Eyelid Surgery Wiltshire

A blepharoplasty is the medical term for an operation on either the upper and/or lower eyelids to reduce/redistribute the amount of bulging fat as well as excise any excess skin, thereby giving the eyes a fresher and more youthful look. The operation can be performed under local anaesthetic, but is usually performed under general anaesthetic. It takes 1-2 hours to perform and can either be done as a daycase procedure or requiring 1 day stay in hospital. The standard operation involves making incisions (cuts) which follow the natural skin creases in the eyelids. In the case of the upper lid this cut is positioned about 5 mm above the eyelashes, whereas in the lower eyelid the cut is made just below the eyelash line. The incisions are extended a little way into the crows feet area (smile lines at the outer corner of the eye). In the upper eyelid, the excess skin is excised along with a strip of underlying muscle, and any excess bulging fat located beneath the muscle is also excised. In the lower eyelid, the excess bulging fat is released from its containment under the muscle and is repositioned and allowed to redrape over the lower bony rim of the orbit. Any excess fat and skin can also be excised but this is done to a lesser degree than in the case of the upper lid. The wounds are then closed with stitches which are removed after 1 week and covered with steristrips. In cases where the lower eyelids contain bulging fat but with no skin excess, then the fat can be removed by an incision entirely within the inside of the eyelid. This is called a transconjunctival blepharoplasty. Here, there are no external scars and the wound is stitched with dissolving sutures.

A browlift is an operation to try and reverse the effects of ageing on the brow and so rejuvenate the forehead to make it look younger. The operation usually takes between 1-2 hours to perform and is done either as a daycase procedure or else requiring 1 day in hospital. In its simplest form, the direct open browlift involves cutting away an ellipse of skin and muscle just above the eyebrow and stitching the wound closed with dissolving stitches. This can be very effective at elevating the eyebrow, but leaves a visible (albeit short) scar and cannot address the forehead frown lines. An indirect open brow lift involves either a long incision at the junction of hairline with the forehead, or an incision well behind the hairline which passes from the top of one ear across the scalp to the top of the other ear. Through these incisions (cuts), the skin and muscles of the forehead are reflected down and the muscles causing the deep frown lines are reduced. A rim of skin is excised from the edge of the incision so that when the wound is stitched, the eyebrows are elevated. The scalp wounds are then closed with dissolving stitches and the wounds are then covered with a bandage. For smaller elevations of the brow, for example about 5mm, an endoscopic browlift technique can be performed. This involves making 3-4 short vertical incisions (cuts) behind the hairline and passing a telescope connected to a camera through the incisions to show the surgery on a video monitor. Instruments are inserted through the other incisions allowing the muscles which cause the frown lines between the eyebrows to be reduced. The eyebrow is elevated by tightening the deeper layers of the scalp with stitches, but no skin is excised, and so a smaller elevation in the brow is possible with this technique compared with longer scar techniques. The advantages of an endoscopic browlift are that scars are small and can often be well hidden. The bruising and swelling may be reduced.