Professor Mark Ashton
MB., BS. MD. FRACS (Plas)
Specialist Plastic Surgeon
Professor Ashton is a Melbourne based plastic surgeon. He is chair of plastic and reconstructive surgery at Epworth Freemasons Hospital, former head of plastic and reconstructive surgery at Royal Melbourne Hospital (2001 – 2016) and Royal Women’s Hospital (2000 – 2016), and is one of Australia’s most respected and internationally renowned plastic surgeons.
The following information is designed to help you understand our process for upper blepharoplasty surgery, including assessment and suitability, and will emphasise essential information to consider before proceeding with surgery.
AHPRA registration number – MED0001135718
WHAT IS UPPER EYELID BLEPHAROPLASTY?
Upper eyelid blepharoplasty is a surgical procedure involving the removal of excess eyelid skin and the associated underlying fat pads, particularly those located in the inner corner of the eyes, in order to achieve a less puffy or droopy upper eyelid contour.
Our aim is to provide a comprehensive, informative and personalised patient experience. During the initial consultation process, you will have the opportunity to meet Prof Ashton, our dedicated nursing and administration staff, and our practice manager.
We encourage every patient to seek a second opinion with a qualified specialist plastic surgeon, before proceeding with any surgical procedures.
Your initial consultation with Prof Ashton will require a valid referral from your general practitioner (GP), or other qualified healthcare provider. It is preferable that your referral is from your usual GP, as they will ensure all relevant medical history is included in your referral.
During your consultation, you and Prof Ashton will discuss your treatment objectives, and with your written consent, clinical photos will likely be taken for medical purposes. Mark will assess your medical history to ensure that all suitable and relevant treatment options are thoroughly discussed with you.
Our nursing staff and practice manager will also provide additional information regarding the procedure discussed, to ensure you are well-informed and you understand your choices. You will be afforded adequate opportunity to address any remaining questions prior to leaving our rooms, we are always happy to answer questions you may have.
If you decide to progress with your surgery, after having reviewed the information provided to you during your initial consultation, you will then have a second consultation with Prof Ashton for further discussion. During your second appointment, you will also meet with one of our nurses again to discuss the necessary surgical documentation, including the initial preoperative and postoperative care instructions.
Whilst you might be enthusiastic to schedule your surgery as soon as possible following your second consultation, the current AHPRA guidelines mandate a 7-day cooling off period between your second consultation and booking and paying a deposit to secure a surgical date.
Communication is one of the most important aspects of your upper blepharoplasty consultation process and surgical planning. It allows you and your surgeon the ability to ensure your concerns and the related surgical options have been adequately discussed.
Our bodies are all unique and no two people will have the same results. In our practice, we find most patients invariably have a pre-determined result in mind. Therefore, it is critical you are always afforded a platform to openly and clearly communicate with your plastic surgeon, to ensure they understand the results you are hoping to achieve, prior to your surgery.
We find one of the most effective tools to communicate your wishes is via images. We encourage you to bring screenshots or photos to your initial consultation to articulate this.
What You Must Know Before Considering Upper Blepharoplasty Surgery
It is important to understand the risks involved with any surgery. The choice to undergo any surgical procedure, elective or urgent, should be based on the comparison of the potential risks to the potential benefits. Although most patients do not experience severe surgical complications, you must discuss the risks versus the benefits with your surgeon, to ensure you understand all the possible consequences of your planned surgery.
There are risks associated with any surgery, and upper blepharoplasty is not immune to these risks. Some risks are common to all forms of plastic surgery, and others are specific to upper blepharoplasty. If any complications arise, it may be necessary to bring you back to theatre to address and resolve these concerns.
Some of the potential risks relating to upper blepharoplasty surgery are:
- Pain and discomfort
- Temporary swelling, leading to a tight feeling in the eyes
- Removal of too much skin and asymmetry of the eyelids
- Corneal injuries
- Noticeable scarring of the incisions
- Changes in vision, usually resolves quickly; rarely, some may be long lasting or permanent
- Rarely, blindless may result
It is important to inform Prof Ashton prior to surgery if you are prone to experiencing dry eyes, as your surgical plan may need to be adjusted. In some cases, Prof Ashton may even recommend that you don’t undergo the surgery, to avoid the potential of exacerbating the dryness in your eyes.
The risk of infection can occur despite using antibiotics in the post-operative period. It appears to be more common in patients who continue to smoke post operatively, or who have comorbidities such as diabetes. There are other specific risks associated with surgery that you should discuss with your surgeon prior to consenting to any surgery.
General anaesthesia is commonly used, however, there is an array of potential complications which can occur during or after general anaesthesia. These complications can be as major as death or brain damage, or as minor as muscle soreness or pain at the site of your cannula. The most common complications are nausea, vomiting and sore throats, and all specialist anaesthetists are trained to avoid and manage complications as they arise.
One of our anaesthetists will be in contact with you the week prior to your surgery to confirm your health status, and answer any questions you may have regarding the anaesthetic and post operative pain management.
As cigarette smoke constricts the small blood vessels within the tissue, smokers have a higher incidence of wound healing problems. In particular, smokers are much more likely to develop wound breakdown and infection. For this reason, it is critical to stop smoking 2 weeks prior to surgery and for 6 weeks postoperatively.
Deep Venous Thrombosis And Pulmonary Embolism
During surgery, there is a risk that blood may accumulate in the veins of the lower legs. Post-surgery, these clots can dislodge from the vein walls of the calves and travel to the lungs, resulting in problems with breathing or even death.
Some medications can increase the risk of deep venous thrombosis. It is essential you discuss your current medications with your surgeon and your anaesthetist prior to surgery.
Please be aware this is not an exhaustive list of potential risks. Every patient responds differently to general anaesthesia and surgery. Please ensure you discuss the surgical risks with your surgeon prior to moving forward with any surgery.
If I Decide To Proceed, What Can I Expect When I Undergo UPPER Blepharoplasty Surgery?
Hospital And Admission
We perform all our upper blepharoplasty surgeries at Epworth Freemasons Private Hospital in East Melbourne. If an overnight stay is necessary, each of our patients have a private room with an ensuite, and at Epworth Freemasons there are 12 state-of-the-art operating theatres with the latest anaesthetic machines and theatre equipment. There is also 24 hour onsite medical emergency care, with an onsite Intensive Care Unit.
You will need to fast prior to your surgery, usually from midnight the night prior. Your admission paperwork will be provided to you a minimum of 3 to 4 weeks prior to your operation so that any questions you may have can be answered well before your admission.
Upper blepharoplasty surgery is only performed on our patients by Professor Ashton, a qualified specialist plastic surgeon, and is carried out under the administration of general anaesthesia by one of our accredited specialist anaesthetists.
This procedure can be performed as an extended day case or with an overnight stay. Under a general anaesthetic, local anaesthetic is infiltrated into the skin of the upper eyelid, and the redundant skin is gently removed with any bulging fat repositioned or removed. Following this, a small sleeve of the eyelid muscle is usually plicated, and the incisions are sutured using extremely fine dissolving sutures.
Following upper blepharoplasty surgery, you will spend time in the Post Anaesthetic Recovery Unit, and ice packs will be placed over your eyes.
We recommend you stay in hospital overnight so we can monitor your blood pressure and heart rate, and to ensure you rest. This is important as we are aware that bruising or bleeding around the eyelids can occur relatively easily when you exert yourself. Any bruising is most pronounced around day 4 after surgery, and typically dissipates by day 10. In general, most patients can resume work within 7 to 10 days.
To minimise the risk of bruising on the eyelid, it is important you refrain from taking Aspirin, multivitamins, and supplements for 10 to 14 days prior to your surgery, as these can thin your blood and increase any bruising.
You will be reviewed by Prof Ashton prior to being discharged from hospital, and the nursing staff will ensure your discharge medications, usually antibiotics and pain medications, are ready for you. You will be provided an information bag to take home which contains our afterhours details, as well as the dates and times for your follow up appointments with our nursing team and Prof Ashton.
During your post-operative period, we will monitor your recovery and progress. Typically, we would schedule a follow-up appointment 1-week post-surgery, to examine your incisions, remove sutures, and advise if you can resume work.
We advise avoiding any strenuous exercise or activities for 4 weeks following your surgery. During your recovery, will provide precise guidance on the level of activity or exercise you should engage in during your recovery.
It is important to keep the surgical incisions clean for 2 weeks after the operation. Sometimes the sutures may become dry, we advise placing Chlorsig ointment on the suture line to keep them supple and moist.
Recognising that each patient’s healing process is unique, our post-surgical care is tailored to accommodate your needs. We will address any concerns you or we may have, and you will receive thorough post-surgical care from Prof Ashton and our dedicated team throughout your recovery.
Interested In Upper Blepharoplasty?