the number of eyelids done. (including preparation)
5. Is it painful?
No. Local anesthetic is injected into the eyelids before the procedure. There may be some initial discomfort due to the injection of the anesthetic, but there is no pain during the procedure itself. An anesthesiologist may be called to monitor the vital signs of the patient and to sedate or keep her comfortable throughout the procedure.
6. Do I have to be admitted in a hospital?
No. This procedure can be done on an outpatient basis.
7. Who can perform cosmetic eyelid surgery?
Although many plastic and cosmetic surgeons can perform blepharoplasties, Eye Plastic Surgeons also known as Oculoplastic Surgeons specialize in this procedure. These are eyeMDs (ophthalmologists) who have undergone specialized training in eye plastic surgery. The formal name of their specialty is Ophthalmic Plastic and Reconstructive Surgery. They are members of a society called The Philippine Society of Ophthalmic Plastic and Reconstructive Surgery (PSOPRS) which is a specialty society of the Philippine Academy of Ophthalmology (PAO), the national society of eye doctors. You can consult your eye doctor who is a member of the PAO, and ask for a referral to any qualified eye plastic surgeon.
8. What are some of the other conditions that eye plastic surgeons can take care of?
Eye plastic surgeons have received special training in aesthetic as well as reconstructive surgery of the eyelids, orbit and lacrimal system. They can take care of any abnormality of the eyelids, such as turning in or turning out of the eyelids, drooping or retraction of the eyelids, excision of tumors or cancers of the eyelids and orbit, including reconstructive surgery for these conditions. They also take care of the tear duct system and surgery for the tear ducts. They also perform repair and reconstruction following eye trauma, including care of the eye socket and reconstructive surgery for fitting of artificial eyes.