Surgical eye rejuvenation (blepharoplasty)

This procedure removes excess skin, fat & in some cases muscle from the upper & or lower eyelids. In the context of cosmetic blepharoplasty, the aim is to rejuvenate the eye or periorbital area. Incisions are placed in the natural skin folds of the lid, hiding surgical scarring. 

Here is the concept- harmony & balance. Rejuvenation is about improving three aspects of aging. 

Skin tone: Eyelid laxity, upper/lower or both, can be tightened with surgery, lasers or other non-surgical options such as Tixel or HIFU.

Skin texture or quality. Skin on the lids or surrounding the upper & lower eyelids can be improved with lasers or deep chemical peels. Surgery does not correct skin quality. 

Volume; as the name suggests, replaces fat loss in the area. Surgery & lasers do not replace volume.

Combination treatments including surgery, lasers, fillers & in some cases fat transfer gives the best outcomes.  

Note: This is only an attenuated explanation, further things we consider is eyebrow position relative to lids as well as lateral eyelid positioning and more. 

Blepharoplasty (laser or surgical) is done under conscious sedation with blocks to the area. This ensures patient comfort during the procedure.  Surgery takes 45-90 minutes to complete.

Most cosmetic blepharoplasties are combined with lasers & surgery, as the primary aim is to refresh & rejuvenate tired eyelids (as opposed to medical conditions whereby vision is affected). 

Severe laxity of the upper eyelids is best treated with surgery. In most patients, lower eyelid skin laxity is not severe enough to warrant excision (transconjunctival approach), hence we use CO2 & erbium lasers to tighten. 

Lasers are also employed to resurface the ‘C’ shaped area around the eye joining your upper to lower eyelid- namely erasing the deep wrinkles in the crow’s feet area. This gives a better, more harmonious blend to the eyes & surrounding skin. 

If excess skin is impairing your vision, the treatment is surgical over lasers. 

If it’s purely cosmetic & vision is not affected, then you may be a surgical candidate, depending on your age, ethnicity & physical findings. 

We will be able to tell you whether you can hold off on the procedure or if it’s best to go ahead sooner. Our dermatologists employ a range of non-surgical methods to rejuvenate the eye area, see below. 

In cases of mild to moderate laxity, dermatologists employ lasers & devices to treat the eyelids & the surrounding skin. The best method depends on your skin type/colour & the clinical findings. Non-surgical options include- 

• Tixel resurfacing: for mild cases of laxity. Lower eyelids do better than upper eyelids
• RF heating/ Tempsure/ Pelleve. Mild to moderate laxity, thin skin. Lower lids & crow’s feet do best with radiofrequency rejuvenation.
• HIFU with off label Ultherapy or Ultraformer. Heavier lids than above. Off label to the upper lids. Best for ethnic skin types.
• CO2 or erbium fully ablative lasers: great for mild to moderate laxity of both upper & lower lids.
• Fractional Fraxel HD with CO2 modulation; best for laxity associated with sun damage & collagen breakdown.
• TCA & Jessner or phenol peel: best for moderate to severe laxity of lower> upper lid laxity in patients who do not want surgery.
• Hyper Dilute Ca OH wash; is a really good treatment for minimal downtime lower lid rejuvenation. This collagen stimulating filler takes 2-4 months to give optimal results.

SHOP iS Clinical Youth Eye Complex 15g

Just over a week. 

You will have bruising and swelling after your eyelid surgery. As a guide; 

• Surgical only: Recovery in one week. Sutures out on days 5-6. 
• Surgical & laser blepharoplasty: As above, but skin healing & redness for another few weeks. 
• Laser blepharoplasty: Swelling for 4-5 days, redness for 4-8 weeks.

The best results are seen at 1-2 months post-surgery, when swelling & redness subsides. 

Some patients may be eligible for a Medicare rebate; however, your upper eyelid laxity must objectively meet strict criteria, namely obstruction of vision. It only applies to surgical & not laser procedures. There is no rebate for lower eyelid surgery. We will give you a guide as to costs during the initial consultation.

There are several reasons why the eyelids can start to droop. These include; 

• True skin laxity due to collagen loss & breakdown with age
• Volume loss as part of the natural ageing process
• Muscle injury or damage of the eyelids 

If you have a heavy forehead and a sagging brow, a brow lift is the preferred option. In some cases, it is a combination of brown & eyelid lift that gives the best results. 

You will be guided on the day of the consultation.

As with any surgical procedure, some scarring is to be expected, however we place the incisions within the natural crease lines or create a new crease line. For laser cases there are no lines as we blend the treated skin with the surrounding skin texture. 

The best results from surgical & laser procedures are seen between 3 to 6 months

All procedures carry risks of adverse effects. Surgical or laser blepharoplasty risks include; 

• Asymmetry: mild & correctable
• Dry eyes: due to skin tightening. Usually settles in a few weeks
• Lower eyelid skin tightening: Most cases settle within 8 weeks
• Bleeding post-operatively: Very rare (retrobulbar haemorrhage) 

You can minimize your risks by following specific post-operative instructions including rest, ice, elevation, & smoking. Your dermatological surgeon will discuss all the potential risks and complications with you during your consultation so that you know what to expect. 

As a guide; 

Upper lid surgical blepharoplasty only: $3,990

Upper lid surgical & lower lid laser: $4990

* Most patients require both upper & lower in the context of cosmetic rejuvenation.

**Medicare rebate only applies to upper eyelids with evidence of visual obstruction.

***Quote inclusive of theatre costs.