Upper and Lower Blepharoplasty

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Upper and Lower Blepharoplasty

Plastic surgical procedures have to be performed by plastic surgeons!

In ideal case the eyelid does not have excess skin, nor puffiness and its muscletone is firm. Blepharoplasty is a common aesthetic procedure, but not just in the older age-group. There are persons who need eyelid surgery around her/his 20’s-30’s of age because of their susceptibility.
Our eyes are one of the most important determining factors of the characteristic of our face. The signs of aging, the wrinkles present  first in the eyelids. The sagging, wrinkled eyelids and bags under the eyes make tired and old appaerance to their owners. We mostly recommend to have rhytidectomy after the development of wrinkles around the eyes and bags under the eyes. Our skin has a natural aging process. The amount of collagen and flexible filaments of the skin is decreasing, parallel to this, the elasticity will decrease as well. Around the globe of the eye excess fat tissue will appear. This fatty deposit will present more in the front and will cause the puffiness of the eyes. This excess fat can not be eliminated by weight loss. Because of the previously mentioned reasons the soft skin of the eyelids will become wrinkled and under the lower eyelid bags will appear.
Because of the atrophy of the skin and the underlying tissues the skin will loosen and sag. Those wrinkles which are physiologically presented, will be more deeper and new wrinkles will present. This process occurs in different ages in the different persons and progresses by different velocity. There are women and men who has these malformations in early ages. Beyond the individual factors certain factors strongly influence and speed up the natural aging of the skin. This factors are the ethnic background, weather conditions ( number of sunny days, humidity, wind, temperature fluctuations ), excessive sunbathing, lifestyle habits ( excessive stress, excessive consumption of alcohol and nicotin, insufficient sleep, lack of relaxation ), certain diseases ( hepatic diseases, artherosclerosis, high blood pressure, diabetes, taking medication for a permanent period ). As much exposure of ultraviolet radiation the skin gets through the life, as bigger the lesion in the skin. These malformations are more visible on the eyelids, face and neck. Because of these malformations You look more older than You really feel yourself. During the operation the loosened, wrinkled skin will be strechened, and the excess skin will be removed. The final result of the blepharoplasty will be visible after the total cessation of swelling. After the eyelid surgery the skin of the eyelids will be again firm, and the smoothness and youth of the skin around the eyes will be reconstructed. Blepharoplasty makes firmer and younger the old, tired and floopy eyes. As the eyes are situated in the central part of the face, they have a favorable effect on the whole face. The blepharoplasty by itself does not resolve the problems of sagging eyelids, wrinkles and folds of the face and the neck. These malformations can be solved as well, but the eyelid surgery has to be perfomed simultaneously with other surgical procedures (endoscopic forehead plasty, laser rejuvenation and resurfacing, wrinkle filling and facial plasty).
It is a natural expectation that women and men wants to have smooth eyelids and eyes without bags, thus their lineament can remain youthful in every ages. The eyelid surgery gives back the elasticity of the skin around the eyes, thus enhances the youthful appearance and increases self-confidence as well.

WHO IS CANDIDATE FOR EYELID SURGERY?

  • Excess skin in the upper eyelid
  • Loosen and sagging skin from the upper eyelid, which can impaire the normal vision
  • Puffiness in the upper eyelid, which makes a tired appearance to the face
  • Excess skin and fine wrinkles of the lower eyelid
  • Bags and dark circles under the eyes, often excessive identation at the rim of the bone in the lower eyelid
  • Sagging lower eyelid is visible.
  • The person looks older than her/his real age because of the problematic eyelids.

The upper and lower eyelid surgery can help in all of these. The blepharoplasty can not correct all the expectations -sometimes unreal-, which were dreamt by the patients. We can not resolve everything with the operation. On the one hand it has limits by the techniques of the operation, on the other hand just only those corrections can be performed which

 are fit to the harmony of the face. The eyelid surgery is not a solution for sagging eyebrow, for wrinkles and folds of the face and neck. These malformations can be reconstructed, but the eyelid surgery has to be complemented by other procedures ( endoscopic forehead surgery, laser rejuvenation, wrinkle filling and facial plastic surgery ).

THE FIRST CONSULTATION

At the consultation we will discuss Your problems, expectations and desired outcome. We will talk about everything which is in connection with the eyelid surgery and important in the aspect of the rejuvenation procedure of the eye. We will examine the eyelids, the eyebrow and the face, and their proportions to each other. We will put attention to the genetic factors, which can influence the operational plan. We will draw attention to the asymmetry and the neural affection. We will check the quality of the skin of the eyelids and their fatcontant. There is asymmetry which even can not be corrected by blepharoplasty. We will give You some advices about those procedures, which can reconstruct the facial appearance. These are usually performed together with the eyelid surgery: endoscopic forehead plasty, facial plasty, wrinkle filling and laser rejuvenation and resurfacing.
We will take some photographs –from different directions- about the present condition. The photographs allow the patients to examine and evaluate the face from different directions. If there are other malformations on the face, the eyelid surgery by itself is not sufficient, other procedures can be necessary to be performed. We will decide the necessity of this together with the patient. We will show You the expected result of the operation in front of a mirror.
You will be asked about Your medical conditions, medical treatment, drug allergies, use of current medications and previous surgeries, procedures. It is very important to get accurate information about every medical conditions to plan the procedure with the best thoughtfulness. After the proper information the well-planned blepharoplasty will  ensure You the biggest satisfaction.

REVIEW ABOUT THE EYELID SURGERY

THINGS TO DO BEFORE THE OPERATION

Before the blepharoplasty some examinations can be necessary to make. With their results the operation will be performed in the best security. If You smoke, take aspirin or other blood thinner medications, or any anti-inflammatory drugs or other medications, please let us know! This drugs can increase bleeding or can cause other interactions during the general anaesthesia.

SURGICAL PROCEDURE

The eyelid surgery is almost always performed in local anaesthesia, without any pain.
During the surgical procedure we will remove the excess skin from the eyelids, thus the skin of the eyelids will become again tight. So many years ago we just removed the loosen skin and after the repositioning we closed the incision. Today with the modern procedure we not only treat the excess skin but the muscle and fat tissue under the skin as well. If it is necessary we cut out the muscle and the fat deposits of the eye cavity which can cause the presentation of the bags under the eyes. This ameliorates the result and the durability of the operation. At the end of the operation we close the incision with sutures and put the little surgical tapes.
In special cases we can make the result more beautiful by laser rejuvenation and resurfacing.

Upper eyelid surgery :

The incision is in the natural crease of the upper eyelid. If the excess skin is too much, we need to make the incision longer laterally into a laugh line. From this incision we remove the excess skin and fat tissue. After the total recovery these scars are almost invisible and they are in partly hidden position.

Lower eyelid surgery :

The incision is just below the lower lash line. After total recovery the scar is invisible. If the excess skin is too much, we need to make longer the incision laterally into a laugh line. From this incision we remove the excess skin, muscle and fat tissue. If it is necessary, we make plain the fat tissue, thus the puffiness and swelling of the lower eyelid will disappear. If the muscle is too loose, we cut out a little from it and after we close the incision.
In the case if the lower eyelid does not have excess skin, the excess fat can be removed without incision.
According to personal features the lower eyelid surgery can have different results, not everybody can have perfect result.

THINGS TO DO AFTER THE OPERATION

After the eyelid surgery it is always suggested to relax and spare yourself with due foresight. Wearing sunglasses can help to protect the eyes against the irritative effects of the sun and the wind. On the next few days after the operation is recommended to sleep with upraised upper body. The tissues around the eyes belong to the most loosest tissues of the body. Thanks to this laxity the eyelids will be swollen, can have bruises and a little amount of blood can leak from them in the first two days. Temporary tension and burning, itchy feeling can occur. The eye gap can be cleaned by camomile tea impregnated ear cleaning stick. The patient can feel tension, often can water, even after the operation of the lower eyelid.
It is very rare that under the conjunctiva a little hematoma appears. It needs more time to disappear, than the bruises around the eyes. Between the first and the third days after the operation You can feel more discomfort, but this is just a temporary problem, which is caused by the above mentioned malformations. The initial decoloration and swelling are just temporary symptoms and disappear fast. Temporary asymetry can be presented on the eyelids, which is caused by oedema and bruises. These will disappear by themselves in a few days. In very rare cases this can last for a few weeks as well, but will disappear without any sign simultaneously with the swelling. These are natural consequences of the operation.
The first two days after the operation You have to put ice around the eyes. Using eye drops can help to decrease the watering, the dryness of the eyes, and can help to prevent the conjuctivitis which can develop in very rare cases.  It is recommended to wear dark sunglasses after the operation. The stitches are usually removed the seventh day after the operation. It is not recommended to use make-up on your eyelids in the first two weeks and eye-lash in the first three weeks.
The operational scars will be visible till the first two-three weeks after the operation, after 2-3 months they will be almost invisible. The final result of the eyelid surgery will be visible two months later, but 90% of the result can be seen after the third week as well.
Six weeks after the operation avoid any stiff sports and physical activity! During this period You have to avoid sunbathing and going to the solarium! Do not use your contact lenses in the first two weeks.
After every plastic surgical procedures You have to return for follow-up care regularly, thus after the eyelid surgery as well. The regularity of this depends on the type of the procedure and other personal feautures of the patient. At the previously discussed follow-up cares we will examine the operational area and discuss about the things to do in the future. Please remember that if You have any questions or problems, please do not hesitate to contact us independently the appointment!

EYELID SURGERY RISKS AND COMPLICATIONS

If the operation is performed by a qualified plastic surgeon, the operation and the post-surgical recovery period will be without any unexpected episodes. The eyelid surgery as all other surgical procedures can have complications, even ideally. Besides the generally presented complications ( bleeding, infection, poor healing of incisions ) – which are very rare -, can occur some special complications because of the blepharoplasty. Because of the temporary swelling closing of the eyes can be imperfect, and in the case of lower eyelids they can turn out a bit temporary. Rarely it can happen that under the very thin eyelid skin the scars can be visible as little nodes but these will totally disappear by the time. In the incision line can occur some little white cysts (epithelial cyst), which is harmless and it can be removed with a tiny procedure in a few minutes.
The anaesthesia can cause temporary double vision, which will totally cease after the elimination of the anaesthetic effect.
With the most modern devices, materials and stitches which were inserted by the most friendliest techniques it can happen that the colour of the scar will be brisk and red, thick in touch and a little bit widened. This depends on mostly personal liability, thus it can have significant differences. This malformation decreases by the time, thus the scar will be thinner and its colour will lighten. If this does not occur, we remove the scar and treat the new scar with other special scar-treating methods.
The complications can be vanquished or revised with the appropriate treatments and procedures, thus they do not effect the final result of the operation or slightly influence it.

RESULT

Blepharoplasty makes firmer and younger the old, tired and floopy eyes. As the eyes are situated in the central part of the face, they have a favorable effect on the whole face. In reasonable cases we can ameliorate the results with other procedures (endoscopic forehead plasty, laser rejuvenation and resurfacing, wrinkle filling and facial plasty). Eyelid surgery makes women and men more confident giving back them their self-reliance.
You have to know that the scars will pale by the time and fade into their environment, but never will be totally invisible, not even in the case that the incisions are in natural creases of the upper and lower eyelid.
The durability of the blepharoplasty is long-lasting, but not forever. Gravity and changes in the flexibility and water-content of the tissues, other alterations with aging have effect on the quality and quantity of the tissues in the eyelid and the face. These influence the appearance. If the years let sign on the eyelids, the face or the neck, other facial rejuvenation procedures can be necessary to be performed, which can reconstruct these signs.