Surgical Indications

Indications – upper eyelids

Excessive upper eyelid skin (bleparochalasis) is common in both males and females, particularly at the outer eyelid margin, it causes upper eyelid hooding and is the most common concern leading to upper eyelid reduction surgery.  In some cases the hooding can be severe enough to limit the field of vision!   The excess skin can make changing contact lenses very difficult, and female patients often experience difficulty applying eyelid makeup as well.   Frequently there is also a slight fatty bulge at the inner corner of the upper eyelid which requires reduction as part of the surgery.

Upper eyelid skin excess is exacerbated by descent of the forehead tissues, generalised thinning of the skin and subcutaneous tissues, and by progressive hollowing of the temple region.  Each of these issues needs to be addressed for an optimal result, particularly eyebrow height relative to the orbital rim.

Indications – lower eyelids

Unlike the upper lids where excess skin is usually the primary complaint, in the lower lids the most common indication for blepharoplasty is bulging below the eyeball causing the patient to have the appearance of heavy bags and dark shaddows under the eyes.  Not infrequently, there is also a degree of excess of skin which can be removed during the surgery.

Contra-indications

Patients with a history of dry eye syndrome are usually not good candidates for blepharoplasty.  Patients who have had LASIK or other similar eye surgery should wait 3 months before having a blepharoplasty.