Our eyelids have multiple functions necessary to maintain comfortable, healthy eyes and good vision. Eyelids have characteristics that are related to racial background but also vary from person to person. It is important to understand the aesthetic relation of a person’s eyelids and face to ensure this harmony is not altered but rather enhanced.
Eyelids have seven layers each with its own function. When operating on the eyelid it is critical to understand the role of each layer as well as being familiar with the function and protective mechanisms of the eye. Having trained as an eye surgeon prior to training as an ocular plastic surgeon, A/Prof Wilcsek has an intimate understanding of this interaction.
A significant portion of A/Prof Wilcsek’s practice involves surgery in patients who have had prior trauma or eyelid surgery. Re-do surgery is always more challenging and must be approached with careful consideration. Some patients may have had skin cancers removed that have either recurred or which were not fully excised at the initial procedure.
Other patients may have had surgery of the eyelids or surrounding areas that have resulted in an unsatisfactory change in the position or contour of the eyelids.
Anyone who has undergone prior surgery or sustained eyelid trauma, who is unhappy with the outcome either aesthetically or because of symptoms related to poor lid position can be assessed. A/Prof Wilcsek will examine you and give possible treatment options that he feels would be beneficial.
Prior surgery or trauma can lead to multiple problems including asymmetry of eyelid height or contour, malposition of the eyelid (turning inwards “entropion”, or drooping outwards “ectropion”) or an inability to close one’s eye. These problems can lead to irritation of the eye, tearing, visual disruption, mucus discharge or potentially scarring of the cornea and loss of vision.
The surgery required will vary for each patient. A/Prof Wilcsek will go through the surgical plan with you after assessing your eyelids. Often in revision surgery the surgical plan is modified at the time of surgery depending on the distribution and severity of scarring found at the time of revision surgery.
The most obvious bruising and swelling should settle over a week. Often the lid needs tightening as part of the procedure and in some patients skin grafts or flaps (neighbouring tissue is rotated into the area of tissue loss) are used. In these cases the thickness and contour of the lid may take weeks to months to settle.
Most patients will take 3 – 5 days off work. Physical activity in the first week should be minimal and then building up to a normal level over the following two weeks.
Any surgery carries risks, and revision surgery unfortunately carries an increased risk of recurrent scarring. This is case specific and A/Prof Wilcsek will discuss this fully at the time of your consultation.
