Cosmetic eyelid surgery- Blepharoplasty

Cosmetic eyelid surgery, Blepharoplasty, corrects these changes and restores a more youthful and alert appearance. Blepharoplasty, which is one of the most popular cosmetic surgeries, rejuvenates you by removing the excessive skin, fat and muscle of the eyelids or rearranging them and makes you look more youthful and rested. Its useful results remain for years, sometimes for a lifetime.

Eyes are the "windows to the soul" and play a crucial role in our social relations.Usually, looking at each other is the first step in human relationships. That's why the appearance of our eyes can significantly influence how we are perceived in day-to-day interactions and also has a great effect on our self- confidence.As we age the appearance of our eyelids changes, producing a tired and old appearance.The bulk of these changes include:

• Fine wrinkles around eyelids

• stretching and loosening of the eyelids skin, which sometimes forms overhangs(sagging eyelids).

• storing of excess fat in the fat pads under the eyelids

• Eyelid muscles laxity and loss of elasticity

• Eyebrow or eyelid ptosis (drooping of the eyebrows or eyelids)

These changes can make you look old and tired.Moreover, if it is severe enough, it can partially block the peripheral visual field and also interfere with your vision.

Cosmetic eyelid surgery, Blepharoplasty, corrects these changes and restores a more youthful and alert appearance. Blepharoplasty,which is one of the most popular cosmetic surgeries,rejuvenates youby removing the excessive skin, fat and muscle of the eyelids or rearranging them and makes you look more youthful and rested. Its useful results remain for years, sometimes for a lifetime.

Different types of Blepharoplasty:

Blepharoplasty can be accomplished as a single procedure, or in conjunction with other facial surgery such as a brow lift, a face lift or Botox injection.In general, cosmetic eyelid surgery includes three major types, each having its own advantages and applications:

Upper Eyelid Blepharoplasty:In upper eyelid blepharoplasty the excess skin and fat bags of the upper eyelid (which cause puffy eyes) are removed, at the same time eyelid ptosis can be corrected. Moreover, the excessive skin which is obstructing the peripheral vision can be removed.In total it creates a younger and more alert appearance. Occasionally a browlift procedure is performed at the same time as the upper lid blepharoplasty.

Lower eyelid Blepharoplasty: Lower eyelid surgery is usually done to removefat bags under the lower eyelid (which cause baggy eye). Usually a portion of the lower eyelid skin is removed. Overall, these changes lead to a more youthful appearance.

Transconjunctival Blepharoplasty:This method is used mostly in young people, whose skin has not lost its elasticity yet and is relatively stiff. In this procedure an incision is made inside the lower eyelids(the conjunctiva), leaving no visible scar, and the pockets of fat beneath the lower eyelids are removed. The advantage of this method is that it requires no incisions on the skin.

Eyelid surgery can be performed at an office, clinic or hospital. It is usually done on an outpatient basis and do not require hospitalization. Surgery time varies between one to three hours,depending on whether you’re having your upper or lower eyelids, or both, operated on.Surgery is usually performed under local anesthesia but, depending on the patient and the doctor’s discretion, the patient may undergo general anesthesia.

In upper eyelid blepharoplasty, first an incision is made along the natural crease of the upper eyelid.Through this,the surgeon cuts a crescent-shaped area of skin and under skin muscles and will remove almost all the excess fat.

Ptosis can also be corrected at the same time, by using absorbable sutures. Then, the incision is closed with fine sutures.

In lower eyelid surgery an incision is made just below the lash linealong the natural creases of the eyelid. Excessive fat is removed, and where there is Excess skin, a thin crescent flap of skin is cut and the incision closed with fine sutures.

In transconjunctival blepharoplastyan incision is made inside the eyelid(the conjunctiva), through which the excess fat is removed. Then the incision is closed with absorbable sutures.

The best candidates for blepharoplasty are individuals who are at least 35 years old and droopy, or baggy eyelids (because of excess fat) have changed their faces unpleasantly. They should be in good overall health, with no serious illness. Due to the growing trend of cosmetic surgery,it is important for patients to have realistic expectations before undergoing surgery in order to be satisfied with their results.

To achieve a proper perspective, viewing the before and after surgery images of people who have previously been operated and probably consultingwith themis very helpful. Also, it should be noted that corrective eyelid surgery does not resolve the following problems:

• Crow’s feet, sagging eyebrows and frown lines (Botox injection is a good way for treating these wrinkles)

• Dark circles around the eyes

• Sagging eyebrows

However, we must remember that blepharoplasty is a surgical procedure, and its possible side effects will noteasily dissolve. Therefore, precise specialized consultation is necessary before the operation.

Results:

Wound healing is a gradual process. The incision site usually has a pink tint until 6 months and thenlittle by little turns into a fine white line which is almost fading.

Eyelid surgery leads to advantageous results including:

• Peripheral visual field improvement

• Increased self-confidence

• Lasting results for many years, sometimes lifelong

Complications:

When an eyelid surgery is done by a highly experienced eye specialistcomplications are infrequent.Of course, like any other surgery, there is always the potential risk of complications such as infection or allergy to the anesthetic. Following doctor’s instructions, before and after surgery, will reduce the risk of complications. Some minor post- surgery complications include:

• Temporary diplopia or blurred vision

 • Swollen eyelid

• Asymmetry between right and left sides

• Tiny whiteheads after your stitches are taken out

These are usually temporary and will gradually resolve within a few weeks.

  • Following surgery, some patients may have difficulty closing their eyes especially when they sleep, leading to dry eyes and irritation. This is usually mild and gradually improves after a few weeks. Using artificial tears or moisturizing ointment at bedtime can help to control this mode; but if it is severe and lasts for a long time, it can cause scratches on the cornea or corneal ulcer which can lead to serious visual problems and should be corrected by a second surgery.
  • Very rarely, postoperative bleeding may occur which by creating pressure on the optic nerve may lead to severe and persistent vision loss. To prevent this complication, patients should avoid bending their heads and doing heavy activity. In case of any severe pain or loss of visual acuity,they should immediately go to the doctor.
  • There are some illnesses which increase the risk of surgical complications. Diseases such as hyperthyroidism or Graves’ diseases, dry eye, cardiovascular disease, high blood pressure and diabetes can increase the risk of surgery.
  •  Also history of retinal detachment or glaucoma can also increase the risks of surgery.

For an accurate understanding of risks and to prevent them, it is necessary to discuss all the medical problems, medications and illnesses with your doctor and a precise consultation should be done before surgery.

After surgery, the surgeon will lubricate the incision and sutures with ointment and, if necessary, apply a bandage. As the anesthesia wears off, your eyelids may feel tight and painful. This is usually mild and dissolves with taking common painkillers. If you feel any severe pain, contact your surgeon immediately.Cold compresses, as well as head elevation when lying down (putting a few pillows under your head), are usually recommended and will help to control the swelling and bruising. Theamount ofbruising and swelling vary from person to person;they usually reach their peak during the first week, and generally dissolve after two to four weeks.Your eyelids may be gummy or sticky for a week or so. Taking recommended eye drops often help.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. (e.g., blurred vision, or diplopia)which gradually goaway. You should be examined by your doctor regularly for the first 2-3 weeks. The stitches will be usually removed 4-5 days to a week after surgery. Once they're out, the swelling of the eyelids will gradually subside, and you will look much better.

 

Getting Back to Normal Daily Activities

Most people are able to read or watch television after one or two days. However, it is not possible to wear contact lenses for about 2-3 weeks, and the patient should wear eyeglasses.

After a week to 10 days, when all sutures are removed and the wound is almost healed,normal activity may be resumed.By then, depending on doctor's instructions, the patient will be able to wear makeup to hide the bruising that remains. Usually, the eyes are extremely sensitive to sunlight, wind, and other irritants for 3-4 weeks after surgery. Meanwhile, it is better to wear sunglasses and a special sunblock made for eyelids.

It is better to keep one’s activities to a minimum for 4-5 days, and to avoid strenuous activities (e.g. bending, picking up things, and rigorous sports)for3-4 weeks. You may also be told to avoid alcohol, since it causes fluid retention.These activities can raise blood pressure and may increase the risk of bleeding.

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