Cosmetic Eye Surgery

The Blepharoplasty Procedure

Most blepharoplasty procedures are completed under local anesthesia, with or without mild sedation. All four eyelids may be operated on or just the upper or lower ones. The procedure is relatively painless, although you may have occasional mild discomfort during the procedure. The entire procedure may take from one to three hours, depending largely on whether all four lids are being operated on, or just the upper or lower ones.

Incisions are made which are well hidden in the natural folds of the eyes to free and remove excess skin and orbicular muscle. In some cases excess fat can be removed through an incision placed inside the lower eyelid. A few small surgical pieces of tape will cover the incisions and are removed the following day or shortly thereafter. Because eyelid skin is thin you may have discolouration and some swelling but this will be a temporary discomfort. Although you should be able to resume wearing make-up and contact lenses within a few days after surgery it is advisable to be cautious. Within a few weeks the thin surgical scars will become less visible and gradually blend into your eyes natural line resulting in vibrant, open and refreshed eyes.

Individuals with certain medical conditions may have increased risk with blepharoplasty. These conditions include hypothyroidism, Grave's disease, dry eye syndrome, high blood pressure and diabetes. Be sure to discuss any medical problems with your oculoplastic surgeon before proceeding with surgery. You should also inform your oculoplastic surgeon if you have any known eye conditions such as glaucoma or a history of retinal detachment.

Blepharoplasty has become increasingly popular with both men and women as it is quick, pain is minimal and it does not interfere with one's social engagements nor require lengthily time off work.

Frequently asked questions regarding Blepharoplasty

Q: Why should I choose an ophthalmic plastic surgeon rather than a general plastic surgeon when it comes to cosmetic eye lid surgery?
A: Ophthalmic plastic & reconstructive surgeons are trained ophthalmologists who super specialise in oculoplastic surgery. Cosmetic eye surgery represents a significant portion of their training, which makes them more qualified in this field, than a general plastic surgeon who has not been trained in ophthalmology.

Q: How soon can one go back to work after undergoing oculoplastic surgery?
A: Generally speaking swelling and discolouration should have disappeared within a week or two. This is however dependant on the patients general health, age and capacity to heal.

Q: Is oculoplastic surgery a permanent solution?
A:Yes bearing in mind that as one ages naturally the skin loses elasticity.

BOTOX Injections

Botox is a toxin that has been used extensively for a variety of conditions, including facial wrinkles, eyelid spasm, hemifacial spasm, entropion (inward turning of the lower eyelid) and even certain types of strabismus (crooked eyes). It is especially useful for emotional wrinkles adjacent to the eyes and in the forehead known as Dynamic wrinkles.

Tiny doses of Botox are administered with a very fine needle in the areas of concern, often alleviating the wrinkles for about 3 to 6 months. This alternative is a welcome one to many individuals who have concerns about more invasive cosmetic surgical procedures.

Botox is used to rejuvenate Dynamic wrinkles and cannot improve face wrinkles cause by sun damage and age.

What is Botulinum Toxin (Botox)?

Botulinum toxin (Botox) is a complex protein produced by the anaerobic bacterium Clostridium botulinum. It produces a total of seven different toxins all of which have the same end result, the paralysis of muscle. One of the toxins, Botulinum Neurotoxin Type A, is now available for medical use under the trade name Botox. Advantage can be taken of the effects of Botox to alleviate muscle spasm or to weaken a muscle for therapeutic purposes. In therapeutic applications, minute quantities of botulinum neurotoxin type A are injected directly into selected muscles. Ocular conditions that respond include squints and spasm of the eyelid (blepharospasm).

Botox therapy is invasive. Its use should be reserved for patients in whom an ophthalmic diagnosis has been established with reasonable certainty. At our surgery, Botox therapy is conducted by a skilled interdisciplinary team and sophisticated instrumentation and electromyography are available to ensure valid diagnosis, state-of-the-art treatment, and appropriate follow-up. Our ophthalmologists who administer this drug are highly trained in its use and qualified to manage any complications. Botox treatment of ophthalmic conditions requires proper identification of the affected eye muscles

What are the Indications for the Use of Botox Treatment?

Is Botox Safe?

Since 1990, success rates of over 90% have been reported in medical literature. Wide attention has been given to Botox and more and more applications have been found for it, often with equally impressive success rates. Botox is now the treatment choice for muscular spasms affecting the face, and repeated studies have demonstrated that it is a very safe and effective treatment.

How is Botox Used?

Injections into the target muscle are carried out by a very fine needle. The sites of the injection will vary slightly from patient to patient, and according to the ophthalmologist's preference.

How Long Does it Take to Work?

Benefits begin in 1-14 days after the treatment and last on average three to four months, after which it can be repeated. All effects of the toxin ultimately reverse with time.

What are its Side Effects and Complications?

Minor in the vast majority of applications. Side effects are generally transitory, well tolerated, and amenable to treatment. They are related to the dose of Botox administered. Persistent complications are distinctly rare, and serious side effects are uncommon. Some of the reported side effects include:

Flu like symptoms. These are mild and transient.
Systemic complications are uncommon
Tenderness or bruising at the site of injection, and headaches again mild and transient.
Muscle weakness. This is to be expected in the muscles injected but in practice this is rarely a problem.
Weakness in other areas is rarely troublesome and is associated with large doses.
Allergy is a theoretical risk but is virtually unknown.
Antibodies can be produced and if this happens the toxin becomes ineffective, but there are no other effects. The antibodies often disappear with time and treatment may be successfully recommenced after an interval.
Other very low incidence of complications of botulinum toxin injections includes droopy eye (ptosis), dry eye and photosensitivity. One of the more common adverse effects, ptosis, is due to diffusion of toxin from the upper eyelid injection sites to the levator muscle.

Although the side effects of the toxin are generally uncommon and not serious there are nonetheless contraindications to treatment with botulinum toxin. Please telephone the Ophthalmic Surgery Centre for further details.

Pregnancy and lactation.
Infection in the vicinity of the injection site.
Current therapy with a certain class of uncommonly used antibiotics, known as the amino glycosides.
Blood clotting disorders or current therapy with drugs inhibiting blood clotting, e.g. Warfarin.
Diseases affecting the muscles, particularly myaesthenia gravis.
Allergy to tetanus toxoid is a potential, but not absolute contraindication.

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