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Eyelid Reconstruction

Eyelid reconstruction refers to procedures performed to restore the form and function of the eyelids. This may be necessary for various reasons, including congenital (from birth) conditions, trauma, cancer, or other medical issues affecting the eyelids.

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Everything you need to know

Eyelid reconstruction refers to procedures performed to restore the form and function of the eyelids. This may be necessary for various reasons, including congenital (from birth) conditions, trauma, cancer, or other medical issues affecting the eyelids.

Common reasons for eyelid reconstruction include:

  • Congenital abnormalities: Some individuals may be born with eyelid malformations that require surgical correction to improve both appearance and function.
  • Trauma: Injuries to the eyelids, such as cuts, burns, or blunt force trauma, can result in deformities or loss of tissue that may necessitate reconstructive surgery.
  • Cancer removal: In cases where eyelid cancers are surgically removed, reconstruction may be required to restore the eyelid’s structure and protect the eye.
  • Eyelid malposition: Conditions such as ectropion (outward turning of the eyelid) or entropion (inward turning of the eyelid) may be corrected through reconstructive procedures to improve eye comfort and function.

The specific techniques used in eyelid reconstruction vary based on the individual’s condition and the extent of the problem. Surgeons may use various approaches, including tissue grafts, flaps, or other advanced reconstructive methods. The goal is to achieve both a functional and aesthetically pleasing result whilst maintaining the health and integrity of the eye.

Before

Consultation

Firstly, you will need to book a consultation with one of our oculoplastic surgeons.

During the appointment, they will take a detailed medical history, including information about medications, allergies, past surgeries, and lifestyle habits (such as smoking). The surgeon will also conduct a comprehensive examination of your eyes and eyelids to assess various factors, such as the condition of your eyes, eyelids, skin, eyelid laxity, and the presence of conditions like blepharitis or dry eyes, which could impact the surgery.

Based on the evaluation, the surgeon will develop a personalised treatment plan tailored to your needs.

If surgery is recommended, your surgeon will discuss expected outcomes, potential risks and benefits, as well as the necessary pre- and post-operative care. Photographs will be taken for comparison post-surgery, and it’s beneficial to bring any previous facial photos for surgical planning.

Pre-Assessment

If you decide to have surgery, you will have a pre-assessment, which is a standard check to make sure you are safe to go ahead with surgery. It’s also a good opportunity to ask questions about the procedure and what to expect on surgery day.

If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

Surgery day

Eyelid reconstruction is a day-patient procedure meaning most people can be treated and go home the same day. It is usually performed with local anaesthetic, meaning you will be awake but will not feel any pain. However, you may have sedation to help you relax or have general anaesthetic where you will be asleep.

If you will be having sedation or general anaesthetic, you should stop eating six hours before surgery. Two hours before, you should stop drinking (including water), chewing gum and sucking boiled sweets. Brush your teeth with toothpaste only on the morning of surgery. If you are just having local anaesthetic, you will not need to fast.

On the morning of surgery, do not wear any facial make-up or contact lenses, wear loose, comfortable clothes and bring a small bag with things you might need during your stay. Items to remember include a toothbrush and toothpaste, your phone and a charger, and any prescription medications. Your doctor will let you know if you can take any medications with a sip of water before surgery or if you should wait until after. As your eyes will be sensitive to light after the procedure, it’s a good idea to bring a pair of dark sunglasses with you as well.

Once you have arrived and are settled in your room, a nurse will monitor your vital signs (such as body temperature and blood pressure) and run through your medical history, medications and emergency contacts.

Your doctor will then once again run you through the procedure and ask you to sign a consent form for surgery.

During

Local anaesthetic is administered through a needle and will numb the area around your eyes.

The surgery will start when the anaesthetic has taken effect. The surgeon makes precise incisions based on the planned reconstruction technique. In some cases, adjacent tissues may be mobilised to cover defects or gaps in the eyelid. This can involve the use of adjacent skin or cartilage.

Keep in mind that the method the surgeon uses will depend on your specific issue. Tissue grafts or flaps may be used to replace or augment the eyelid tissue. These grafts may be taken from various areas of the body or made from synthetic material. Grafts are carefully positioned and sutured into place to reconstruct the eyelid’s structure.

The surgeon uses fine sutures to close the incisions and secure the reconstructed tissue in its new position. Sutures will be placed with precision and hidden as much as possible to achieve a natural contour and ensure proper function.

Overall, eyelid reconstruction should take between 45 minutes to 2.5 hours depending on the complexity of your case.

After

Once we’re happy you’re doing well, we will take you to your private room where you can start your recovery.

You should be able to go home within a few hours – however, you will need to have a friend or relative collect you as you will not be able to drive after surgery. If you had general anaesthetic or sedation, if possible, ask someone to stay with you overnight you will feel very tired for around 24 hours. During this time you should not drink alcohol, cook or make important decisions.

As with any surgery, there will be some after-effects. These include:

  • The need for pain relief
  • Some postoperative swelling
  • Dry eyes
  • Sensitivity to sun
  • Blurred vision

Most of these symptoms should go away in a few days.

Most patients experience bruising and swelling for the first ten days after surgery. To help reduce this, we advise you to use ice packs in the days following eyelid surgery. Frozen peas placed in a small plastic bag and covered in a thin cloth is an effective icepack. This can then be gently placed on your eyes up to 6 times a day. Do not rub or place any pressure on your wounds. Although it won’t take away the bruising, ice packs do help to reduce swelling. You should also gently clean your eyelids using the prescribed creams or eye drops.

During the initial 7 days post-surgery, it’s recommended to sleep in a semi-upright position with multiple pillows supporting your head. This will facilitate the reduction of swelling.

As your wounds heal, you may experience some itching. It is crucial to resist the temptation to rub your eyes or eyelids after eyelid reconstruction.

After two weeks, you should also be able to wear contact lenses again. However, run this by your doctor in your post-surgery check-up. During this post-procedure appointment, the team will check for any skin resurfacing, any improvement in your visual field and how the incisions are healing. They will prescribe you further medicine if you’re still suffering from dry eyes.

Recovery time can vary, but patients are typically advised to avoid strenuous activities and protect the eyes during the initial healing period.

The recovery journey is always personal, so make sure to follow your surgeon’s advice. Not only will this speed up the recovery process, it will ensure better outcomes and reduce any risks post-surgery, such as infection.

It’s important to note that eyelid reconstruction is a highly individualised procedure, and the surgical approach may differ based on your unique circumstances.

Patients considering eyelid reconstruction should consult with a qualified oculoplastic or ophthalmic plastic surgeon to discuss their specific case and treatment options.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.