Eyelid rejuvenation is an integral part of facial rejuvenation. Ageing changes on the face tend to create tired looking eyes. Blepharoplasty is a cosmetic surgery procedure for rejuvenating the eyelid to recreate youthful eyes. Blepharoplasty is one of the most commonly performed facial cosmetic surgeries. A properly performed blepharoplasty creates significant rejuvenation of the upper and mid face.
Eyelid surgery requires careful assessment and planning. A properly planned and executed blepharoplasty provides tremendous improvement to the face.
The aim of the surgery is to recreate "bright" eyes.
Signs of ageing on the eyelid-
Both eyelids exhibit signs of ageing starting from the early 40's.Drooping of the brows causes looseness of the skin on the upper lid, which becomes a fold /curtain of excess skin. This fold of skin hides the normal shelf on the upper lid. Fat protrusions on the upper lid may become prominent with time. In some cases, there is loss of volume and deepening of the eye socket.
On the lower lid, eye bags are frequently the initial sign of ageing. Protrusion of fat and loose skin along with sagging of the eyelid supporting structures creates baggy lids with loss of the normal upward slant of the eyes. The circular muscle around the eyes (orbicularis oculi) also tends to lose tone and produces festoons under the eyes.
In advanced stages, the lower lid margin rolls down (senile ectropion) and leads to continuous tearing. Loss of volume can occur in many cases and together with pigmentation changes leads to deep set eyes with dark circles.
Assessment and planning-
Proper assessment and planning is the most critical element to ensure a pleasing successful outcome. The ageing changes on the lids are always assessed in relation to the rest of the face.
Specific to the eye lids, assessment will include
Tone of the supporting structures
Location and degree of fat protrusion
Soft tissue volume on the lids
Slant of the eye
Cheek- eyeball relationship
Complete visual exam
There are multiple techniques to achieve proper rejuvenation of the eyes. Lower blepharoplasty has more variations-
Trans conjunctival blepharoplasty is for correction of eye bags without a lot of loose skin.
In other open lower blepharoplasties, a fine incision is made just below the eyelashes. In cases where the tarsal plate which supports the eye lid is lax, a tarsal tightening procedure is also combined- either a canthopexy or canthoplasty.
The mid face can also be rejuvenated using the same approach along with blepharoplasty. This is called sub periosteal cheek lift, which creates powerful rejuvenation of the face.
In cases with loss of volume, fat grafting or filler injections are performed to restore the soft tissue volume.
Pre op requirements-
Complete health work up
Thorough evaluation by ophthalmologist for vision and other relevant tests
Stop smoking 3 weeks prior to surgery
Stop aspirin and blood thinners 10 days prior to surgery
Full disclosure regarding existing medical condition/allergies
Blepharoplasty is performed under local anesthesia or general anesthesia depending on the extent and technique used. The surgery is often performed as a day care surgery and takes about an hour to two hours to complete.
Cosmetic surgery on all four lids takes longer time to complete.
In most cases, eyelid surgery is combined with brow lift surgery. In such cases, brow lift is first performed and the lid surgery follows.
Modifications are made to the skin, muscle, underlying fatty tissue and the tarsal plate.
The eyeball is completely protected at all times during the surgery thereby minimizing chances of injury to the eyes.
The eye lids swell considerably after surgery. The swelling usually subsides in 7-10 days. Bruising over the eyes and the cheeks takes about 2 weeks for resolution.
Sutures are removed on day 6 after surgery.
Dryness of the eyes and mild irritation may be experienced, which can be treated with eye drops.
Ice compress over the eyes in the first 24 hours helps to minimize the swelling and bruising. Normal light physical activities can be resumed from day one.
Antibiotics, eye drops and pain medications will be prescribed for 3-5 days after the surgery.
Complications/risks are relatively rare following eyelid cosmetic surgery. How ever, it is important to be aware of possible complications-
Inability to completely close the eyes.
Cost of eyelid surgery-
There is considerable variation in the type of surgery performed in each person.
The cost will vary depending on the method chosen, whether other facial cosmetic surgery is required, only upper or lower lids or all four lids and so on.
Please contact us with your needs, pictures and medical info to find out what should be the best surgical plan in your case and how much it will cost you.
Blepharoplasty; cosmetic eye lid surgery; eyelid rejuvenation; upper blepharoplasty; lower blepharoplasty; tarsoplasty; tarsopexy; tarsal tightening; canthopexy, canthoplasty, peri orbital rejuvenation.