Eyelid surgery, also known as an eyelid tuck or blepharoplasty, is a simple procedure that I commonly recommend to both men and women alike. Relaxed eyes are essential for a beautiful youthful look.

Eyelid Surgery (Blepharoplasty) in South Africa

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Relaxed eyes are essential for a beautiful youthful look.

Eyelid surgery, also known as an eyelid tuck or blepharoplasty, is a simple procedure that Dr Nerina Wilkinson commonly recommends to both men and women alike. 

Many of her patients complain about looking tired and angry and are astounded at how an eyelid operation can revive their look and reveal their bright sparkling eyes again.

What is blepharoplasty
(eyelid surgery)?

Blepharoplasty is a surgical eyelid rejuvenation procedure that focuses on sagging eyelid skin, as well as the complete rejuvenation of the periorbital area. 

As we age, the very delicate skin and supporting structures around the eyelids can easily stretch. The upper eyelids sag, creating a hooded look while the lower eyelids sag creating bags beneath the eyes. Overall this results in a tired appearance and in severe cases, this extra skin can even impair your vision.

 Modern blepharoplasty understands that a youthful eyelid is a full eyelid and as surgeons, we need to rather replace lost tissue and inflate the loose skin rather than only removing and tightening the skin. Dr Nerina Wilkinson, therefore, focuses on restoring a youthful appearance to the eyes by not only removing sagging skin through eyelid surgery but also on focusing on the surrounding periorbital tissues for holistic rejuvenation of the eye area as with her Signature EYELight360™ procedure.

Find out more about our approach to eyelid surgery, or book a consultation with Dr Nerina Wilkinson + Associates.

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Frequently asked questions about eyelid surgery (blepharoplasty)

Our approach to Eyelid Surgery (Blepharoplasty)

In the past, the procedure of choice was a blepharoplasty alone, which involves the removal of eyelid skin and addresses loose skin and protruding bags. 

Dr Nerina Wilkinson’s approach to eyelid surgery (blepharoplasty) is more holistic – believing that the eyes are the window to the soul, and should always be assessed in conjunction with surrounding tissues. 

The aim is to beautify a face by enhancing volumes around the eyes, filling the loose skin and hollows in the upper eyelids, lower eyelids and temporal area. Modern blepharoplasty understands that a youthful eyelid is a full eyelid, and as surgeons, we need to replace lost tissue and inflate loose skin instead of only removing and tightening skin.

Dermal fillers can be used to enhance facial features. However, fat filling (the injection of your own fat cells removed by liposuction) can create a more harmonious result, achieving a more three-dimensional volumizing and lifting effect.

If you’ve suffered for years with eyelid ptosis, or are worried that sagging eyelids and eye bags make you look older or more tired than you are, know that there is a solution. Blepharoplasty can result in a more relaxed looking face and combat the signs of ageing.

Dr Nerina Wilkinson works with the natural beauty of her patients and focuses on enhancing it subtly to create a look that they are happier with.

Who is the ideal candidate for Eyelid Surgery?

The best candidates are those who fully understand the procedure and have realistic expectations about the results. Before you decide to undergo eyelid surgery, think carefully about your expectations and discuss them with your surgeon. 

The best candidates for eyelid surgery are men and women who are physically healthy and psychologically stable, with realistic expectations. Most blepharoplasty patients are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age. 

A few medical conditions increase risks and complications associated with eyelid surgery – these include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. 

A detached retina or glaucoma can also be grounds for caution and thorough checks need to be conducted by an ophthalmologist before proceeding further.

As with any surgical procedure, it is best to discuss your specific medical history and needs with your doctor. Book an appointment to consult with Dr. Nerina Wilkinson. 

How is Eyelid Surgery (Blepharoplasty) performed?

 If you’re having all four eyelids done, Dr. Nerina Wilkinson will probably work on the upper lids first, then the lower ones. In a typical procedure, Dr Wilkinson makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids.

The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, she separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle.

The incisions are then closed with very fine sutures. If you have a pocket of fat beneath your lower eyelids but don’t need to have any skin removed, she may perform a Transconjunctival Blepharoplasty. In this procedure, the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.

What is Upper Blepharoplasty (Eyelid Surgery)?

Upper blepharoplasty or upper eyelid surgery is performed to remove loose or excess skin and fat on the upper eyelid and may be used to improve field of vision. 

Your blepharoplasty procedure may involve upper eyelid surgery, as well as lower eyelid surgery, depending on your initial assessment with Dr. Nerina Wilkinson.

Book a consultation to find out more.  

What is Lower Lid Blepharoplasty (Eyelid Surgery)?

Lower lid blepharoplasty is a procedure that involves the use of surgical techniques to improve the appearance of the lower eyelids, and the surrounding tissues. Lower blepharoplasty aims to address wrinkles, loose skin and excess fat for skin under or around the eye. 

Your blepharoplasty procedure may involve lower eyelid surgery as well as upper eyelid surgery, depending on your concerns and based on your initial assessment with Dr. Nerina Wilkinson.

How long does Eyelid Surgery take to perform?

Blepharoplasty surgery usually takes 1 to 3 hours, depending on the extent of the surgery. If you’re having all four eyelids done, your cosmetic surgeon will probably work on the upper lids first, then the lower ones.

You will also need to stay in our rooms for about an hour after your procedure to allow time for Dr. Nerina Wilkinson to see you before being discharged.

How long do results from Eyelid Surgery last?

For many people, eyelid surgery is permanent, but for some, follow-up procedures may be required after a period of 5-7 years. After eyelid surgery, your periorbital area will still age normally. 

Your satisfaction with your eyelid surgery is likely to be greater if you have a thorough understanding of the procedure and maintain realistic expectations. Please contact us to discuss your specific concerns.

Eyelid Surgery: Before and After

When a blepharoplasty procedure is performed correctly, there is typically minimal scarring. However, it is common to have scars around the eyes after eyelid surgery. 

These scars/scar tissue has to be cared for correctly, and the visual appearance of scars can fade over time with the right skincare regimen and targeted products. 

Before Blepharoplasty (Eyelid Surgery)

Before an eyelid surgery procedure, you can expect various examinations and tests to take place in order to ensure you are well prepared and any areas of risk are taken into account. 

Before your procedure, you will be required to schedule and complete any pre-operative tests requested by Dr. Nerina Wilkinson.

You will need to stop smoking for four weeks before and four weeks after surgery.

You will also need to stop taking aspirin, anti-inflammatories, herbal medicine, diet pills and other medication (unless chronic) 2 weeks before your surgery. 

Remove any eyelash extensions or false lashes prior to surgery. Loose lashes can get into the eye and cause damage to the cornea or contaminate the wound.

Ensure that you have arranged everything you will need for your

recovery after blepharoplasty (e.g. meals, pillows, straws, ice, books, etc.) 

Arrange for someone to drop you off at the clinic and collect you after discharge. You may not drive for 24 hours after receiving oral sedation.

Schedule a pre-operative consultation with Dr. Nerina Wilkinson 1 week before surgery.

Day of Blepharoplasty (Eyelid Surgery)

Take normal daily medication e.g. blood pressure, diabetic, antidepressants in the morning with a small sip of water. 

Wear comfortable loose-fitting clothes with easy to slip on flat shoes. Bring sunglasses and a hat/scarf to put over your head when discharged.

After Blepharoplasty (Eyelid Surgery)

There are various potential side effects and complications associated with eyelid surgery and patients often query how their periorbital area will look after the procedure.

After surgery, we will lubricate your eyes with ointment and apply micropore tapes to the incisions.

Your eyelids may feel tight and sore as the anaesthesia wears off, but most of your discomfort can be controlled by the medication prescribed by your doctor. If you feel any severe pain, it is important to inform us immediately.

You can expect some swelling and bruising after surgery which differs from patient to patient. It depends on the extent of the surgery as well as the individual’s tendency to bruise.

NO smoking for 4 weeks after surgery; smoking reduces blood flow to the skin and may compromise wound healing.

Dr Wilkinson will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. You’ll be shown how to clean your eyes, which may be gummy for a week or so. 

Many doctors recommend eye drops or ointment since your eyelids may feel dry at first and your eyes may burn or itch. 

For the first few weeks, you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

You will be required to see Dr. Nerina Wilkinson post-operatively after +/- 2 – 4 days to have the dressings replaced, after 1 week to remove stitches and at 6 weeks for a surgical follow-up. 

Failure to adhere to these instructions may lead to complications and jeopardize the results of your surgery.

Exercise, work, sun exposure, and regular daily tasks also need to be avoided for a period of 5-7 days, and intensive tasks need to be avoided for 3 weeks. Most people feel ready to go out in public (and back to work) in 7-10 days, but it is essential to refrain from activities that may raise your blood pressure, including bending, lifting, and rigorous sports. 

Alcohol should also be avoided as it causes fluid retention which increases swelling. 

You can find some examples of blepharoplasty patients post-op below.

How long is the recovery period for Eyelid Surgery?

Most patients require up to several weeks to recover fully from blepharoplasty but can return to normal activities much sooner. You will be required to see Dr. Nerina Wilkinson post-operatively after +/- 2 – 4 days to have the dressings replaced, after 1 week to remove stitches and at 6 weeks for a surgical follow-up.

You should keep activities to a minimum for 5-7 days, and it’s especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. 

You should also avoid alcohol since it causes fluid retention which increases swelling. 

After 2 to 3 days you should be able to read or watch television and most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor’s instructions, you’ll probably be able to wear makeup to hide the bruising that remains. After two weeks you should be able to start wearing false eyelashes and contact lenses again (even though they may feel uncomfortable for a while). After about three weeks you should be able to complete more strenuous activities

You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and sunblock when you go out.

Healing is a gradual process, and your scars may remain slightly pink for 6 months or more after surgery. Eventually, though, they’ll fade to a thin, nearly invisible white line.

How do I choose the best Eyelid Surgery procedure for me?

To see if this is the best cosmetic surgery procedure for you, always start with a professional consultation with a qualified and experienced cosmetic surgeon for an in-depth analysis of your facial features and to reach a good understanding of your skincare concerns and goals.

Dr. Nerina Wilkinson’s unique and comprehensive surgical consultation is available for you to discuss and analyse your concerns and goals and for her (together with her team of specialists) to provide bespoke advice.

Schedule your facial cosmetic surgery consultation today!

What does Blepharoplasty (Eyelid Surgery) cost in South Africa?

In South Africa, eyelid surgery (blepharoplasty) generally costs in the region of R19 000 – R40 000, depending on whether the focus is on the lower eyelid, upper eyelid or both. 

The cost of blepharoplasty is also dependent upon the time spent in theater, as well as in preparation for blepharoplasty. To prepare for blepharoplasty, you will need to have a consultation with a cosmetic surgeon, followed by any specialist consultations relevant to the eye or skin required in order to assess your periorbital area thoroughly before your surgery. 

Our usual pricing Dr. Nerina Wilkinson’s eyelid surgery is broken down as follows: 

  • Upper Blepharoplasty (eyelids): +/- R 20 000 – R 24 000
  • Lower Blepharoplasty (eyelids): +/- R 30 000 – R 45 000
  • For both: +/- R 50 000 – R 63 000

This is excluding a consultation (R1800) as well as any medication required for surgery (+/- R 800 – R 1 500) specialist appointments you may require based on Dr Nerina’s advice and investigations during the consultation/preparation phase. You can also choose to spend an extra night at our clinic should you require or prefer it (+/- R 7 000).

Please note that these fees are only estimates and can change once you have seen the Dr. Nerina Wilkinson for your first assessment.

Please contact us to ask any questions you may have regarding eyelid surgery.

Are there alternative non-surgical treatments to Blepharoplasty (Eyelid Surgery)?

Yes, there are non-surgical treatments to help reduce sagging or loose skin around the eyes. 

A procedure such as Morpheus8™ uses non-surgical advanced technology combining the power of radio-frequency energy with adjustable depth micro-needling to address skin laxity. Morpheus8™ comfortably penetrates the skin at a deeper level than other micro-needling treatments, transforming your complexion and restoring more youthful skin. It is the only treatment that can mold fat under the skin to obtain optimal results.

Dermal fillers are also commonly used to fill under eye hollows and provide volume to the periorbital area, with results lasting 12 – 18 months. More advanced procedures such as lipofilling have also become increasingly popular. This involves the injection of your own fat cells in an area requiring volume and can provide longer-lasting, harmonious results.

The Periocular Brightening Peel has been formulated exclusively for Dr Nerina Wilkinson + Associates for those wanting a less invasive approach. This bespoke treatment is specifically designed for clients who want firmer, brighter and more even tone the skin around the eye area. This indication-specific combination peel, together with micro needling, forms part of the exclusive periocular protocol for superior results around the eye area.

Is Blepharoplasty safe?

Eyelid surgery is normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications. 

Dr. Nerina Wilkinson will help you develop a comprehensive understanding of the procedure, and the risks and complications associated with blepharoplasty. You will also get asked about certain variables that might impact the success of the surgery, including your age, any medical illnesses, lifestyle and habits.  

Dr Nerina will also explore your expectations and provide you with a thorough understanding of what awaits you after eyelid surgery. 

What are the possible risks and complications associated with Eyelid Surgery?

As with any surgery, eyelid surgery (blepharoplasty) is a specialised medical procedure that can have complications depending on a variety of circumstances. 

Your health and lifestyle should always be assessed in conjunction with your expectations for your blepharoplasty, before the procedure. 

Dr. Nerina Wilkinson will ask you for a detailed medical history and information about your lifestyle and habits to understand and define areas of risk and decide whether you are suitable for the procedure.

Serious adverse effects are more unlikely, but there are common side effects, complications and risks associated with a blepharoplasty procedure.

Eyelid Surgery Side Effects

After undergoing a blepharoplasty (eyelid surgery) procedure, you can expect to experience some of the most common side effects which range from mild pain, discomfort, numbness, swelling and bruising around the eyes, to bruising on the whites of the eyes, unpleasant sensations associated with the eye(s) including wet, dry and irritated/disturbed eyes, and extreme sensitivity to light.

These side effects should resolve within a month and are considered normal with any eye surgery.

Dr. Nerina Wilkinson can provide more insight into any additional side effects, and address any concerns you may have regarding eyelid surgery. Contact us to find out more. 

Eyelid Surgery Complications & Risks

There are various complications associated with eyelid surgery, some of which are more severe than others. 

Minor complications include double or blurred vision for a few days, temporary swelling at the

corner of the eyelids, persistent discolouration and a slight asymmetry during healing and/or scarring. Tiny whiteheads may appear after your stitches are removed but can be removed easily with a very fine needle. 

Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases, this condition may be permanent. Another very rare complication is Ectropion, a pulling down of the lower lids. In this case, further surgery may be required.

In extremely severe cases, blindness has occurred following Blepharoplasty but is extremely rare.

Eyelid Surgery Scarring / Scarring Associated with Eyelid Surgery

Scarring is to be expected with eyelid surgery, however, with proper care, the post-op scars from blepharoplasty can fade and almost disappear over time. To ensure you are caring for your scars correctly, you may need to follow a specific skincare regime that includes key skincare products designed to help you care for, and repair, scar tissue.

Where is Blepharoplasty surgery performed in Cape Town?

Eyelid surgery is usually performed in private cosmetic clinics and other medical clinics that have a focus on aesthetic surgery. 

Dr Nerina Wilkinson + Associates is a private, high end, luxurious clinic located in the prestigious V & A Waterfront in Cape Town where Dr Wilkinson founded the House of Aesthetic Couture and Skin Science. Your surgery will be performed at Dr Wilkinson’s clinic, and you will be required to stay at the practice for +/- 1 hour after the procedure.

What type of anaesthesia is used when performing eyelid surgery?

Blepharoplasty can generally be performed under oral sedation, allowing you to be totally relaxed and asleep throughout the procedure, without having the harsh side effects associated with a general anaesthetic. Occasionally, we may use a general anaesthetic and in that case, a certified Anesthesiologist will be responsible for your wellbeing.

The

Eyelid Surgery Procedure

During your initial consultation, Dr Nerina Wilkinson will examine your eyelids for a loss of deep soft tissue and excess skin.  At the same time, she assesses the overall tightness of the muscles too. 

It’s important to discuss your expectations openly before undergoing the procedure. Dr. Nerina Wilkinson will take time to describe different options available and the risks, benefits, and limitations of each treatment. 

You will need to decide whether to do all four eyelids or if you’d like to do the upper and lower lids separately. In addition, you will need to choose whether you would like to use fat grafting to regain youthful fullness of the periorbital (eye) area. Dr. Nerina Wilkinson will advise you when making these decisions. 

Please bring along a record of any recent eye exams, and information from your ophthalmologist. Photographs from your past/youth are also incredibly useful for Dr Nerina to determine the best course of action for rejuvenating skin around the eyes and surrounding tissues. 

This one-to-two hour procedure is performed as a day surgery at our clinic in Cape Town. You’ll be placed under conscious sedation for the duration of the procedure which is completed in three steps:

  1. Incisions – Small well-hidden incisions are made in the crease of the eyelid, following the natural lines in the skin. These may extend into the crow’s feet or laugh lines. Alternatively, If you have a pocket of fat under your eyelids but don’t need to have any skin removed, a different procedure might make more sense for you. This is known as a ‘transconjunctival blepharoplasty’. During this procedure, the incision is made inside your lower eyelid, leaving no visible scar. This is usually performed on younger patients whose skin has more elasticity.
  1. Tailoring – On the upper eyelid, fatty deposits and excess skin around the eyes are removed in preparation for muscle tightening. 

To prevent an operated and skeletonized look, Dr. Nerina Wilkinson is conservative and only removes the fat pockets that are visible. A full eyelid is a youthful eyelid. When working on the lower lid, an incision is made below the lash line, through which excess fat and skin are removed. 

She believes that every patient requires support and volume in the lower eyelid to prevent pulling down the margin of the lower eyelid due to gravity. For more permanent results, fat grafts are my procedure of choice, however, if you are concerned about the effect of a fuller lower lid, then you could opt for the injection of a filler before deciding on fat grafting.

  1. Finishing touches – Sutures are used to close the incisions, very thin surgical tapes are applied to the scars, and your eyes are lubricated with ointment.

Most patients return home on the same day, however, if you are considering a 4 lid blepharoplasty, it is best to spend one night in the overnight facility where our well-trained nursing staff apply ice and special light therapy to accelerate the healing and reduce the swelling.

Our nursing staff will instruct you to keep your head elevated for several days and to use cold compresses to reduce swelling and bruising. Bruising varies from person to person, it reaches its peak during the first week and generally lasts anywhere from two weeks to a month. 

You’ll be shown how to clean your eyes, which may have a slight discharge for a week or so. We recommend eye drops since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks, you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

The stitches will be removed after five to seven days post-surgery. Once they’re out, the swelling and discolouration around your eyes will gradually subside, and you’ll start to look and feel much better.

Dr Nerina Wilkinson has over 20 years of experience in the field of plastic surgery, and fully understands her patients, their needs and their emotions leading up to surgical/aesthetic procedures, which allows her to provide world-class advice and care. Additionally, her staff are exceedingly well trained and experienced and equipped to provide you with incredible pre and post-operative care.

Put yourself in excellent hands and contact our clinic today to book your consultation for blepharoplasty.

Procedures

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EYELight360™ Blepharoplasty

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Periocular Brightening Peel

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Dr Nerina Wilkinson - experienced cosmetic surgeon in Cape Town

About Dr Nerina Wilkinson FCS (Plast SA)

Dr Nerina Wilkinson and her team of aesthetic doctors and skincare specialists are considered the “go-to” expert for patients seeking a highly personalised, bespoke facial rejuvenation treatment plan. We take our clients on the ultimate curated journey to beauty and confidence.

Dr Nerina Wilkinson and her team specialise in Eye Rejuvenation & Restoration

In treating the delicate periorbital area, she is passionate about the combination of advanced technologies, energy devices, skin treatments and surgery: resulting in the most natural rejuvenation and regeneration

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