Eyelid surgery: Blepharoplasty

What is it and how is it done?

Surgical correction of soft tissue surpluses such as skin, orbicularis muscle and fat bags of the eyelids, is called blepharoplasty . The presence of these surpluses especially deteriorates the external appearance, sometimes giving an unfavorable mood predisposition, while in more severe cases, it interferes with the visual field. Other alterations of the upper eyelids, such as the decrease or ptosis that progressively impede vision, or the stigmata of premature aging such as “crow’s feet” and eyebrow drooping, require specific techniques that we associate when necessary, to blépharoplasty .

What are the requirements for this improvement?

The presence of surpluses in upper and / or lower palpebral pouches, manifested by protuberances, also of cutaneous surpluses, which are evidenced by erasing the upper and lateral palpebral groove. Alterations that can be observed in adults of any age, as there are cases with obvious family component. The expectations must be realistic and balanced, since the objective is specified in favoring the external appearance, and restoring the visual field. There are multiple ocular alterations such as lacrimal secretion deficit, high intraocular tension or glaucoma, diabetic retinopathy and visual acuity alterations in which we carefully weigh the risk-benefit ratio before considering any procedure. Some people suffering from medically controlled thyroid disorders can reduce irritation from exposure of their cornea, improving the protection of the eyeball by fat reduction and other surgical techniques. In addition, the presence of inferior palpebral weakness with eversion of the edge ( ectropion ) and other anomalies of the edges can be treated with appropriate techniques in a combined way.

Ways to perform blepharoplasty

Depending on whether it is an isolated procedure or combined with other techniques such as traction or face lifting, it can be with local anesthesia and sedoanalgesia or general anesthesia, always in the operating room of an approved hospital. Its duration is reasonably short, although it depends on the techniques to be performed on each specific person, be they only the superiors or all the eyelids. Upper blepharoplasty : It begins with the design of key points to modify followed by the incisions that are limited to natural folds where they will be hidden, to continue with the elimination of excess skin and part of the orbicular muscle. Once the surplus bags have been identified, they are eliminated in a precise way, proceeding to close them in one or two layers. Lower blepharoplasty : The usual access to the three fat bags is internal or transconjunctival , therefore without visible scar or need for sutures. When there is excess skin and its removal is necessary, always discreet, the immediate subciliary route to the eyelashes is used. Commonly, adhesive strips and fresh dressings are applied on eyelids, allowing home discharge in most procedures . When the correction of the forehead, eyebrows or lateral folds (crow’s feet) is necessary, we combine the above with techniques that allow a more ambitious and extensive rejuvenation.

BASIC INFORMATION

The result obtained is clear once the initial inflammation and ecchymosis have been
resolved.
The smoothness, rejuvenation in the eyes and improvement of the visual field when
appropriate, is usually maintained permanently

There are those generally associated with any intervention such as those mentioned
above, which we prevent with early review and follow-up. The fine scar is hidden or
concealed in eyelid folds; In some exceptional cases it may require further
review. The best prevention is obtained by following the instructions provided by the
surgeon both before and after the intervention. Otherwise, early detection can
redirect the results. Therefore, the follow-up is always carried out by the plastic
surgeon who knows the extent of the procedure, and the incidents during its
development. Alterations that are usually transient, such as tearing, blurred or poor
vision for a few days, asymmetry in the eyelid position, and feeling of tightness when
occluding or sleeping can also be seen.

Immediate convalescence takes place at home, applying cold on the eyelids that is
usually enough to relieve discomfort; Occasionally minor analgesics and the use of
eye drops.
In the first review at 48 hours, we removed the dressings to explore the result and
detect any signs of bleeding or bruising, which we can correct. In addition, the
plastic surgeon provides instructions for hygiene care and permitted activities. Fine
sutures are removed in the next revision 2 days later.
Sedentary activities can be resumed around 4 to 5 days later, but energetic efforts
and sports will be delayed for at least 3 weeks.