111 Harley - Exclusive Cosmetic Surgery - the Uk's most exclusive cosmetic surgery group

As you age, the skin around your eyes loses its elasticity. You may develop loose folds of skin on your upper eyelids and deep creases under your lower lids. Your muscles in this area may also slacken so that any fat bulges forward and looks baggy. Cosmetic eyelid surgery can remove the excess skin, fat, or both, from around your eyes.

Preparing for your operation

Your surgeon will examine your eyelids, vision, tear film (a layer of tears covering the surface of your eye), front of your eye and your retina. He will examine the condition of your skin, and measure the position of your eyebrows and eyelids.

Your surgeon will explain how to prepare for your operation. For example if you smoke you may be asked to quit, as smoking increases your risk of getting a chest or wound infection and slows your recovery.

Cosmetic eyelid surgery is usually done as a day case under general anaesthesia. This means you will be asleep during the operation. Alternatively you may prefer to have the surgery under local anaesthesia, in which case the area around your eyes is numb but you stay awake. A sedative may be given with a local anaesthetic to help you relax.

Your surgeon will advise which type of anaesthesia is most suitable for you.

At the hospital or clinic your nurse will explain how you will be cared for during your stay. Your nurse may do some tests such as checking your heart rate and blood pressure, and testing your urine.

Your surgeon will examine your eyes and take photographs, so that the results of surgery can be compared with your original appearance.

About the operation

The operation takes one to two hours, or less if just the upper or lower lids are being done. Your surgeon may use either conventional or laser techniques.

For surgery on the upper eyelids, cuts are made into the natural lines and creases in your eyelids, and in the wrinkles at the corners of your eyes.

For surgery on the lower eyelids, cuts are made just below your eyelashes. This means your scars will run along the natural folds of your eyes.

Excess fat, muscle and loose skin are then removed, and the cut is closed using fine stitches.

If only fat is removed and there is no excess skin, the cut may be made inside the lower eyelids, leaving no visible scar.

Your surgeon will apply ointment to your eye area to stop it from drying out and use sterile paper tape to support your eyelids.

What to expect afterwards

You will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. You will be able to go home when you feel ready.

You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

Your nurse will give you some advice about caring for your eyes before you go home. You may be given eye ointment to use at home and a date for a follow-up appointment.

Dissolvable stitches will disappear on their own in seven to ten days. Non-dissolvable stitches are usually removed three to five days after surgery.

Recovering from cosmetic eyelid surgery

If you need them, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.

The tape supporting your eyelids is usually removed after three to five days. Lower eyelid support may be worn for one week.

You will have some swelling around your eyes. Applying a cold compress, such as ice or a bag of frozen peas (both wrapped in a towel) can help to reduce the swelling and bruising. You should not put ice directly on your skin as it can give you an ice "burn".

There are some important things to remember while recovering from cosmetic eyelid surgery:

• Keep your head propped up on pillows when you are lying down. This helps to reduce swelling and bruising.
• Don't bend forwards for a few days.
• Clean around your eyes and use the ointment as advised by your surgeon.
• Don't wear eye make-up until your surgeon tells you it's safe to do so.
• Don't wear contact lenses for at least two weeks.
• Don't drive until your vision has returned to normal and your eyes have stopped watering.
• Most people are able to read or watch television within a few days and can return to work after seven to ten days.

What are the risks?

Cosmetic eyelid surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects:

• Soreness, swelling and bruising around your eyes - this can last up to a month.
• Sticky, dry and itchy eyes - this usually clears after a week.
• Watery eyes - this can last for a few weeks.
• Sensitivity to light - this will improve after a few weeks.
• Double or blurred vision - this usually improves after a few days.
• Scarring - this should fade over the course of a few months.
• Sometimes tiny whiteheads appear along the line where the stitches were. Your surgeon can remove these with a needle.