Blepharoplasty Cosmetic Eyelid surgery (Eyelid Lift)

Introduction:

Blepharoplasty (Cosmetic Eyelid surgery), also called eyelid lift, is a type of cosmetic plastic surgery performed in order to modify the eye region of the face in an aesthetic aspect. The procedure of Blepharoplasty involves excision and the removal, or the repositioning (or both) of the excess tissues, the skin (Excess skin & fat called Dermatolochalasis / Blepharochalasis) and the fat, and the augmentation of the corresponding muscle and tendon tissues. This procedure can encompass a mid-face lift & fixes cosmetic and functional problems of the ‘periorbita’ – the area from the eyebrow to the upper portion of the cheek (extended blepharoplasty). Lower blepharoplasty surgery or the upper eyelid surgery should be performed only by a reputed oculoplastic surgery. Although the procedure is fairly simple, but the ocular structures are delicate therefore chances of unsuccessful surgery can be present.

Objectives of Blepharoplasty procedure are as follows:

Restoration of correct functioning to the affected eyelids

Restoration of the aesthetics of the eye region of the face

Smoothing the underlying ocular muscles

Tightening the supporting structures

Resecting and re-draping the excess fat of the retroseptal area of the eye – which will help to produce a smooth anatomic transition from the lower eyelid to the cheek.

Indications for upper eyelid surgery:

Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision, can be treated by upper eyelid lift surgery.

Upper eyelid surgery can remove excess fatty deposits that appear as puffiness in the upper eyelids.

Bags under the eyelids can be corrected by blepharoplasty.

Lower eyelid surgery can remove excess skin and fine wrinkles of the lower eyelid.

Lower eyelid surgery can correct droopiness (laxity) of the lower eyelids, showing white below the iris (the colored portion of the eye).

Surgical Procedure:

A blepharoplasty surgery treatment procedure is generally performed by making external surgical incisions along the natural skin lines (creases) of the upper eyelid. The natural skin crease then conceals the surgical scar from view. In the lower eyelid, lower blepharoplasty surgery is performed through the inner red portion of the eye (trans-conjunctival blepharoplasty), so that the scar is hidden. This incision also opens up the mid-face to an elevation & aesthetic correction, without the need for additional incisions on the face. This procedure is the common method to carry out the eyelid lift surgery.

Trans-Conjunctival-Blepharoplasty

Trans-Conjunctival Blepharoplasty

A blepharoplasty surgery usually requires about 1 hour per eye to complete.

After the surgery, the initial swelling and bruising following the surgery will subside and resolve with 1–2 weeks; the ultimate, steady results of the blepharoplasty correction will be evident after a few months.

The results of a blepharoplasty procedure are best appreciated by comparing pre- and post-operative (before-and-after) photographs of the eye region of the patient.

The anatomic condition of the eyelids, the (wear-and-tear) quality of the patient’s skin, his or her age, and the general condition of the adjacent tissues, resultant to the anatomic conditions of the patient, influence the functional and aesthetic results obtained with the eyelid surgery.

In addition to the anatomic conditions of the eye region of the patient, the occurrence of medical complications is determined by factors such as:

Dry-eye syndrome — which can become worsened by the disturbance of the natural, lacrimal (tear) film of the eyes

Palpebral (Eyelid) skin laxity – looseness of the lower eyelid margin, which makes the lower eyelid prone to misplacement

Eyeball prominence – the projection of the eyeball in relation to the malar (cheek) complex, which makes the lower eyelid prone to misplacement

Post-surgery recovery:

Initial healing may include some post eyelid surgery swelling, bruising, irritation or dry eyes and discomfort that can be controlled with medication, cold compresses and ointment. Irritation at the incision sites also is possible.

Potential complications:

  • Unfavorable scarring
  • Dry eyes
  • Temporarily blurred or impaired vision
  • Lid lag, a pulling down of the lower eyelid may occur and is often temporary
  • Difficulty closing your eyes
  • Ectropion, rolling of the eyelid outwards
  • Bleeding (hematoma)
  • Infection
  • Poor wound healing
  • Blood clots
  • Fluid accumulation
  • Anesthesia risks
  • Numbness and other changes in skin sensation
  • Pain, which may persist
  • Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required
  • Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  • Skin discoloration and swelling
  • Loss of eyesight
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Possibility of follow- up surgery

Conclusion

Generally, except the rare cases, lower blepharoplasty surgery or lower eyelid lift surgery is considered to be a cosmetic procedure. Upper eyelid surgery is also done for mainly cosmetic reasons, except in the cases where the drooping is severe to the extent that the field of vision gets obstructed. Upper eyelid surgery not only clears the obstruction but helps in restoring the symmetry of the area around the eyes. The patient will not have to raise his/her head to see more clearly. Eyelid lift surgery is fairly uncomplicated surgery and it does not take much time also. The complications stated above are very rare. Eyelid surgery, irrespective of whether it is upper eyelid surgery or lower eyelid lift surgery can be performed on adults as well as young children. Lower eyelid lift surgery and upper eyelid surgery can also be performed in tandem if the problem present is too severe.