Blepharoplasty

Blepharoplasty may form part of a facelift surgery or may be performed as a separate procedure if the eyelids manifest signs of ptosis. Blepharoplasty aims at solving the problem of eyelid ptosis, removing eyelid bags or lifting the external canthus by 1-2 mm, giving a youthful appearance to the face and eyes. Wrinkles around the eyes (crow’s feet) cannot be fully corrected through blepharoplasty. Eyebrow ptosis also cannot be corrected, unless it is combined with a forehead lift. The need for blepharoplasty is not determined based on age, but based on the problems that may arise in the eyelids. So, bags may also be present in younger ages, requiring the need for blepharoplasty. Through blepharopslasty, the bags are removed permanently, while eyelid ptosis may continue even after the procedures, but at a much slower pace.

Blepharoplasty incisions for the upper eyelid are placed within the eyelid fold for the upper eyelid and on the edge of the lower lashes for the lower eyelid. These incisions almost never leave a scar and disappear soon, but the timeframe varies from patient to patient. The only case when no incisions are made is on the lower eyelids of young patients without ptosis, but with excessive bags from projected extrabulbar fat. In this case, the incision is made in the inner side of the lower eyelid, through the mucous gland.

Blepharosplasty is performed with local anesthesia; however, it is preferable that the anesthesiologist uses twilight anesthesia on the patient, which will also facilitate the surgeon. The procedure does not last longer than 45 minutes. Upon awakening, the patient experiences blurred vision due to the ophthalmic ointment applied during surgery. This condition does not last longer than 2-3 hours. The possibility of conjunctivitis is rare, but it can be treated with eye drops (collyrium).

In the first two days, the eyelids do not shut completely at night if the patient has also undergone a forehead lift. In this case, cool chamomile compresses and collyrium should be applied three times a day. The sutures and tapes are removed on the fourth day. The bruising disappears within a week, unless hematoma delays it for a while longer. The blepharoplasty incisions are indiscernible after a little while. Moisturizers improve and preserve the results. It is also imperative to avoid exposure to the sun. Most patients may return to their normal activities on the fourth day, when the sutures have been removed, while others may even return to their activities as early as the second day, provided they wear sunglasses.

A new and more advanced technique has been developed in blepharosplasty procedures. This involves a type of limited subperiosteal facelift of the middle face. The technique aims at enhancing the cheeks and softening the nasolabial grooves. This procedure is not superior to the classic technique and is now becoming part of the initial surgery. A temporal lift may also be performed through a small, 1 cm (0.4 in.) incision through the scalp, without burdening the procedure. Finally, the fat that is removed from the bags is used to fill the nasolabial grooves. All these techniques now form part of every blepharoplasty surgery performed by our team whenever necessary.