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BLEPHAROPLASTY: WHY HAVE AN EYELID REDUCTION?

Plastic Surgery Dubai | 25 November 2021

The skin loses its elasticity and our muscles slacken with age. For the eyelids this results in an accumulation of loose skin which collects as folds in the upper lids and forms deepening creases in the lower lids. At the same time there is slackening of the muscle beneath the skin allowing the fat, which cushions the eyes in their sockets, to protrude forward to give the appearance of bagginess. In some families there is an inherited tendency for bags to develop during early adulthood before any skin changes.

What is blepharoplasty surgery?

Blepharoplasty surgery, commonly known as an eyelid reduction, is an operation to reshape the eyelids. An upper-eyelid reduction can improve your vision and make you look younger. A lower-eyelid reduction can help to reduce wrinkles and puffiness.

Why have an eyelid reduction?

With age, our muscles slacken and the skin loses its elasticity. For the eyelids, this results in folds in the upper lids and deepening creases in the lower lids. Also, the slackening of muscle beneath the skin allows the fat which cushions the eyes in their sockets to bulge forwards to give the appearance of bagginess. In some families there is an inherited tendency for bags to develop during early adulthood.

Folds, creases and bagginess often seem worse in the morning, particularly after periods of stress and lack of sleep. This is because fluid that is normally distributed throughout the body when it is upright tends to settle in areas where the skin is loose, such as the eyelids, when a person is lying down. The ageing process can also cause drooping of the eyelids, and folds of skin to gather in the upper eyelids. Sometimes there is so much skin that the upper lids hang over the eyelashes.

What will happen before my operation?

We will meet to talk about why you want surgery and what you want. I will make a note of any illnesses you have or have had in the past. In particular, you should tell me if you have ever had any thyroid disease, high blood pressure, diabetes or eye disorder (such as a detached retina or glaucoma). I will also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor. I will examine your eyes, face and skin, and may take some photographs for your medical records. I will ask you to sign a consent form for taking, storing and using the photographs.

I will measure your height and weight to make sure that it is safe to do an operation. If you are overweight, pregnant or planning to become pregnant, I may suggest delaying your operation. If you would be having the surgery under a local anaesthetic, I will make sure that you can lie flat and still. I may want you to be checked out by an ophthalmologist.

How is the surgery performed?

Eyelid reductions can be carried out under local anaesthetic or general anaesthetic. In a typical procedure, I make cuts that follow the natural lines of your eyelids – in the creases of the upper lids and just below the lashes in the lower lids (see the eye on the left of the diagram opposite). These cuts are extended a little way into the crow’s feet (also known as laughter lines) at the corner of the eyes.

What is the alternative treatment?

Sometimes, a sagging forehead and eyebrow can make the eyelid look like it is sagging. I may recommend an eyebrow lift instead of, or at the same time as, an eyelid reduction.

Only wrinkles in the skin which is cut away by the surgery will be improved. Folds of skin extending on to the cheek will not normally be improved. If you have wrinkles and saggy skin elsewhere on your face and neck, it may be useful to have a facelift or necklift (or both) at the same time as the eyelid reduction. A facelift can be used to not only lift the eyebrow and the upper eyelid, but also to lift and open the outer corner of the eye.

Although an eyelid reduction is the best way to reduce sagging of the eyelid, a laser can sometimes be used to burn the surface of your skin in a controlled way. This is called laser resurfacing and it can be carried out at the same time as the eyelid reduction to improve any remaining wrinkles. After laser resurfacing, the skin heals to be softer and less wrinkled. This improvement is not permanent, and the procedure does not work well on dark skin. It has no effect at all on dark circles under the eye.

Botox (injections of the botulinum toxin) can also be used to smooth out fine wrinkles.

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