Cosmetic Eyelid Surgery or Blepharoplasty

Aesthetically, the eyes are the most important part of the face. The eyes represent the individual's age and reflect the person’s mood and inner feelings, and unfortunately the eyes and eyelids show signs of aging earlier than other organs of the body.

Plastic surgery of the eyelids, also known as "Blepharoplasty", is designed to remove excess skin of the eyelids, improve puffy and droopy eyelids, and in some cases correct eyelid depression, and the main purpose of this cosmetic surgery is to rejuvenate the faces of individuals.

The best candidates for eyelid surgery are people at least 35 years of age, whose droopy and hooded eyelids or puffiness under their eyes have caused unpleasant changes in their faces (in exceptional cases, younger people who suffer from the above problems for special reasons can also undergo this surgery.)

This surgery requires that the person is generally healthy and has no specific illness. One has to have realistic and reasonable expectations of the surgery and its results. It can be helpful to take a look at before and after blepharoplasty photos of other patients and consult people who have already undergone this surgery.

It should be noted that blepharoplasty does not improve these items:

1. Dark circles around the eyes

2. The wrinkles around the eyelid and between the two eyebrows and the forehead (a good way to correct these wrinkles is to inject Botox).

3. Lifting drooping eyebrows that requires a surgery at the same time as blepharoplasty or separately at another session.

Before surgery, a thorough ophthalmic examination is essential. Determining the visual acuity, checking the lacrimal layer, eye movement, motor and sensory nerves of the face and eye, examining the condition of the eyebrows and their symmetry, are some of the tests to be done.

Before surgery the ophthalmologist should be informed if there is a specific illness or a medication allergy or taking specific routine medication. It is necessary to not take blood thinners such as aspirin and the like, according to the ophthalmologist's direction, from 10 days to 2 weeks before surgery.

Prior to surgery, the systemic status of the person should be examined and the necessary blood tests should be done. If there is any specific illness, it should be examined and, if necessary, the ophthalmologist may consult the relevant specialist and the illness should be treated before surgery.

Surgery is usually performed on an outpatient basis and there is no need for hospitalization, and almost always surgery is performed under local anesthesia. In very exceptional cases, surgery may be performed under general anesthesia, depending on the patient's condition and, if deemed appropriate, by the ophthalmologist.

 

Upper eyelid surgery

In an upper eyelid surgery, excess skin, muscle and fat bags (which look like in puffy form, especially in the inner parts of the eyelid) are removed based on the possibilities and the surgeon's choices with a surgical knife, laser or radio waves. In addition, if a drooping eyelid also exists, it can be corrected during surgery.

  Upper eyelid surgery improves the shape and position of the upper eyelid, and if the excess skin or droopy eyelid limits the person’s field of vision, it also eliminates this vision problem and, in total, gives a younger appearance to the person. A brow lift surgery can also be done simultaneously in combination with an upper eyelid surgery.

Lower eyelid surgery

In most cases, lower eyelid surgery is performed to reduce puffiness and fat bags below the eyelids. The final result is sometimes achieved by removing excess fat only by displacement or redistribution the fat, and sometimes by a combination of these both procedures. The procedure is often performed by creating an incision inside the lower eyelid (transconjunctival incision) and at the end it does not need to suture. If there is excess loose skin, an incision should be created under the eyelashes line, which the excess skin or loose muscle is removed through it. At the end, the incision is stitched delicately. In the lower eyelid surgery, laser or radio waves can also be used. The advantage of using lasers and radio waves is the simultaneous closure of bleeding vessels in the removal of the fat tissue, thus reducing the risk of bleeding during and after surgery and its possible risks and complications.

At the end of the surgery, the surgical incision site and the stitches are covered with a lubricating ointment and there is no need for eye dressing and bandage. The eyelids may feel tight and sore or pain as the numbing medicine wears off. The discomfort is usually mild and easily controlled with pain medicine. If you have any severe pain or reduced vision, be sure to call your ophthalmologist. It is generally recommended to use a cold compress for 24 to 48 hours and keep your head raised (use several pillows during sleeping). After 48 hours, if you have bruises, use a warm compress. These measures help to control swelling and bruising of the surgical site.

The rate of swelling and bruising of the surgical incision site varies from person to person, and usually the swelling and bruising will be maximized after a few days and resolve between two to four weeks. One to two weeks after surgery, the eyelids have mild secretion or adhesion. The use of appropriate drops helps to eliminate these discomforts. In the first days after surgery some complications like tearing, light sensitivity, and temporary vision problems (such as mild blurred or double vision) may occur which are gradually resolved. The stitches are usually removed six to eight days after surgery, and after suture removal, the swelling of the eyelids is reduced and the person looks better.

 

Best time to return to daily activities

Most people can read and do their daily activities two days after surgery. After six to eight days, when all sutures are removed and the wound heals, you can do light sports activities. From this time if your ophthalmologist determines, you can use cosmetics to hide the bruises and the surgical wound. Usually between three and four weeks after surgery, the eyes are sensitive to sunshine, intense wind and dust. During this time, it's best to wear large appropriate sunglasses.

After two weeks, you can do heavy activities, such as lifting heavy objects or doing power exercises.

Possible post-operative complications

Any surgery can have its complications. Due to the fact that the eyelids are in direct contact with the eyes and a person’s vision, it is recommended that eyelid surgery is carried out by subspecialists of eye plastic surgery who are familiar with the exact anatomy of the eyelid, and do not injure a person's vision. Certainly, the more experienced the surgeons are, the less post-operative complications occur. Experienced ophthalmologists of Noor Eye Hospital perform eyelid surgery carefully and provide patients with the highest quality services.

The mild post-operative complications include: double vision or mild blurred vision, swelling and bruising of the eyelids and around them (often with varying degrees of intensity on both sides), asymmetry of the surgical incision site on eyelids, small white wounds or spots on the stitches surface. These complications are temporary and resolve after a few weeks.

After surgery, the eyelids may not completely close in some people, especially while sleeping. This complication is usually mild and gradually gets better after a few weeks. Using artificial tear drops and moisturizing ointments during sleeping helps you decrease this complication, but if this condition is severe and makes the eyelid remain open for a long time, it can cause dry eye and corneal ulcers, which may lead to serious eye problems. In this situation, it should be followed by a second corrective surgery.

In very rare cases, lower eyelid surgery may result in an acute hemorrhage, which by pressuring on the optic nerve leads to severe and permanent vision loss. In order to prevent this complication, the person should avoid bending or doing strenuous activities in the early hours after surgery, and should be examined by an ophthalmologist if any severe pain or vision loss occurs.

About remaining effect of the stitches and scars site, it should be noted that the surgeon's acquaintance with the vital anatomy of the vessels and nerves and vital tissues of these areas is very important. If the surgeon makes tiny cuts (incisions) into the natural creases or folds of the eyelids, it will not have significant effects on the eyelid. The scars may remain slightly pink for 3-6 months or more after surgery. They will fade to a thin, nearly invisible white line and gradually they will dissolve. In the lower eyelid, if there is no excess skin and only puffiness is due to fatty outflow, the procedure is performed by creating an incision inside the lower eyelid (transconjunctival incision) and at the end it does not need to suture. If there is excess loose skin, an incision should be created under the eyelashes line, where will not leave a noticeable effect.

An eyelid surgeon tries to make the two sides look quite similar after surgery, but occasionally and rarely, due to the difference in the repair process on both sides, eyelids may not be completely symmetric.

About the possibility of returning this problem with increasing age, it should be noted that this issue varies from person to person, and as we can not prevent from aging, we can not completely prevent from changing tissue and loosing the skin over time, but by controlling health and skin care, it can be controlled to some degree.

The points that a candidate for Bleoharoplasty should know:

Do not use some medications such as Aspirin, Ibuprofen, Indomethacin, Piroxicam and Mefenamic Acid for about two weeks before surgery, and if you need any pain killer for any reason, just use simple Acetaminophen or Codeine.

1. Before entering the operating room, be sure to completely remove your makeup.

2. Use a cold compress for 24- 48 hours after surgery. To do this, you can use a bag of frozen food, put a few cubes of ice in it and place it on your eyelids and around your eyes. Be sure before placing the ice bag on your eyes cover the surgical wounds of your eye lids with two pieces of sterile gauze. Use a warm compress after 48 hours to remove any possible bruises.

3. During the first two days after surgery, when you sleep, it is best to lift the pillow below your head and sleep with your head elevated 45 degrees. This will minimize the bruising and swelling of the eyelids.

4. Take your prescribed medicines according to your ophthalmologist’s instructions.

5. According to recommendation of your surgeon, 6-8 days after surgery, go to the hospital or your surgeon’s office for suture removal.

-What is blepharoplasty?

- Who are the best candidates for blepharoplasty?

-What should be expected from blepharoplasty?

- What should an ophthalmologist do before blepharoplasty?

- Is an eyelid surgery performed under general anesthesia?

-What can cause pain after blepharoplasty?

-Can blepharoplasty be performed on both of upper and lower eyelids?

- When can I return to daily activities?

- How long does it take for suture removal after blepharoplasty?

-Is blepharoplasty a dangerous surgical procedure?

-Is it possible to use cosmetics after blepharoplasty?

 

 

 

-What is blepharoplasty?

It is plastic surgery of the eyelid which is performed to remove excess skin and puffiness of the eyelids, and in some cases correct eyelid depression.

- Who are the best candidates for blepharoplasty?

The best candidates for eyelid surgery are people at least 35 years of age, whose droopy and hooded eyelids or puffiness under their eyes have caused unpleasant changes in their faces.

-What should be expected from blepharoplasty?

1. Dark circles around the eyes are not removed.

2. The wrinkles around the eyelid and between the two eyebrows and the forehead (a good way to correct these wrinkles is to inject Botox).

3. Lifting drooping eyebrows that requires a surgery at the same time as blepharoplasty or separately at another session.

-What should an ophthalmologist do before blepharoplasty?

Before surgery, a thorough ophthalmic examination is essential. Determining the visual acuity, checking the lacrimal layer, eye movement, motor and sensory nerves of the face and eye, examining the condition of the eyebrows and their symmetry, are some of the tests to be done. A complete blood test and checking the person's systemic condition is also essential.

- Is an eyelid surgery performed under general anesthesia?

Except in some cases, surgery is usually performed on an outpatient basis and there is no need for hospitalization, and almost always surgery is performed under local anesthesia.

-What can cause pain after blepharoplasty?

The eyelids may feel tight and sore or pain as the numbing medicine wears off. The discomfort is usually mild and easily controlled with pain medicine.

-Can blepharoplasty be performed on the both of upper and lower eyelids?

Yes; this surgery can be performed for the beauty of the upper and lower eyelids.

- When can I return to daily activities?

After two days you can do your usual activities.

- How long does it take for suture removal after blepharoplasty?

This is a short time and usually between six to eight days, all sutures are removed.

-Is blepharoplasty a dangerous surgical procedure?

If this surgery is performed by subspecialist ophthalmic plastic surgeons, there is no problem because they are familiar with the exact anatomy of the eye and eyelid.

-Is it possible to use cosmetics after blepharoplasty?

After six to eight days, when all the sutures were removed and the wound heals, cosmetics can be used to hide the bruises and surgical site.