With aging, loss of elasticity to the eyelid skin results in an excess of skin, giving the appearance of sagging eyes(fig 1.a). The fat, which normally protects the eyeball from the bony eye socket, seeps out into the area under the eye (fig 1.b) making the face look much older. Many people with this condition are asked if they are tired or sleepy, when they are not!q
Rejuvenation of the eyes results in a dramatic improvement in appearance. Modern French aesthetic surgery does not believe in changing the shape of the eyes but rather giving you the appearance you once had when you were younger. The tired, puffy eyed is replaced with a younger, brighter and more resolute look.
During the pre-surgical consultation, you will be examined or asked to answer queries concerning vision, tear production, use of lenses, and your desires for surgery. Your surgeon will explain what you can expect from blepharoplasty and take a complete medical history.
People with circulatory, ophthalmologic, or serious medical conditions must rely on the diagnostic skills of their own personal specialists to determine whether blepharoplasty is an option to consider. A consultation with your ophthalmologist is required to ensure there’s no contra-indication to surgery.
After a mutual decision is made by both you and your surgeon, the technique indicated for your individual surgery will be discussed. The type of anesthesia, the surgical facility, any supportive surgery and the risks will be outlined.
Blepharoplasty, or “eyelid surgery” is a procedure by which excess fat and excess skin are removed from the eyelids and region around the eyes to give a more youthful appearance. This relatively short and simple procedure can be performed with hidden incisions and minimal downtime to give a dramatic improvement in appearance.
In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed (fig 2). Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.
In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lash line and smile creases of the lower lid (fig 3.). Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures.
Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.
This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows. It is usually performed on an outpatient basis, with local anesthesia. Eyelid surgery is often performed in conjunction with other facial rejuvenation procedures such as facelifting.
Patients are discharged the same day of the procedure to a responsible party. You cannot drive yourself home after surgery.
There is usually some mild swelling and bruising around the eyes. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort. The sutures are usually well-hidden and are removed after the first 5 days. Some patients may experience dryness of the eyes post-operatively. The eyelid skin heals very quickly, and most patients can be up and around within a couple of days. Camouflage make-up can be used on the eyelids 24 hours following surgery, allowing return to work as soon as possible. After a week of non-stressful activities, you may resume a normal routine.
What are the possible complications?
Small changes in your eyelid shape can occur after the redundant skin and fat are removed. The lower eyelids, in particular, are subject to retraction inferiorly and can cause some rounding of the eyelid margin. To reduce the risk of retraction, a self dissolving stitch is placed to suspend the lower eyelid muscle to the orbital rim. Small changes of the lash line can also occur if the lid margin is rolled outward. Some people heal with scars that are more prominent and red. One can expect these to resolve with time
Any surgery in and around the eyes can potentially jeopardize vision. It is extremely unusual for any permanent change. On occasion, however, the swelling in this area can cause temporary changes in refraction. For this reason, it is recommended to delay having any prescription measurements made immediately after eyelid surgery. In addition, some of the ointment around the eye can cause some blurriness to your vision.
All surgical procedures have risk. Although most procedures are successful, medicine is not an exact science and no one can guarantee that you will have the desired outcome. Your surgeon will openly discuss the risks and complications of any procedure with you.