Understanding the Benefits and Risks of Eyelid Surgery in Singapore
What is eyelid surgery?
Eyelid surgery is an out-patient surgical procedure performed to improve the appearance of the eyelid and in some cases, it is for functionality reasons to improve one’s vision function.
Why have eyelid surgery?
1. Blepharoplasty
Blepharoplasty, a type of eyelid surgery, is performed to reform the upper or lower eyelid to improve and return the aesthetic youthful appearance of the eyes.
2. Ptosis
Another common eyelid condition is ptosis, which is the drooping of the eyelid usually due to ageing. As one ages, the skin around the eye will lose its elasticity and the levator muscle that is responsible for lifting the eyelid can stretch, resulting in a droopy eyelid.
Ptosis can also happen at birth, which is known as congenital ptosis, where the levator muscle is not developed properly. The exact cause is sometimes unknown but at times, it can be due to trauma or neurological reasons. For children with ptosis whereby the vision is blocked, it is important to intervene medically or surgically to prevent the onset of lazy eye (amblyopia).
In some cases, ptosis can be caused by medical conditions such as stroke, brain tumour, cancer or neurological disorders affecting the nerves or muscles of the eye.
Depending on the severity of the condition, a droopy upper eyelid can block or greatly reduce vision depending on how much it obstructs the pupil. Those with severe ptosis may face issues with daily activities or even mobility issues that lead to injuries or falls. They also tend to lift their eyebrow and eyelid for prolonged periods of time leading to tiredness, ache and discomfort to the eye. At times, they may even need to tilt their head back or tape their eyelid up.
Ptosis can be corrected with ptosis surgery whereby the oculoplastic surgeon strengthens the eyelid muscle by shortening it. This helps lift the droopy lid, improving vision as well as the eye’s appearance.
3) Epiblepharon
Epiblepharon refers to the inward turning of the eyelashes due to abnormal horizontal folding of the skin near the upper or lower eyelid. This results in the eyelashes pointing directly towards the cornea (surface of the eye) and causes corneal abrasion as the lashes are constantly rubbing and scratching against the cornea. Those with epiblepharon can experience tearing, redness, discomfort or pain in the eye.
Some children with mild epiblepharon can outgrow this condition as the eye and facial structures change. Mild cases may be treated with lubricating eyedrops or ointment to keep the surface well-lubricated and to reduce the rubbing effect of the lashes.
In severe cases, epiblepharon correction surgery may be required. It usually involves removing a small area of excess skin just below the lid margin to help the lashes rotate outwards.
4) Ectropion
Ectropion occurs when the lower eyelid droops down and turns outward. This can be caused by age, skin disease, a tumour, trauma or an injury to the eyelid. Ectropion can make the eye dry, watery and sensitive to light and wind.
Entropion occurs when the lower eyelid turns towards the eye. Common causes can be due to age, infection or scarring inside the eyelid. When the eyelid turns inward, the eyelashes and skin may rub against the eye. This can cause discomfort, tearing and redness of the eye. If it is not treated, it can cause a corneal infection.
Ectropion surgery and entropion surgery return the eyelid to its normal position. This helps reduce painful and irritating symptoms and protects the eye.
Preparation for eyelid surgery
Blepharoplasty is usually an outpatient procedure with no need for overnight hospitalisation. This surgery may be performed under local anaesthesia or general anaesthesia.
During the pre-operative assessment, the oculoplastic surgeon will decide how much skin, muscle, and/or fat to remove. Markings will be made to indicate the surgical incisions and where the tissue removal will be. Typically, the oculoplastic surgeon will make an incision hidden within the natural fold of the upper eyelid. For the lower eyelid, the incision will be placed either just below the lower lashes (subconjunctival incision) or hidden inside the lower eyelid (transconjunctival incision).
Through the marked incisions, excess skin, muscle and possibly fat will be removed. Tissues may be redistributed internally to reduce bulges and puffiness. The incisions will be closed with sutures or glue.
Benefits of eyelid surgery
Eyelid surgery can present several benefits ranging from cosmetic to functionality. Ptosis correction surgery can improve visual function while ectropion and entropion surgery return the eyelid to its normal position to alleviate discomfort and tearing from corneal abrasions. Lastly, during blepharoplasty, the oculoplastic surgeon may remove extra fatty tissue near the eyelid or tighten muscles and tissue which can make the eye look less tired and more alert.
Possible risks and considerations
After eyelid surgery, one may temporarily experience pain or discomfort, swelling or bruising, numbness of the eyelid, difficulty in closing the eye and dry eye. Some may also experience blurry vision when using eyedrops or ointment, light sensitivity and double vision post-surgery. These symptoms usually improve over time.
Cold compresses are usually recommended to reduce any swelling and bruising. The oculoplastic surgeon may recommend you sleep with the head slightly raised higher than the chest for a few days.
Potential risks include those related to anaesthesia, infection, bleeding, numbness, noticeable scarring, eyelid asymmetry, temporary blurring of vision, or rarely loss of vision. In those cases, one may require a revision surgery to correct some of these problems.
Contact us
If you are experiencing any of the above eyelid issues and would like to seek professional help, please contact Eye Max Centre at +65 6694 1000 or manager@eyemax.sg.
