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Blepharoplasty: everything you need to know about eyelid surgery

Blepharoplasty Dubai | 16 November 2019

The eyes have a dramatic impact on appearance and can let others know how we feel – whether we are happy, sad, angry, or tired. They are one of the first things we notice and they have a great deal to do with how others perceive us as they glance at our facial features. Eyes with excessive or sagging skin are frequently associated with a perception of old age (even when they occur in a young per-son) and tiredness. 

Unfortunately the eyes are often one of the first areas on the face to show tell-tale signs of aging. Over time, the eyelids may begin to droop and sag. Bags can form under the eyelids making it hard to feel alive and vibrant. The loose skin over your eyes and the fat bags under your eyes may be making you look more tired and older than you feel inside. 

Cosmetic eyelid surgery, or blepharoplasty, is an operation (actually, a set of operations) for your eyelids designed to maintain the appearance of your eyes. Surgery of the eyelids, blepharoplasty upper and lower, can correct sagging eyelids, remove fatty pouches beneath the eyes and remove excess skin from the upper eyelids. 

The result is a brighter, more alert, and rested appearance. 

WHAT IS AN EYELID SURGERY (BLEPHAROPLASTY)

Blepharoplasty is an operation performed on the eyelids (upper, lower or both) which involves the removal of skin and soft tissue, resulting in a fresher more youthful appearance to the eyes and entire face.

The blepharoplasty procedure is done to reduce the heaviness around the eyes. This appearance can be associated with skin, fat, and muscle excess both to the upper and lower eyelids leaving patients with a tired appearance even though may feel well rested. Blepharoplasty is often done as an elective surgery for cosmetic reasons. Lower eyelid blepharoplasty seeks to improve puffy lower eyelid “bags” and reduce the wrinkling of skin.

Blepharoplasty is sometimes needed for functional reasons. When an advanced amount of upper eyelid skin is present, the skin may protrude over the eyelashes and causes a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision.

HOW IS EYELID BLEPHAROPLASTY PERFORMED?

The surgery is performed under local anesthesia with or without IV sedation. Because of the facial anatomy changes from one individual to another there is not one procedure that suits every individual. Each operation is customized to suit the individual’s anatomy and the desires of the individual. In general terms, the following principles apply to blepharoplasty surgery.

For upper eyelid surgery, the incision is made in the natural skin fold. Excess skin is removed and a conservative amount of orbicularis muscle is removed. Although it is traditionally advocated to remove eyelid fat during the blepharoplasty procedure, I believe that in many cases the fat can be repositioned and contoured as opposed to completely removed. This more modern approach to blepharoplasty leaves the eyelids looking more youthful and avoids the hollowed sunken surgical look of years gone by.

For lower eyelid surgery, the incision can be internal or external. Through the incision on the inside of the eyelid (trans-conjunctival) fat tissue is removed as required. If excess skin removal is required this can often be accomplished by a well concealed incision placed laterally. The skin is closed with very fine sutures.

If the excess skin is enough I always prefer to approach the surgery with the external scar, which is placed very close to the eyelashes line, and will be extended sometimes in the lateral area of the eye. With this technique, you can address at the same time the extra skin and the fat bags, targeting also an excess of the orbicularis muscle and remove it.

WHO IS A CANDIDATE FOR BLEPHAROPLASTY?

Do you look tired even though you aren’t? Is the skin of your upper eyelid overhanging the normal lid crease and starting to impinge on the eyelashes? Are there bulges and bags where there shouldn’t be? Do your eyes appear smaller than they did in years past? If you have answered yes to any of these questions you might be a good candidate for blepharoplasty. 

The best way to determine if you are a good candidate for an eyelid tuck is to book a consultation to make sure that you are a suitable candidate for surgery at the time of your consultation.  The ideal candidate for a blepharoplasty is someone who has developed noticeable pockets of fat in the lower lids, or excessive, redundant skin in the upper lids. Anyone with signs of aging in the upper or lower lids may benefit from blepharoplasty.  Blepharoplasty may be also be used to improve sight by removing excess skin out of the patient’s field of vision.

Eyelid blepharoplasty can make a remarkable difference in the appearance of your face, alleviating the appearance of tiredness and old age. Your eyes appear fresher and more youthful and these results may last for many years. The degree of improvement varies from patient to patient.

WHAT WILL HAPPEN AT THE CONSULTATION?

I will discuss the degree of change you would notice in your appearance. The procedure and its risks and limitations will be explained to you. Your medical history will be reviewed and then I will examine the skin and fat around your eyes. Your eye sight, peripheral vision and tear ducts might be checked if necessary.

HOW LONG DOES THE SURGERY TAKE?

The procedure general takes 60-90 minutes depending on whether upper or lower eyelids are done.

WHAT WILL I FEEL DURING THE PROCEDURE?

Initially you may feel a tight sensation around the eyes, with minor discomfort that lasts for a day or two. A mild pain reliever can be taken as needed. People who have had the procedure are often surprised at how painless eyelid surgery can be.

WHAT CAN I EXPECT AFTER SURGERY?

You will be given an instruction sheet to take home with you, which will outline the steps you should take to care for your eyelids after surgery. The first evening after surgery, you should rest quietly with you head elevated. Cold compresses are to be used as per the instruction sheet provided. 

WHAT IS THE RECOVERY PERIOD LIKE?

At first the incisions will probably be red and somewhat bumpy. Eventually the resulting scar should become flat and inconspicuous. The swelling and discoloration around your eyes will gradually subside, and you will start to look and feel better each day. Swelling and bruising varies considerably from person to person. Stitches will be removed after 7 days.

The scars are usually minimally visible even if sometimes an extension in the lateral part of the eye is needed and this scar can remain more visible than the others.

Bruising typically disappears within 7-10 days. After the first week you will be permitted to use makeup, if desired, to conceal any discoloration. Your vision might be blurry for a few days. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. You need to avoid wearing contact lenses for the first week. You might also consider wearing dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation. The eyes may tire easily for several weeks.

HOW LONG DOES THE SURGERY LAST?

Following blepharoplasty surgery the face will have a more youthful appearance and in many cases the eyelids feel less heavy. The results generally last 10 to 15 years and the surgery usually does not need to be repeated.

HOW PRECISE IS THE RESULT?

There is no such thing as a perfect operations and no surgeon is perfect. No individual has perfect pre-existing anatomy and no skin wound heals without some degree of scarring. A mild degree of asymmetry between eyelids is the rule, rather than the exception. A realistic expectation from the surgery would be an 80% improvement in the upper eyelid appearance and a 70% improvement in the lower eyelid appearance.