As we age there are a number of changes that occur at the periorbital tissue level:the skin becomes more lax and thinner, wrinkles appear between the eyebrows and crow’s feet, the connective tissue loses firmness, including the orbital septa. This last phenomenon, together with the atrophy of the fat in the periorbital compartments and the fact that these fat accumulations begin to “fall” and protrude outwards and downwards, cause the appearance of the popularly known as “bags”.which are nothing more than pseudoherniation of this tissue. Other alterations that may appear with the passage of time are ptosis of the eyebrows, elevation of the palpebral sulcus, etc.
All these changes that contribute to the aging of the periorbital area will produce a sad, tired appearance in the patient, even when the patient is well, rested and in an excellent mood.
Classically, blepharoplasty was considered a problem of excess tissue and the procedure basically consisted of removing the excess tissue, including skin, muscle and fat compartments. However, nowadays the attitude is rather to remodel the area, removing excess tissue, but also providing tissue in those areas where it is deficient, in short, remodeling the areas that need it.
At DraVillaverde we will analyze your case to recommend the best surgery or treatment to give your face back the youthfulness you want to see.
UPPER EYELID BLEPHAROPLASTY
The most frequent alterations in this area are blepharoachalasia or excess skin, which can sometimes be of such magnitude as to cause visual problems, falling over the eyelashes or even occupying part of the visual field.which can sometimes be of such magnitude that it can cause visual problems, falling over the eyelashes or even occupying part of the visual field.
If there is a significant excess of adipose tissue pockets, they are removedHowever, it must always be from a conservative point of view, since an excessive removal could cause a sunken, skeletonized basin, with an aged appearance, just the opposite effect to the one sought with this surgery.
As for the skin, a conservative resection must also be performed, since excessive resection could cause the dreaded lagophthalmos as a complication.
Finally, in some cases it is also recommended to remove the thickened orbicularis oculi muscle.
What is upper eyelid blepharoplasty like?
Upper blepharoplasty can be performed under local anesthesia only or may require sedation.
- Estimated time is 45-60 minutes.
- No hospital admission is required.
- Recovery is fast, in 5-7 days.
LOWER EYELID BLEPHAROPLASTY
Lower eyelid bags are one of the most frequent causes of a sad, tired and haggard look. For the treatment of this structure, two complementary procedures have to be performed:
- On the one hand, a small, discreet skin resection, since there is not usually a large excess of skin in the lower eyelid. In fact, there are occasions in which if the excess skin is mild or moderate, it can even be treated with peels, lasers or other treatments with local and superficial action.
- Resection of adipose tissue “adipose bags” through a transconjunctival approach preferably, as this will avoid altering or violating the orbital septum and/or the orbicularis oculi muscle, thus reducing the possibility of ectropion. An alternative approach is the subciliary approach, through the skin just below the eyelashes.
- Canthopexy/canthoplasty: sometimes the supporting structures of the lower eyelid are lax and distended and need to be tightened to achieve an optimal result. This is achieved by tightening and reanchoring the lateral canthal tendon, known as “canthopexy”.
Lower eyelid surgery procedure
- It is performed under local anesthesia and sedation.
- The intervention time is short: 45-60 minutes.
- No hospital admission is required.
- Recovery time : 5-7 days.
ADIPOSE TISSUE GRAFTING
Sometimes the treatment of both eyelids can be complemented with an adipose tissue graft, especially in the malar area and the tear through deformity, in such a way that the volumes that have been lost or altered with age are repositioned.
Grafting procedure
- It can be performed under local anesthesia and/or sedation.
- Minimal complication rate.
- No hospital admission required
- Time required to perform this procedure: 45 minutes.
- A rest period of 5 to 7 days is required for optimal grafting.
If you are considering correcting your drooping eyelids, make a no-obligation appointment and we will make a personal assessment without obligation.
Preoperative blepharoplasty surgery
Prior to surgery, the patient’s medical history should be known and perform a complete eye examination of the patientThe patient should be able to determine if there is a history of dry eye, explore the laxity of the lower eyelid, check for ptosis or drooping of the eyelid due to dehiscence or disinsertion of the levator muscle of the eyelid, or if there is ciliary ptosis (eyebrow ptosis).
It is important before surgery to avoid taking aspirin or NSAID-type anti-inflammatory drugs, as they may increase the risk of perioperative bleeding.
Similarly, the patient must arrive at the surgery with proper blood pressure control, since hypertension is also associated with an increased risk of bleeding.
Postoperative period after blepharoplasty surgery
After surgery, it should be noted that due to the nature of the lax tissue of the eyelids, they tend to swell and accumulate fluid inside. For this reason rest is recommended in the week following the operation.In addition, sleep with the head elevated (on two pillows for example), apply cold for short and repeated periods to the area, and maintain adequate control of blood pressure and pain (avoiding taking anti-inflammatory drugs such as NSAIDs and/or aspirin).
Stitches are usually removed after 4-5 days.
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