Once the muscles and fat around the eyelids lose their volume and elasticity, the eyelids can become loose and no longer retain their normal position around the eye. Surgery can restore the eyelid back to the correct position and protect the eye being damaged.
Eyelid laxity surgery refers to the procedure that aims to correct and restore loose eyelids back to their correct positions, to keep the eyes protected from damage.
Eyelid laxity can occur as ectropion or entropion.
Ectropion is where the lower eyelid turns outwards and sags down. When left untreated, an ectropion commonly results in a watery eye, as the lower eyelid punctum (tear drainage hole in the inner part of the eyelid) is no longer sitting against the eye. This means that normal tear drainage from the eye is reduced.
The surgery corrects the underlying weaknesses that have caused the eyelid to rotate and drop away from the eye.
The inability of the eyelids to close properly, together with poor tear drainage means that the front surface of the eye is not adequately lubricated, leading to painful, sore eyes and repeated infections.
Entropion is where the upper or lower eyelid turns inwards against the surface of the eye. This can be a sight-threatening condition if not corrected.
Botulinum Toxin injections can be used to temporarily restore the normal eyelid position, but the injections need to be repeated at regular intervals.
Surgery for entropion stops the eyelashes scratching the surface of the eye and avoids pain, watering, redness, inflammation and infection.
Both entropion and ectropion surgery involve repositioning and tightening of the muscles and supporting tendons that maintain the eyelids in their normal position around the eye.
Initially, you will have a consultation with your surgeon, during which the surgery will be fully explained to you. There will also be a detailed discussion on expected surgical results, risks and benefits of surgery and the care that will be required before and after the surgery. A detailed medical history will also be taken and if you have any medication that you take, please bring this with you.
Please inform us about any allergies, previous surgery and smoking habits.
A full examination of your face and eyelids will be carried out to assess your eyes, eyelids, skin, eyelid laxity (how loose the eyelids are) and whether you have any conditions like blepharitis or dry eyes which can affect the surgery. It may be necessary to treat an underlying condition first, before carrying out any surgery, in order to give you the best surgical outcome.
You will have the opportunity to ask any questions that you may have and we will also discuss whether any non-surgical treatments, like Botulinum Toxin injections, will help to achieve your desired outcome.
Ectropion and entropion surgery can be carried under local anaesthesia, with or without sedation or under general anaesthesia. Your consultant will discuss the options with you to agree on the best option.
Whichever form of anaesthetic is used, the surgical area will be numbed so that you do not feel any pain. Sedation causes you to be in a calm and relaxed state, but you will still be able to respond to instructions.
You will be given clear instructions when to stop eating and drinking before your surgery. This is usually 6 hours prior to surgery with sedation or general anaesthesia, although clear fluids (water) can be taken up to 2 hours before surgery. We ask that you do not wear any makeup or face cream on the day of surgery.
Smokers will be asked to stop smoking at least 6 weeks prior to surgery and for 2 weeks following surgery, as smoking delays the healing process and causes a higher risk of complications. If you take any non-steroidal anti-inflammatory drugs like Aspirin or Voltarol, Warfarin or NOACS like Apixaban your consultant will advise on when to stop or reduce the dose of these drugs. Should you require medication to treat a heart or lung condition, your surgeon will check with your cardiologist or chest doctor which drugs can be safely stopped temporarily.
A dressing will be applied to cover the surgical area and this can usually be removed the following day after the procedure. It is common for your vision to be blurry after the surgery as a thick antibiotic ointment is applied into your eyes to prevent against infection and to stop the front surface of your eyes from drying out.
This blurred vision will gradually settle, but you will be given eye drops and ointment to use in your eyes and on your eyelids after the surgery. The majority of our patients will return home on the same day as their surgery, but if needed an overnight stay can be arranged. Our experienced nurses will give you clear instructions to help you manage your postoperative care.
Swelling and bruising is normal following eyelid surgery. This should start to settle after 2-3 weeks, but in some people, postoperative swelling and bruising can take longer to settle. We advise you to use ice packs for the first 10 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 the wound up to 6 times a day, without rubbing or placing any pressure on the wound. For the first 7 days after surgery, sleeping semi-upright with several pillows placed underneath your head will help the swelling to settle.
You will be given eye shields to cover your eyes at night to protect the wounds whilst you are sleeping. Anything more than gentle exercise (like walking) should be avoided for at least 2 weeks following surgery and swimming should be avoided for at least 6 weeks post-operatively. Makeup can be worn again 3-4 weeks after surgery. As the eyelid wounds heal, they may become “itchy” – it is important not to rub your eyes or eyelids following surgery. Contact lens wear should also be avoided for the first 2 weeks after surgery.
Recovery time varies but we advise you to rest for the first few days after surgery. You will be able to work from home on a computer after 2 days, but it is important to keep your eyes well lubricated with the eye drops that you have been given. Most people who have undergone surgery to correct eyelid laxity can return to work after 10 days.
If sutures have been used during surgery, these will be removed 10 days after surgery if the wounds are healing well. We will take photographs to show the results of your surgery at this first post-operative visit and again 3 months later.
Finance Options/Interest-Free Credit
We also offer 0% interest finance options making it easier to spread the cost of surgery over up to 24 months.
A minimum 10% deposit is required and the balance is split over your chosen monthly period of either 6, 12 or 24 months at a rate of 0% APR.
OCL Vision’s oculoplastic surgeon, Miss Susan Sarangapani, offers both surgical and non-surgical cosmetic treatments, sometimes combining both as appropriate. This holistic approach allows her to personalise care for each patient and deliver optimal results.
Susan Sarangapani specialises in natural-looking results with strong attention to detail, alongside an empathetic consultative approach to ensure she understands exactly what every patient is looking for.
Susan Sarangapani is part of OCL Vision, a group of expert eye surgeons offering consultation, treatment and surgery onsite in one place. Choose from their central London location (close to Harley Street) or Elstree, Hertfordshire.
Susan Sarangapani is an expert in her field and has undertaken a fellowship at the internationally renowned Craniofacial Unit of Chelsea and Westminster Hospital, ensuring extensive training in facial and eyelid reconstruction surgery.
Miss Susan Sarangapani specialises in Oculoplastics; she uses both surgical and non-surgical treatments to achieve outstanding natural-looking results in eyelid and facial restoration treatment. Susan offers personalised care and takes an empathetic approach when providing consultation.
Susan can be seen at our clinic in New Cavendish Street in Central London, as well as in Elstree, Hertfordshire.
If you would like to discuss your treatment options, make an enquiry or call us on 0203 369 2020
Last updated on
December 30th, 2022
Ms Susan Sarangapani