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This patient is a 33-year-old female who recently underwent a circular blepharoplasty to address congenital droopy eyelids. She has had dissatisfaction with her appearance since her teenage years and sought the procedure to correct the issue. Despite initial parental discouragement and financial constraints, the patient was able to undergo the procedure during the pandemic when she was transferred to remote work.
What is blepharoplasty
Blepharoplasty is a cosmetic surgery used to remove sagging eyelids and bags under the eyes. If the surgery is performed only on the upper eyelid, it is called upper blepharoplasty, on the lower eyelid – lower blepharoplasty, and on both – circular.
The operation is performed for aesthetic reasons or to improve vision: sagging eyelid skin often interferes with seeing objects to the sides. On the upper eyelid, the surgeon makes an incision along the natural fold, and on the lower eyelid – slightly below the lash line. Excess skin, muscles, and excess fat are removed or redistributed through the incision. Sometimes the incision is made on the inside of the lower eyelid, but this method does not allow for the removal of excess muscle tissue and skin. After correction, the wound edges are sutured or closed with a skin adhesive.
Blepharoplasty can be performed under local anesthesia, sedation, or general anesthesia. With sedation, the patient is put into a state of “twilight” or deep sleep while continuing to breathe independently. With general anesthesia, the patient’s consciousness is completely suppressed, and all muscles, including respiratory muscles, are relaxed, so the patient is placed on artificial lung ventilation.
Correction of the upper eyelids takes about an hour, while the correction of the lower eyelids takes up to two hours.
Visible signs of the surgery, such as bruising, swelling, and redness, may persist around the eyes for several days. Patients may experience pain, numbness around the eyelids, tearing, and light sensitivity. Some symptoms, such as light sensitivity, may only completely disappear after several weeks. To make the recovery period easier, doctors recommend taking a short break.
Complications after blepharoplasty rarely occur. Possible complications include eye muscle injuries, vision disorders, eyelid eversion or excessively low position of the lower eyelid. Sometimes, the eyes may appear asymmetrical after correction. The surgeon should explain how high the risks of such problems are and how to act if they have to deal with them.
In some patients, the results of blepharoplasty last a lifetime, while in others, the eyelids may sag again with age. This is more common with the upper eyelids, but not until 5-7 years later. If there are indications, the surgery can be repeated.
The patient’s experience of getting ready for the surgery.
The patient was given the option to undergo their operation under local anesthesia or sedation, with the latter being a state of light sleep. They opted for sedation due to concerns about lying still for the three hours that the surgeon’s work was expected to take.
Prior to the surgery, the patient underwent tests and an ECG at the same clinic for two weeks. They then consulted with a therapist who determined that there were no contraindications to the surgery. The costs for these pre-operative procedures were included in the operation’s overall expense.
The surgery was scheduled for a Friday at noon, which was deliberately chosen by the patient to minimize interference with their work schedule. They were instructed to have a glass of water in the morning, but not to eat anything. Despite having had a light dinner the previous night, the patient sat hungry at the clinic from 10:00 AM until the operation was postponed six hours later.
The patient waited alone in a two-bed room for the surgeon, during which time they were given a disposable gown and slippers to change into. The nurse asked how they were feeling and whether they had any allergies before taking their temperature, blood pressure, and inserting a catheter into their vein to administer sedative medication during the operation. The surgeon arrived at 4 PM, marked the places for the future incisions on their eyelids, and took “before” photos.
Despite having read negative reviews and seen pictures of other patients with bruises and swelling on the internet the day before, the patient was worried and very scared. However, the surgeon was able to calm them down, and the patient went to the operating room with joyful anticipation that the procedure would soon be over. They cautioned against reading negative reviews beforehand, as every person’s body reacts differently to procedures and thus recovery is unique for each individual.
The patient’s experience of undergoing the surgery.
After connecting a sedative drip to the catheter and informing me that the surgery had commenced, I believe I dozed off as I have no recollection of responding. The surgery was generally successful, except for an instance when I thought the sedation had worn off and experienced pain, causing me to panic. However, I am uncertain if I truly felt the discomfort or if I simply became anxious about waking up too early. The medical team swiftly sedated me again, and I did not awaken until the end of the procedure.
There was also an unfortunate incident where the laser used in the surgery burned my eyelashes on one eye. Nonetheless, they eventually regrew anew.
The patient’s experience of the recovery period
An hour following the surgery, the clinic discharged me with an extensive list of medications, including painkillers, antihistamines, antibiotics, and vitamins. In addition, I was advised to apply ice to my eyes four times daily for thirty minutes each time until the stitches were removed.
The surgeon cautioned me that the recovery period for eyelid surgery is shorter than that of body surgery due to the thin skin in the area. However, it is essential to handle the stitches with care since improper healing may result in noticeable scarring, necessitating a repeat surgery.
To avoid disrupting the stitches, I had to follow specific rules, such as sleeping on my back without a pillow. This proved to be the most challenging aspect of my recovery. Nonetheless, I fondly recall the day when I was finally able to sleep on my side without discomfort.
The first day after the surgery, my eyes were swollen, and light quickly exhausted them, causing me to mostly lie down and listen to audiobooks. However, by the following Monday, I was capable of working on my computer. The bandages applied around my eyes were uncomfortable, causing the skin underneath to itch and my eyes to feel tight. After five days, I could no longer endure the discomfort and removed a few of the bandages myself, resulting in redness and irritation.
After a week, the stitches were removed without significant discomfort, and my eyes remained inflamed for a couple of days. However, ten days later, there were no signs of the surgery. One would have to examine closely to detect that I had undergone plastic surgery.
What was the outcome of the operation?
The doctor advised that the final assessment of the changes could only be determined three months post-surgery. However, after only two weeks, I am already pleased with the results. In my opinion, the surgeon has exceptional skills; they managed to maintain the integrity of the eye incision while giving my gaze a more alert, refreshed, and relaxed appearance. The intervention is only noticeable by faint red lines in the upper eyelid crease and along the lower lash line.
Although my loved ones did not notice any significant changes, I did not undergo the surgery for their benefit. Rather, my intention was to improve my own self-image and eliminate the discomfort and puffiness above my eyes.
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