What is Blepharoplasty?

A blepharoplasty is a surgical procedure to remove excess skin and soft tissue around the eyes. When affecting the upper eyelid, excess skin can cause a feeling of heaviness and impact on a patient’s vision. The lower eyelid can be puffy and be cosmetically displeasing. Blepharoplasty surgery can also be done to enhance the appearance of youthfulness.

Why should I consider having an Oculoplastic surgeon do my blepharoplasty?

An Oculoplastic surgeon is qualified eye specialist (Ophthalmologist), who has additional training specifically in surgery of the eyelid. Our skills are honed on more complex eyelid operations, best demonstrated by eyelid reconstruction after tumour removal. When we apply these skills to blepharoplasty we respect both the aesthetics of the eyelid but also the function of the lid in protecting the eye and maintaining vision.

Other doctors offering blepharoplasty surgery may not have the same understanding of the eyelids complex role in maintaining the health of the eye. Anyone with a history of uncomfortable or dry eyes should be seen by an eye care professional prior to considering blepharoplasty. It is ideal if that same eye professional can assess your appropriateness for and also perform your eyelid surgery.

Will Medicare or my health insurance pay for my blepharoplasty?

Medicare with contribute to the cost of upper eyelid reduction (blepharoplasty) if it meets the criteria set by them. If you meet the Medicare criteria, and are also privately insured, then your health insurance will likely contribute too.

If you do not meet the Medicare criteria, then the full cost of surgery will be your responsibility. This is considered a “cosmetic procedure”.

Will it hurt? Will I be asleep for the procedure?

This procedure is usually performed under local anaesthetic, so the patient is awake but may be sedated. Sedation often results in amnesia for the period of the operation. Recovery from local anaesthetic is almost instantaneous. There is little, if any additional strain on the heart and lungs, so age is no barrier to having this procedure. Surgically, the benefit of being awake means that the right amount of excess skin is removed.

There are a few tricks to minimising the discomfort associated with injecting local anaesthetic around the eyes. Oculoplastic surgeons do this day in, and day out, so become quite good at this aspect of the procedure which is often the greatest source of anxiety for our patients.

Some surgeons use scalpels, others use laser? Does it matter?

Dr Smith uses the CO2 laser for his blepharoplasties. It is in the first two weeks that the difference between laser versus scalpel is most apparent with significantly less bruising and swelling. This means a quicker recovery and return to normal and being able to get on with life. It is the favoured surgical technique of the majority of blepharoplasty surgeons for these reasons.

Will there be a scar? Will there be bruising?

There will be a scar that is virtually imperceptible. This surgery is performed so that the scar is located in the natural crease of the upper eyelid.

Lower eyelid blepharoplasty is often performed from the posterior surface of the lower eyelid, without external scarring. At times an anterior incision is required, which is performed just under the eye lash line, and heals very discretely.

The amount of bruising depends on whether the patient is on blood thinning medications, the method of incision making and how careful the surgeon is with haemostasis (controlling bleeding). The other important factor, is how diligent the patient is with cool compresses in the post operative period. The vast majority of bruising and swelling will have resolved by a week after your surgery.

How long before I can return to work?

It entirely depends on what sort of work and how self-conscious you are. Manual labour type jobs and work in unclean environments should be limited by one week to ten days. Client based work may need up to two weeks. Computer-based work could return to work within a couple of days.

Will I be able to see? How long before I can drive?

After surgery, both eyes will be uncovered and you will be able to see immediately. Driving really depends on whether you have been sedated. Most patients will easily drive the next day.

Can I see a portfolio of previous blepharoplasties?

All patients have a photographs taken as part of their assessment and follow up. Some patients may volunteer to have their photos available to others because they are thrilled with their result. However, past surgical results on others cannot guarantee the same result on yourself. Dr Smith will explain what outcome he can realistically achieve for you and does his utmost to meet this expectation.

See Blepharoplasty Gallery page for recent Before and After Pictures.

What are the complications?

Blepharoplasty is an uncomplicated procedure in the vast majority of cases. When complications arise you need to be confident that your surgeon has the experience and expertise to deal with them in a timely manner. All patients have a small risk of wound infection or poor healing or exuberant scarring. Patients may have asymmetry in the way the skin sits which is easily corrected as long as too much skin hasn’t been removed. If too much skin has been removed, then difficulties closing the eye or dry eye and irritation are possible.

How much does it cost?

Blepharoplasty fees are difficult to compare. Costs include surgeon’s fees, anaesthetist fees and day surgery fees. Initial assessment fees, and post-op fees can be quite variable and whether the cost of any subsequent surgical enhancements are charged to the patient. If you meet eligible criteria, Medicare may provide a significant reimbursement; your private health will likely cover the day surgery fees. Some surgeons are able to offer in-rooms surgery that avoids the day surgery fees at a considerable cost saving for uninsured or cosmetic patients.

Dr Smith has a laser-accredited procedure room, with nursing support, as a safe but low-cost alternative for uninsured or cosmetic patients.

An initial consult with Dr Smith costs $225. If you have a valid referral from your GP, Optometrist or another Specialist, a Medicare-rebate of $72 will apply. Before committing to surgery, you will receive a written quote for all expenses.

Currently, bilateral upper lid blepharoplasty costs $2250 surgical fee plus $150 procedure room fee for uninsured patients.  If IV sedation is requested, then surgery is performed in the South Bank Day Hospital at additional expense.  Uninsured patients may receive a Medicare rebate of approximately $350.  Privately insured patients pay the same surgical fee (but no procedure room fee), receive a higher rebate from their Health Fund, and are performed at the South Bank Day Hospital with an anaesthetist.  Cosmetic surgery is $3650 including GST and are not eligible for any rebates.

Post-op follow-up consultations are included in the surgical fee. Any surgical enhancements and adjustments are included in the surgical fee.

How long do the results last? Will I need to have the procedure again?

Age and gravity, the two main culprits will continue to exert their influence over the remainder of your lifetime. Years or decades later, you may require further surgery.

Please note Dr Tai Smith is consulting at Chermside, Springwood, Caboolture and Bundaberg. He no longer consults at South Brisbane.