Eyelid Surgery (Blepharoplasty)

Upper and lower blepharoplasty (eyelid surgery) by Dr Mark Duncan-Smith, FRACS plastic and reconstructive surgeon at Mount Medical Centre West Perth. Upper blepharoplasty removes excess skin causing hooding or visual obstruction. Lower blepharoplasty addresses under-eye bags, fat herniation, and lower lid laxity. Can be performed under local anaesthesia with sedation or general anaesthesia.

Eyelid surgery (blepharoplasty) at Mount Medical Centre West Perth is performed by Dr Mark Duncan-Smith, a Fellow of the Royal Australasian College of Surgeons in Plastic and Reconstructive Surgery, from his private rooms at 146 Mounts Bay Road, West Perth, Western Australia. Blepharoplasty encompasses two anatomically distinct procedures that address different ageing changes in the periorbital region: upper blepharoplasty and lower blepharoplasty. Upper blepharoplasty corrects dermatochalasis — excess, redundant upper eyelid skin that accumulates with age due to loss of skin elasticity and gravitational descent, causing skin folds, hooding over the lashes, and in more advanced cases a reduction in the superior visual field. The procedure involves making an incision in the natural upper eyelid crease, excising a precise amount of excess skin (and, where indicated, a strip of orbicularis oculi muscle or prolapsed orbital fat), and closing the wound within the natural crease so the scar is effectively concealed once healed. Importantly, when dermatochalasis is documented by an ophthalmologist to impair the superior visual field on formal Humphrey visual field testing, upper blepharoplasty may qualify for a Medicare Benefits Schedule (MBS) rebate and private health insurance benefit under Item 45617, making it a partially or substantially covered procedure for eligible Perth patients — a significant financial consideration. Lower blepharoplasty targets the characteristic signs of lower eyelid ageing: prolapse of the three orbital fat compartments (medial, central, and lateral) through a weakened orbital septum producing under-eye 'bags'; festooning (fluid pocketing) in the lower lid-cheek junction; lower lid laxity; and tear-trough hollowing at the lid-cheek junction. Techniques include transcutaneous (skin-muscle flap) or transconjunctival (invisible, scarless) approaches, with or without fat repositioning into the tear-trough. Recovery from blepharoplasty involves bruising and swelling for one to two weeks, with sutures typically removed at five to seven days. Dr Duncan-Smith performs blepharoplasty either as a standalone procedure under local anaesthesia with intravenous sedation, or combined with facelift or brow lift surgery under general anaesthesia at Mount Private Hospital or Cambridge Day Surgery, Wembley.