Eyelid Surgery

Smaller procedures can be performed in the clinic procedure room with local anaesthetic.

Conditions suitable for this include:

• Chalazion incision and curettage
• Removal of small lumps, cysts and skin tags etc.
• Small biopsies of lesions suspicious for skin cancers
• Removal of small skin cancers e.g. Basal Cell Carcinoma (BCC) or Squamous Cell Carcinoma (SCC)

Firstly, the inside of the eyelids will be numbed with anaesthetic eyedrops. Then local anaesthetic will be injected through the already numbed conjunctiva. This will involve some mild discomfort. The necessary procedure is performed which usually takes about 15 minutes, and an eye pad is applied at the end. The pad is removed after 10 minutes and the is eye cleaned.

You will usually be able to drive home. There will be a small amount of swelling and bruising on your eyelids. This will usually settle down within about 1 week. You can wash your face and shower as usual and water running over the wound is not a problem. It is best to gently pad dry rather than wipe the involved area. Suturing is usually not required and wounds typically heal very well with minimal scarring.

Conditions suitable for this include:

• Ectropion
• Entropion
• Ptosis
• Larger eyelid lesions that are either benign or malignant

Sedation requires you to be fasted before the procedure, 6 hours for food and 2 hours for clear fluids. An experienced anaesthetist will check your medical history and explain the process to you in more detail. A canula will be inserted into a vein on your arm and medications given to you so that you will be relaxed, partially asleep but still breathing on your own.

A full general anaesthetic (including intubation) is usually not required. Typically patients can go home on the same day and will need to be accompanied home.

After the surgery, the eyelids will have significant swelling and bruising which can take 2-3 weeks to resolve. Even if the surgery is only on the upper eyelids, the swelling and bruising will follow gravity and track into the lower lids, and even your cheeks. You will have an eye pad covering your eye for 1-2 days. There will be some pain but usually not severe. You can take paracetamol and that is usually sufficient. You can use ice packs a few times a day for 3 days to help reduce the swelling and bruising.

Either dissolving or non-dissolving sutures may be used depending on your skin type.

• If non-dissolving sutures are used, these will be removed at your post-op appointment at around 1-2 weeks.
• If “fast dissolving” sutures are used, these will absorb/fall out within 1-2 weeks and thus no removal is required.
• If “slow dissolving” sutures are used, these can take up to 2 months to completely dissolve. If appropriate these may be removed sooner.
• The sutures are very fine to ensure a minimal scar. When the eyelids are swollen and tender it may not always be possible to remove all the sutures. In this case, just the ends of the sutures will be cut and they will fall out or can be removed once the swelling and tenderness has resolved.