Eyelid Aesthetics (Blepharoplasty)
What is eyelid aesthetics?
Eyelid aesthetics, also known as blepharoplasty, refers to the correction of sagging, bagging, increased wrinkles, and drooping of the eyelids and eyebrows, mostly due to aging, using lasers, surgery, or injectables and fillers applied around the eyes.
As we age, the skin tissue loosens and sags, and the tissues that hold the fat pockets around the eyes, called septum, weaken, causing the herniation of fat and leading to bags under the eyes. Additionally, the connection between the eyelid-lifting muscles and the eyelid weakens, leading to sagging. Gravity also causes the eyebrows to droop. These changes can lead to psychological distress, reduced visual field, impaired visual function, and headaches or fatigue later in the day. Eyelid aesthetics aim to correct these issues, providing a younger appearance and a more comfortable life.
What procedures are involved in eyelid aesthetics?
Medications: Botox is widely used to correct wrinkles around the eyes and forehead, eliminate crow’s feet at the corners of the eyes, and lift the eyebrows. Botox is a type of toxin that paralyzes the muscles in the applied area and smoothens the wrinkles in the skin. Its effect is temporary, lasting about 6 months, and can be repeated as needed.
Laser Treatments: Carbon dioxide laser can eliminate fine lines and wrinkles on the eyelid skin. The laser shots remove the superficial layer of the skin, and the newly formed surface tissue becomes firmer and tighter, resulting in tighter skin and a younger appearance.
Surgical Treatment: Age-related changes are often corrected surgically. Sagging eyelid skin, herniated fat tissue due to weakened eyelid tissues, eyelid and eyebrow ptosis, drooping tear ducts, and xanthelasmas caused by fat accumulation all require surgical intervention. The exact surgical treatment depends on the individual case.
Upper Eyelid Aesthetics:
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Excess skin between the eyelash line and the upper eyelid crease is removed.
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If there is fat herniation, some fat can be excised.
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If ptosis (drooping of the eyelid) is present, it can be corrected in the same session.
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Rare tear duct drooping can also be repaired.
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Eyebrow lifting can be done. Eyebrow drooping should be properly evaluated; sometimes, lifting the eyebrows alone can be sufficient to correct eyelid sagging.
The most significant complication in upper eyelid surgery is the removal of too much skin, which could prevent the eyelid from closing properly. This is a rare complication and generally avoided with an experienced oculoplastic surgeon.
Lower Eyelid Aesthetics:
- Excess skin and fat are removed.
If the excess skin is minimal and only bagging is present in the lower eyelids, fat can be removed from the inner side of the eyelid without using stitches, avoiding visible scarring.
If there is excess skin, incisions are made along the natural skin folds about 2mm below the eyelash line to remove the extra tissue.
- In cases with lower eyelid laxity, the eyelid must be tightened. Otherwise, there may be retraction.
When removing fat, it's crucial to control bleeding well and avoid excessive removal of skin. Lower eyelid surgery is more intricate than upper eyelid surgery, and during fat removal under local anesthesia, some pain may be felt. Therefore, it is generally preferred to perform fat removal under general anesthesia.
After eyelid surgery, the eyes are not closed, and an ice application is immediately started. Continuous ice application on the first day significantly reduces swelling and bruising. The patient uses oral and topical antibiotics for one week. Stitches are removed after a week. Since the stitches are placed according to skin folds, there will be no visible scarring.