According to documentary evidence of the X century A.D. the ancestor of a technique similar to modern blepharoplasty is the healer Avicenna. It was he who concluded that when removing excess skin of the upper eyelids, it is possible to improve the overview of the human organs of vision.
Since then, this method has been enriched by various possibilities, both to return freshness to the “mirror of the soul” – to the eyes, and to rejuvenate the whole person’s face. This is eloquently testified by patient reviews, photos before and after such an operation.
- What is blepharoplasty
- Indications for surgery
- Types of eyelid plastics
- Upper eyelid blepharoplasty
- Lower eyelid surgery
- Circular plastic
- Transconjunctival blepharoplasty
- Laser blepharoplasty
- Asian blepharoplasty (Singapore)
- Repeat operation
- Blepharoplasty preparation
- What operations are often combined blepharoplasty
- How is the procedure
- Operation duration
- How much will need to be in the clinic
- Recovery period
- How long will the result of the operation last
- The cost of blepharoplasty
- Contraindications to blepharoplasty
- Possible complications after surgery
- Video blepharoplasty
What is blepharoplasty
The essence of the method is the redistribution / removal of excess internal fat in the area around the eye orbits, tightening the surrounding circular muscles. This helps to improve the appearance of the eyelids by eliminating “bags” (hernias), deep wrinkles, and correcting the shape of the eyes. It also solves the problem of skin tightening in the adjacent areas of the cheekbones of the face, eyebrows.
Along with achieving a visual cosmetic effect, which can be estimated from the photo before and after the operation, blepharoplasty is characterized as a minimally traumatic procedure.
Contrary to the opinion that such plastic is relevant for eliminating age-related changes, practice shows its relevance for young people.
So, for example, if in Europe women and men after 45 years old resort to this operation to transform their appearance and restore vision functions, then in Asia, representatives of both sexes turn to 18 years to change the eye section.
Indications for surgery
Indications for blepharoplasty can be:
- decrease in skin elasticity in the eye area;
- deformation of the upper eyelids (sagging / lowering of the skin / corners of the eyes / lacrimal glands, fatty hernia, etc.);
- excess sagging skin of the lower eyelids, sagging of their muscles, which appear in the form of wrinkles, puffiness, “bags” under the eyes;
- the presence of deep nasolacrimal grooves;
- prolapse (ptosis) of the dermis of the face (middle zone);
- asymmetric arrangement of the eyes;
- exophthalmos (protrusion of the eyeball);
- inversion of the eyelids (entropion);
- defects in the eyelids (congenital, post-traumatic).
The presence of these symptoms is accompanied by the appearance of a tired face, the impression of a hollow eye with an invariably drowsy expression, and vision problems. To understand the real possibilities of the operation to correct existing defects, along with studying the available photos before and after it, preliminary consultation of specialists in the field of blepharoplasty is required.
Types of eyelid plastics
For cosmetic skin rejuvenation and prevention of problems in the eyelid zone, blepharoplasty methods such as:
- injection procedures that are performed under local anesthesia for 2 hours;
- hardware plastic surgery of the eyelid skin with exposure to collagen of skin fibers of various means: heat (thermolifting), radio waves (thermage), ultrasound (massage lifting).
Over time, for various reasons (age, lifestyle, genetic predisposition, etc.), the periorbital area of the eyes, the middle area of the face undergoes significant changes.
These are the following changes:
- Initial muscle / skin weakness, slight protrusion of the hernia.
- Complementing the initial changes with excess skin in the lower and upper eyelids with a transition to both cheeks.
- Development of changes with drooping eyebrows, “skeletonization” of the bottom of the eye orbits, the formation of a furrow in the eyelids and cheeks. There is a dynamic deepening of the nasolabial folds with a more intense severity of excess skin.
- The aggravation of visual changes that provoke the appearance of significant fatty deposits, a change in the shape of the eyes due to a rapid decrease in the tone of the eyelids.
For these cases, surgical blepharoplasty is more effective. Photos before and after the operation clearly demonstrate that depending on the stage (type) of changes, it is possible to choose one or another of its types.
Upper eyelid blepharoplasty
The operation to correct the upper eyelids for experienced professionals is one of the least complicated. This procedure is performed on an outpatient basis and, as a rule, under local anesthesia. In the absence of contraindications, if the patient wishes, general anesthesia can be used.
The technique of such blephanoplasty is to incise the natural folds of the skin to remove excess dermis and adipose tissue. In this case, the desired shape of the upper eyelid can be formed. At the end of all manipulations, a suture (microsurgical) is applied to the incision site, which can be removed after 4-5 days.
It is important to remember about the possible temporary appearance after this of hematoma, edema, increased lacrimation. They can last several days or about 20 days, and a positive result of the operation will be noticeable after 1.5-2 months.
Lower eyelid surgery
This more complex type of blepharoplasty is resorted to if it is necessary to eliminate pronounced circles, bruises, puffiness (“bags”) under the eyes. Such an incision operation directly below the eyelash growth line is also performed under local or general anesthesia and lasts about 1 hour.
There are 2 types of lower eyelid correction:
- Classical, with the removal of excess fatty tissue and skin through a tissue incision.
- Fat-saving, where with the help of an incision, a circular ocular muscle is opened, the fibers of which are bred on both sides with a special tool. After this, a fatty hernia moves into the nasolacrimal grooves with the application of absorbable sutures.
If blepharoplasty was performed correctly and correctly, photos before and after surgery allow you to see noticeable positive results in a couple of months.
However, with excessive removal of the skin during this procedure, a complication may occur in the form of an eversion of the lower eyelid (ectropion), increased dryness in the eyes and incomplete closure of them. These consequences will require treatment with the help of special exercises, professional massage.
Such an operation is performed if necessary, the simultaneous correction of the upper and lower eyelids. It can be trusted only by highly qualified surgeons who have solid experience in complying with the requirements for these types of blepharoplasty.
It should be remembered that within 3 days after circular repair, any physical activity is forbidden. Unacceptable is the use of makeup (up to 14 days). Strict implementation of the doctor’s recommendations avoids complications requiring repeated surgical intervention.
The positive results of a competently performed complex procedure and compliance with the rules of rehabilitation will become noticeable in 1.5-2 months. The effect may persist for more than 10 years after surgery.
This method is effective in the formation of asymmetry of the eyes due to elasticity lost by the skin. The indications of its use also include an enlarged eyelid, the presence of puffiness, wrinkles, hernia under the eyes.
Such a less traumatic correction is performed to remove excess fat in the absence of excess skin (but not fine wrinkles, crow’s feet!). This is done with the help of small punctures inside the eyelid (in the conjunctiva) without any incisions, and in the future – the absence of the need for healing of scars, scars.
After the operation, the patient can go home, and after 5-6 days, return to normal work. In the presence of postoperative swelling, bruising, the period of complete rehabilitation is up to 14 days. Already after 30 days, positive results become visible, which last up to 10 years.
Indications for laser blephaloplasty are:
- excess skin;
- the presence of fatty hernias;
- noticeable deformation of the eyelids, eye shapes and asymmetric facial features;
- age-related changes in the skin of the eyelids or its excess at a young age;
- rejuvenation of the skin around the eyes.
This outpatient safe operation is performed without incisions and punctures of the skin, and with the help of a dosed exposure to a light beam (CO2) on biological tissues.
Penetrating into the inner layers of the skin and cutting them, this “warrior of light” is able to “seal” the gaps in the vessels, which reduces the risk of lymph and bleeding, infection of tissues, does not leave any pain, burns on delicate skin. In this case, hematomas, edema do not form on it and a faster recovery is provided.
The positive effect of a high-quality laser procedure lasts quite a long time (5-10 years).
Laser blepharoplasty can be used to correct the upper / lower eyelids, eye section, their expression due to the restoration of the ligamentous apparatus (cantopexy). In the photo before and after the operation, you can consider noticeable positive changes after the operation.
Asian blepharoplasty (Singapore)
This type of surgery is focused on increasing the incision of the eyes of the eastern type .
We are talking about eliminating overhanging tissue in the inner corner of the eye (epicanthus) and creating a “European” double upper eyelid without swelling during the formation of a supraorbital skin fold on it. Such a transformation allows you to increase (round) the eyes, give the look more openness.
Singapore surgery is performed both with an incision inside the eyelid and without it using suture technique. The incisions are hidden in the existing folds of the upper eyelids, which allows you to achieve maximum visual effect. Therefore, this method is considered the “gold standard” of this blepharoplasty.
Suture technique can only be performed if young people have a small fold on the thin skin of the upper eyelids. In this case, compared with the operation with an incision, it will take less time for rehabilitation.
After surgery, the patient’s eyes are closed with a bandage, and he must be under the supervision of a doctor. At home, applying cold compresses to the eyelids and using antibacterial drops (3-4 days) are required. Over the next 2 months, it is necessary to observe a gentle regime without physical activity, sunbathing in the sun / in a solarium, visiting a bath / sauna, etc.
According to those who want to “Europeanize” their eyelids, Singapore is the ideal option – Asian blepharoplasty.
Photos before and after the operation allow you to see the filigree work of surgeons to correct some of the nuances while maintaining ethnic uniqueness and beauty of the eyes.
Reconstructive (repeated) blepharoplasty is performed in such cases as:
- Medical indications – if necessary, correction of medical errors, costs during the rehabilitation period, the occurrence of complications, etc.
Planned (aesthetic) rejuvenation of the eyelids after weakening the effect of the primary operation. The need for repeated plasty may arise after 6-10 years with the new appearance of wrinkles, wrinkles, sagging skin. It is important to realize that blepharoplasty is not a panacea for age-related changes, but their effective delay for a long time. It is possible to extend it subject to the recommendations of
specialists on maintaining a healthy lifestyle, performing cosmetic procedures to maintain tissue tone.
The technique of re-conducting the operation is similar to its primary version, but is characterized by greater complexity. The rehabilitation period in these cases lasts, as well as after the initial plastic surgery with obtaining the final result after 3 months.
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Preparations for the operation are:
- obligatory consultation of a surgeon, ophthalmologist with the identification of problem areas;
- examination with a laboratory examination with the delivery of tests as prescribed by a doctor to study the anamnesis, the state of periocular muscles and skin;
- cessation of hormonal, anti-clotting, anti-inflammatory, aspirin-containing drugs and giving up bad habits (smoking, alcohol, etc.) – 7 days before surgery;
- 5-6 hours before surgery, it is recommended not to eat food.
Immediately before plastics, decorative cosmetics and even natural creams cannot be used.
What operations are often combined blepharoplasty
Combined (simultaneous, complex, simultaneous) plastic for correcting several defects is relevant for solving medical and aesthetic problems. This makes it possible to carry out several operations with a single anesthetic, which positively affects the mental and emotional state of patients.
There are several options for combining eyelid plastic, namely:
- transconjunctival + laser rejuvenation of the eyelids;
- lower eyelids + facelift;
- circular + polishing of the paraorbital (in the presence of hyperpigmentation);
- upper eyelids + rhinoplasty + lip augmentation (cheiloplasty).
Highly qualified specialists (surgeons, anesthetists, resuscitators) in well-equipped clinics can perform simultaneous blepharoplasty with liposuction, face lifting, Botox, lifting other parts of the body (thighs, buttocks), breast augmentation, etc.
However, simultaneous plastic surgery does not imply a combination of volumetric operations or that place a large strain on the face. It should also be remembered that such an operation requires an expansion of the preparatory work, its thoroughness with a clear definition of the algorithm of all manipulations.
How is the procedure
The vast majority of operations are performed on an outpatient basis under local anesthesia in the following sequence:
- marking of the eyelids with the placement of a protective lens on the pupil of the eye;
- applying a special cream with an anesthetic to the operated area or chipping it with an anesthetic (lidocaine), to which adrenaline is added to spasm vessels and reduce their bleeding;
- tissue incision, eyelid correction after exposure to anesthesia after 10-15 minutes on numbed skin;
- completion of the operation by “suturing” incisions with special (absorbable) threads, fastening with surgical tape, glue;
- applying a special agent to the operated area to reduce pain, protect against the appearance of excessive swelling;
- suturing 3-4 days after surgery.
Depending on the type of operation, its duration may be different. For laser plastic surgery, the upper / lower eyelids will take about 40 minutes; with a circular procedure – up to 1.5 hours; transconjunctival, singapuri – up to 2 hours. Carrying out combined plastics takes more time based on the complexity and amount of work of the surgeon.
How much will need to be in the clinic
In general, blepharoplasty is an outpatient activity and, after 40-50 minutes after the doctor has observed the postoperative condition, patients can go home. The time spent in the clinic in each individual case is determined by the surgeon, depending on the reaction of the patient to the procedure.
If constant monitoring by medical staff is necessary, this period can last up to 3 days.
The time and dynamics of recovery after surgery depend on factors such as:
- patient age;
- skin type and condition;
- the specific structure of the eyelid tissue;
- the volume of blepharoplasty.
Full recovery after surgery occurs in the following sequence of changes:
- the first 3 days – an increase in swelling with frequent formation of “bruises”;
- 4th day – the convergence of large hematomas and swelling of the eyelids;
- 5-7th day – the presence of residual phenomena in the form of edema on the dermis, not hindering the removal of sutures (small red scars remain in their place);
- 8-10th days – the disappearance of pale blue spots and puffiness of the eyelids;
- 11-14th days – temporary preservation of the asymmetry of the eyelids, which gradually disappears after 3 weeks.
The final formation of the scar, the disappearance of edema occurs after 2 months.
During this period, you should especially carefully look after the adjusted area, which includes:
- applying cooling compresses;
- sleep on a high pillow (on the back / side);
- the exclusion or minimal use of make
- refusal to take medicines containing aspirin;
- avoidance of thermal, solar procedures (bath, sauna, tanning in the sun and in the solarium);
- minimizing physical exertion;
- wearing sunglasses in bright light;
- the use of natural creams with a high level of protection against ultraviolet radiation.
How long will the result of the operation last
Following the advice of a doctor on rehabilitation will help to get the desired result in a couple of months and extend it for 7-8 years. Much depends on subsequent skin care with the participation of a professional cosmetologist (peeling, mesotherapy, masks, etc.).
It is important to consider that due to natural aging of the skin, the initial positive effect of blepharoplasty gradually disappears. In this case, you have to do a second operation. However, you need to be prepared that here the result will not be so brilliant.
Abuse of this procedure more than 3 times is fraught with the transformation of the face into a sedentary “mask” due to excessive skin tightness.
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The cost of blepharoplasty
The cost of different types of blepharoplasty in clinics in New York ranges from $ 544 – $ 1632. Correction of the upper eyelids will cost up to $ 544., Lower – from $ 408., Circular – $ 680., Transconjunctival – within $ 1292. Pricing takes into account the method of operation, its degree of complexity, related procedures, individual characteristics of the patient’s skin.
The cost of the operation also includes anesthesia and one day of stay under the supervision of specialists (depending on the level of comfort of the ward – more than $ 41). Along with this, costing also includes initial consultation and reception of the surgeon, conducting the necessary instrumental and laboratory examinations, analyzes.
Contraindications to blepharoplasty
A preliminary examination with the study of the results of the analysis is necessary in order to identify the existing restrictions for the operation.
These may be:
- cardiovascular diseases;
- increased intracranial / arterial pressure, blood coagulation, hypertension, anemia;
- acute, chronic ophthalmic diseases (inflammation of the cornea, cataract, glaucoma, etc.);
- oncological problems;
- diseases of the endocrine system (diabetes; thyroid gland, etc.);
- infectious diseases;
- severe form of somatic diseases;
- menstrual period.
Possible complications after surgery
With high blood pressure, adrenaline can aggravate the patient’s condition and make blepharoplasty impossible. And the increase in bleeding before and during menstruation provokes difficulties during surgery and subsequently – increased formation of hematomas.
Ignoring the results of the examination can cause complications during or after surgery.
Complications of the postoperative period may be associated with a medical error during surgery. This can be expressed in eversion / asymmetry of the eyelids, unnatural tension of the skin, deformation of the eye slits of the previously operated eyelids, residual hernia, etc.
When choosing any type of blepharoplasty, it is worth weighing the pros and cons of its implementation . It is important to trust an experienced plastic surgeon, whose portfolio with photographs of patients before and after surgery will help to get answers to many questions.
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