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Excess lid skin (dermatochalasis)

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The skin tends to lose its elasticity with age. In the eyelids this results in excess skin which forms folds in the upper lids. This gives the eyes an old and tired looks and in severe cases, the vision may be affected as the loose skin blocks the visual fields. The medical term for this condition is dermatochalasis.


A 50 year-old woman with tired looks and puffy eyelids underwent upper and lower eyelid surgery. The left picture shows the patient at presentation and the right picture shows the post-operative appearance at 2 weeks.


A 78 year-old man with severe excess upper eyelid skin interfering with his vision. The left picture was taken before the operation and the right picture taken 4 weeks after the removal of the excess skin. Post-operatively, the patient could see better and appears younger.


What can be done?

Eyelid surgery (blepharoplasty) is the only effective method of removing the excess skin and make the eyes appear youthful. Depending on your problem, it may be necessary to remove excess skin, protruding fat or a combination of both.


What does the surgery involve?

The upper eyelid surgery can be carried out under local anaesthesia, intravenous sedation or general anaesthesia. The incisions follow the natural lines of your eyelids - in the skin creases of the upper eyelids . Through these incisions excess skin and protruding fat is removed.

Following surgery the incisions are put back together with fine stitches that are removed after about one week.

If you like to view the actual procedure, click the picture below. (Warning: Actual Surgery Shown)



What can I expect immediately after surgery?

There is a variable amount of swelling and bruising in the skin around the eyelids. All these changes are most noticeable in the first 24 hours after surgery. They will have greatly reduced by the end of the second week. Swelling and bruising can be improved by using cold compresses and sleeping propped upright for the first few days after surgery.


Do I need to take any time off work?

Depending on the nature of your work, it may be necessary to take about a fortnight off work and avoid strenuous exercise, including lifting, for this time. It is important to remember that you will not be able to drive or operate machinery for 48 hours after a general anaesthetic and 24 hours after intravenous sedation.


What are the potential problems?

·         Infection is uncommon and can be minimized by the use of antibiotic eye drops or ointments.

·         Bleeding can occur but is usually slight and can be stopped by applying pressure over the area for at least 10 minutes with a rolled up handkerchief or swab.

·         Closure of the eyelids may occasionally appear tight after surgery because of the swelling.

·         Any incisions made on the face will produce a scar but these should fade with time. After a couple of months they are usually almost invisible.

·         The eyelids may feel itchy and numb for several weeks after surgery.

·         Rarely the outside corner of the lower eyelid may pull down slightly (an ectropion). This tends to settle on its own but may need further surgery.

·         Changes in vision are very rare.



The before and after photos of patients who have had upper eyelid blepharoplasty by Prof Dr Chua



A 52 year-old woman complained of problem appying makeout to her face because her double eyelids have disappeared underneath the excess skin. Following the procedure (left), the double eyelids became more distinctive. The right  picture was taken two weeks after the operation.


A 55 year-old man was unhappy with her haggard looking appearance. Following the procedure, his eyes appeared less menacing.


A 55 year-old woman complained the lateral hoodings of the excess skin in both eyes made her look tired and old. Removal of the excess skin revealed the underlying double eyelids and make her appeared younger.


A 72 year-old man said her visual fields were blocked by the skin hanging down from her upper eyelids. One week post-surgery, she found her visual fields expanded.


A 52 year-old wanted to appeared more youthful. Bilateral upper eyelid blepharoplasty was performed together with the creation of skin creases (double eyelids). The picture on the right was taken one week after the surgery and still showed some eyelid puffiness.


A 55 year-old woman underwent bilateral upper eyelid blepharoplasty to make her looked less tired and more energetic. The right picture was taken at 6 weeks post-operation.


A 53 year-old woman wanted to be applied make-up to her upper eyelids. Her skin creases (double eyelids) were hidden by the excess skin. The right picture was taken 3 weeks post-operation..


This 57 year-old woman wanted to appear younger and alert. The right picture was taken 4 weeks post-operation.


This 40 year-old woman underwent blepharoplasty to make herself appear younger and also to accentuate her double eyelids. The picture on the right was taken 2 month post-operative.


This 61 year-old woman complained the droopy skin in her upper eyelids obstruct her vision and make her appear old. The right picture was taken 9 days post removal of the excess upper eyelid skin and creation of skin creases.


This 43 year-old woman complained that the excess upper eyelid skin obscure her double eyelid and made it difficult to apply eye make-up. Following surgery, the eyes appears wider. The right picture was taken 6 weeks post-surgery.


This 53 year-old woman complained that her eyes are getting smaller due to the excess skin and also puffy lower eyelid caused by eyebags. The right picture was taken 5 weeks after upper and lower eyelid surgery.


This 65 year-old man complained that the overhanging upper eyelid skin was blocking his visioin. Upper eyelid surgery was performed to remove the excess skin and to create a low skin crease (double eyelid) appropriate for man. The right picture was taken 3 months post-operation.


This 62 year-old woman had bilateral severe excess upper eyelid skin and at the same time drooping of the eyebrows. She underwent bilateral upper eyelid skin excision and lifting of the lateral eyebrows.


This 70 year-old woman had bilateral puffy upper eyelid and droopy eyebrows. She underwent upper eyelid surgery to remove the excess skin and fat and also lift of the eyebrows. The right picture was taken 4 months after the operation.



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