Aesthetic Plastic Surgery

The “blepharoplasty” are cosmetic surgery of the eyelids with the aim of eliminating these misfortunes, they are hereditary or due to age.

They may relate only to the two upper or lower eyelids, or the four eyes at once.

A blepharoplasty can be done alone or combined with other aesthetic surgery of the face (frontal lifting, lifting temporal, lifting cervico-facial), even a medical-surgical therapy (laserbrasion, peeling, dermabrasion). These acts are likely to be made during the same speech or during a second operation.
Objectives

A blepharoplasty proposes to correct the signs of aging present on the eyelids and replace the “tired” of the eye with a more rested and relaxed.

The misfortunes of the most commonly involved are:

* Upper eyelid drooping and heavy with excess skin forming a decline more or less marked,
* Slumped lower eyelid and wilted, with small horizontal wrinkles consecutive distention skin
* Hernias fat, responsible for “bags under the eyes” at the lower eyelids and upper eyelids eat.

The intervention is aimed at correcting these misfortunes in a sustainable manner, surgically removing the excess skin and muscle and the fat protrusions, and this, of course, without altering the essential functions of the eyelids.

It should be noted that many other alterations may be present, but their treatment is possible by using techniques more complex than just a traditional blepharoplasty, or through the use of additional surgical procedures. This applies to the collapse of the front and the fall of the eyebrows, wrinkles “lion” between the eyebrows, wrinkles “of the feet” on the corner of the eyes, “dark” eye ” Hollow “Eye” sad “with droopy eyes corner, and small surface imperfections of the skin (scars, stains …).

The operation, performed as well in women than in men, is commonly made from quarantine. However, it is sometimes carried out much earlier, when the misfortunes are constitutional (hereditary factors) and not related to age, as some “fat pockets”.
Before surgery

An interview followed by an examination of the eyes and eyelids have been made by the surgeon to search for anomalies that may complicate the intervention, even against-designate.

A specialized eye exam will be frequently asked in addition to detect any eye disease.

A pre-operative assessment is carried out as required.

The anesthetist will be seen in consultation at least 48 hours before surgery.

Any medication containing aspirin should be taken within 10 days preceding the intervention.

Depending on the type of anesthesia, you may be asked to remain fasting (nothing to eat or drink) 6 hours before surgery.

Types of anesthesia and hospital procedures
Type of anesthesia

Three methods are possible:

* Local anesthesia pure analgesic where a product is injected locally to ensure the insensitivity of the eyelids.
* Local anesthesia depth by tranquilizers administered intra-venous (anesthesia “guard”).
* General anesthesia classic, when you sleep completely.

The choice between these different techniques will be the result of a discussion between you, the surgeon and the anesthesiologist.
Terms of hospitalization

The operation can be performed in “ambulatory”, ie with an exit on the same day after several hours of surveillance.

However, in some cases, a short hospitalization may be preferable. The entrance is then in the morning (or sometimes the previous day in the afternoon) and the output is allowed by the next day.
Intervention

Each surgeon adopts a technique of his own and that adapts to each case to get the best results.

However, we can retain the common basic principles.
Skin incisions

* Upper eyelids: they are hidden in the groove located halfway up the lid, between the mobile and fixed part of the eyelid.
* Lower eyelids: they are placed 1 to 2 mm below the eyelashes, and may extend a bit beyond.

The route of these incisions is of course to the future location of scars, which will be hidden in natural folds.

Note: For lower eyelids, where pockets alone (without excess skin removed), we can achieve a blepharoplasty by trans-conjunctival, ie using incisions placed inside of the eyelids and thus leaving no visible scars on the skin.

Resections

From these incisions, hernias removed unsightly fat and excess muscle and skin is removed released. At this stage, many technical refinements may be made to adapt to each case and according to the habits of the surgeon.
Sutures

They are made of very fine son, usually non-resorbable (to withdraw after a few days).

Depending on the surgeon, the number of eyelids to operate, the scope for improvement, and the possible need for additional gestures, the response may last for half an hour to two hours.
FOLLOW-UPS

There is no real pain, but possibly some discomfort with a feeling of tension of the eyelids, a slight irritation of the eyes or some visual impairment.

The first few days we need to rest up and avoid any violent effort.

The operating suites are essentially marked by the appearance of edema (swelling) and ecchymosis (blue), whose importance and duration vary from one individual to another.

There is sometimes the first few days in an inability to completely close the eyelids or a slight loosening of the external angle of the eye that no longer applies perfectly on the globe. We should not worry about these signs that comply quickly reversible.

The son is removed between the 3rd and 6th days after the operation.

The scars of the operation will gradually diminish, allowing a return to social life after normal working days (6 to 20 days depending on the size of the suites).

The scars may remain slightly pink in the first weeks, but their makeup is quickly authorized (usually from the 7th day).

A slight induration loosened zones may persist a few months, but is not seen by the family.
The result

A period of 3 to 6 months is required to assess the result. This is the time for the tissues have regained their flexibility and that the scars were blurred at best.

The intervention has most often served to offset sagging skin and remove fat hernia correcting the appearance of aged and tired look.

The results of a blepharoplasty are usually among the most durable plastic surgery. The removal of the pockets is almost final, and they usually do not recur. Against the skin, continues to age and the resulting laxity may, over time, replicate the folding of the eyelids. However, it is rare that a new intervention to be considered before a dozen years.
The result of imperfections

These can result from a misunderstanding about what we can reasonably expect. One example is the collapse of the front and the fall of the eyebrows that can not be corrected by lifting fronto-temporal.

They can also occur because of unexpected reactions tissue or scar unusual phenomena. We can continue to see some changes (especially fine wrinkles) or get a look a little too low (edge of the orbit bone visible) or see a slight downward retraction of the lower eyelids, or that a small asymmetry scars or too “white”.

These flaws can be corrected, if necessary, by a small “touch” that will most of the time under simple local anesthesia, from the 6th month after the initial intervention.
The possible complications

A blepharoplasty, although carried out mainly for aesthetic reasons, remains a real surgery that involves the risks associated with any medical procedure, however small it may be.

We need to distinguish between complications related to anesthesia those relating to surgery.

Regarding anesthesia, during the consultation, the anesthetist himself inform the patient of the risks anesthetics. You should know that anesthesia induced in the body sometimes unpredictable reactions, and more or less easy to control: the fact to use a perfectly competent Anesthésiste, engaged in a real fact that the surgical risks are now almost statistically insignificant.

Be aware, in fact, that the technology, products and anesthesia monitoring methods have made tremendous progress over the past twenty years, providing security, especially when the intervention is conducted outside the emergency and in a healthy person.

Regarding the surgery: choosing a Plastic Surgeon qualified and competent, trained in this type of intervention, to minimize these risks, but not completely remove.

Fortunately, the real complications are rare following a blepharoplasty performed in the rules. In practice, the vast majority of happens without any problem and the patient (s) are fully satisfied (s) of their outcome.

Nevertheless, and despite their rarity, you should be aware of the potential complications:

* Hématomes: Most of the time are not serious, they can be evacuated if they are too high.
* Infection: exceptional at a blepharoplasty, except a few micro-abscesses developed a suture and easily treated with small care. A simple conjunctivitis be prevented by systematic prescription eye drops the first few days.
* Abnormal healing: very rare in the eyelids or skin, very fine, usually heals virtually invisible, it may happen that the scars are not, ultimately, as discrete as expected.
* Epidermal Cyst: they may appear along the scars; removed often spontaneously or are easily removable and do not compromise the quality of the final result.
* Injury to the ocular surface often accidental, they are usually not serious, and properly treated, declining rapidly and without sequelae.
* Chémosis (swelling of the conjunctiva which is a gelatinous): rare after blepharoplasty simple, its disappearance may take one to three weeks.
* Troubles in the secretion of tears: a persistent tearing is less a “dry eye syndrome” which has sometimes décompenser deficit existing in tears.
* Ptosis (difficulty to fully open the upper eyelid): very rare, except beyond 70 years where a pre-existing deficit can be increased by the intervention.
* Lagophthalmos (inability to completely close the upper eyelid): possible in the first days after the procedure, it persists beyond a few weeks should not meet.
* Ectropion (shrink down the lower lid): the major form is rare in the setting of a properly performed blepharoplasty. The minor ( “round eye”) occurs on the eyelids sometimes little tonic subject to retraction cicatricial unintended but ends mostly by fading after a few weeks of massage pluriquotidiens to loosen the lid.
* Finally, very exceptionally diplopia (double vision), glaucoma (ocular hypertension) and even blindness after blépharoplasties were reported in the international scientific literature.

In total, we should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards.

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Filed under: Aesthetic Surgery

Tags: Blepharoplasty, Blepharoplasty photos, Blepharoplasty procedures