MedClinic > Blog > Plastic > Blepharoplasty

Eyes are the mirror of the soul, but sometimes they are the first to reveal the truth: our age, degree of fatigue, the amount of sleep lack due to working in the nights, all our tears and laughter will certainly remain on our face.

The eyes are the first to be ageing, since the skin on the eyelids is elastic and thin, having a large amount of subcutaneous fatty tissue, compared to nearby tissues, it is easily susceptible to stretching and is ageing the first. In some people, this is due to structural features and anatomy of the eye. Often, oedema that forms on the eyelids appears at a young age, due to the weakness of the muscular-fascial apparatus, and is manifested by hernias under look of bags and swelling under the eyes and overhanging of the upper eyelids. For the majority, this problem is age-related, since our skin eventually gives in to the law of gravity and nothing can stop this process. Sometimes, even the highest quality creams can not cope with such problems, and then plastic surgery for eyelids, or blepharoplasty comes to the rescue.

Blepharoplasty is a surgical method involving excision of stretched and overhanging skin and subcutaneous adipose tissue of the eyelids. This operation is performed under local anaesthesia, but the patient can choose general anaesthesia.

Preparation for blepharoplasty is an important stage, which cannot be neglected, since it, along with other factors, indirectly affects the rehabilitation process.

A few important rules that must be observed in the preoperative period to avoid complications and for mild performance of surgery:

  1. Refuse the use of decorative cosmetics for the eyes 12 hours before the estimated time of surgery.
  2. Refuse tanning in direct sunlight and a solarium for 2 months.
  3. Pass the general clinical laboratory tests prescribed by your doctor.
  4. For at least 3 weeks stop taking aspirin and its derivatives.
  5. For 2 weeks, cancel the intake of antiplatelet agents and anticoagulants if they are not prescribed for vital indications.
  6. For 1 week, exclude alcohol, and a few days before surgery – smoking. Nicotine constricts blood vessels and impairs blood circulation, thereby reducing regeneration and healing.
  7. Before the operation, you need to have a good rest and sleep, in order to avoid nervous strain
  8. Make an appointment in advance for an operation so that your attending physician can adequately conduct a set of examinations, collect an anamnesis and schedule a time convenient for you.
  9. The difference between the preparation depends on the type of anaesthesia. If general anaesthesia is supposed to be introduced during the operation, then the patient should not eat anything 8-12 hours before the operation, if the patient decided to use local anaesthesia, then he may not worry about eating and eat before the operation itself.

Types of blepharoplasty:

In modern surgery, the most common and often used are the upper, lower and circular blepharoplasty (upper and lower eyelids at the same time).

Indications for upper blepharoplasty:

– Hanging of the upper eyelid;

– Excess of tissue over the eye;

– Puffiness of the eyelids;

– Hernias formed from subcutaneous fat, giving the look a tired look;

– Shifting down of the outer corners of the eyelids;

– Specific shape and section of the eyes;

– Fold of the upper eyelid, which for anatomical reasons is absent;

– Scars and skin defects obtained during accidents, injuries or certain diseases – papillomas, ectropion (twisting of the eyelid towards the eyeball, pulling eyelashes, causing constant friction and chronic inflammation of the sclera).

The problems described above have not only a cosmetic defect, but also affect the function of the visual apparatus of the eye, causing a decrease in the range of vision and sharpness of vision.

How is it carried out?

During upper blepharoplasty, the incision is performed along the natural fold of the eyelid, the required amount of tissue is removed with excision of adipose tissue. The seam on the upper eyelid looks highly cosmetic and almost invisible.

Indications for lower blepharoplasty:

– “bags” and swelling under the eyes;

– excess of the lower eyelid;

– wrinkles of various location, depth and severity;

– injuries, etc.

How is it carried out?

Today, there are two of the most commonly used methods for performing lower blepharoplasty:

Percutaneous or transcutaneous (Latin: trans-through, cutis-skin) access. This access is considered classic and is often recommended for older patients who have excess skin on the lower eyelid.

The transcutaneous method is good because it solves two problems at once:

  1. Removing excess sluggish, stretched skin;
  2. Removal of fatty hernias (if necessary);

The incision is made through the ciliary edge, with the further carrying out of all manipulations, cosmetic seams are applied.

Transconjunctival access in practice is considered more sparing for the patient. It is practiced more often in patients of young age, who need exclusively removal of fatty hernias.

The incision is performed in line with the conjunctiva (the inner side of the eyelid), through which all the manipulations are further conducted. No traces of surgery are visible, as the incision is made on the inner surface. The period of postoperative rehabilitation is significantly reduced.

Rehabilitation and care after the procedure:

  1. Avoid contact with water, cosmetics, direct sunlight before the healing of cutting sites.
  2. Exclude all types of physical activities, leading to eyelid tension.
  3. Diet (to minimise salty, smoked food, coffee, alcohol, smoking).
  4. Sleep in a supine position with a raised head end helps to relieve swelling.
  5. Rinse eyes with saline.
  6. Apply cold compresses to the periorbital area to relieve inflammation and prevent bruising.