Eyelid Surgery (Blepharoplasty)
Blepharoplasty, also known as eyelid surgery, is a surgical procedure that improves the appearance of the eyelids by tightening muscles and tissue or removing excess fat and skin. A lower eyelid blepharoplasty is used to treat the following:
- Under-eye bags
- Drooping lower eyelids
- Excess skin
- Fine wrinkles
- Circles under the eye
A lower eyelid blepharoplasty can be performed on adult men and women alike and offers a younger, more refreshed look that reflects across the whole face.
Blepharoplasty is one of the most commonly performed facial plastic surgery procedures. The popularity of this procedure reflects the importance of the eyes in perfecting overall appearance. If the appearance of the eyes causes a patient to be unhappy, they may want to consider lower eyelid blepharoplasty to improve their look and boost their confidence through a safe procedure with minimal downtime.
Candidates For A Lower Eyelid Blepharoplasty
The best candidates for lower eyelid blepharoplasty are those individuals who meet the following conditions:
- Are in good overall health
- Do not smoke
- Do not have any serious eye conditions
- Have healthy facial tissue and muscle
If a patient has loose, sagging skin or puffy bags beneath their eyes, this procedure can help reduce these unwanted effects and leave the eyes looking young and fresh.
It is important for patients to have realistic expectations before undergoing a lower eyelid blepharoplasty procedure in order to be satisfied with their results. While the procedure can enhance their appearance and may improve self-confidence as a result, it cannot alter a patient’s entire appearance or change the structure of their face.
The Lower Eyelid Blepharoplasty Procedure
The lower eyelid blepharoplasty procedure is performed with either local or general anesthesia. The method or procedure to be used will be determined by the amount of fat that needs to be removed, the location of the fat and how tight to make the eyelid. The procedure typically takes from 45 minutes to an hour.
There are several different surgical approaches that can be used in a lower eyelid blepharoplasty. They are as follows:
Transconjunctival Lower Lid Blepharoplasty
Often chosen when no skin needs to be removed, a transconjunctival lower lid blepharoplasty creates an incision on the inside of the lower eyelid, leaving no visible scar or other evidence of the surgery.
Transcutaneous Lower Lid Blepharoplasty
A transcutaneous lower lid blepharoplasty is performed with a subciliary incision, also known as a pinch technique, to remove protruding fat and excess skin.
Transconjunctival Arcus Marginalis Release
A transconjunctival arcus marginalis release moves the fat within the lid to maintain some volume in the soft tissue. It prevents the ridge of orbital bone from becoming too prominent, which causes the eyes to look hollow and the face to appear older.
After the lower eyelid blepharoplasty procedure is performed, the incisions are closed with sutures and usually wrapped in gauze to allow the area to heal.
Recovery After A Lower Eyelid Blepharoplasty
After the lower eyelid blepharoplasty procedure, the surgeon may recommend applying lubricating drops or ointment and cold compresses to aid in the healing process and minimize side effects such as:
- Dry eyes
The eyes may be wrapped in gauze after the procedure as well. Patients can usually return to work within a few days, but should avoid exercise and strenuous activities for at least two weeks. Stitches are usually removed three or four days after the procedure. Swelling and other side effects usually subside within two weeks after surgery. Contact lenses and eyelid make-up may not be worn for two weeks after surgery. The surgeon will give specific instructions on how to care for the eyes post-procedure.
Results Of A Lower Eyelid Blepharoplasty Procedure
The results of a lower eyelid blepharoplasty procedure are visible as swelling and bruising subside and will continue to improve for up to a year after surgery. The lower eyelid blepharoplasty procedure is designed to produce long-lasting results. While surgery cannot prevent the eyes from aging, most patients are satisfied with their results and do not seek a repeat procedure.
Risks And Complications Of A Lower Eyelid Blepharoplasty
As with any surgical procedure, there are certain risks associated with a lower eyelid blepharoplasty procedure. While rare, these risks include the following:
- Blurry vision
- Malposition of the eye
- Dry eyes
- Skin discoloration
- An inability to fully close the eyes
Dermatochalasis is a medical condition that is characterized by an excess of slack, droopy skin on either the upper or lower eyelid, although it more often affects the upper. Although they often occur together, it is not the same as blepharitis, which is a drooping of the eyelid itself. Dermatochalasis is more prevalent in those older than 40, but can occur at any age. It is typically caused by the loss of elasticity and gradual weakening of connective tissues in the skin that come with aging. Although it tends to run in families, it can be a secondary effect of certain systemic diseases, trauma or prior surgery.
Effects Of Dermatochalasis
In some cases, dermatochalasis affects eye function. The excess skin can block a portion of the visual field, making it difficult to perform everyday tasks. To increase the field of vision, sufferers may continually raise their eyebrows, which can lead to chronic headaches. Dermatochalasis can also result in the eyes’ becoming dry or irritated; an inward turning of the upper eyelid; an outward turning of the lower eyelid; and dermatitis. Even in cases in which it does not result in medical problems, sufferers are often unhappy with the puffiness and bags it causes.
Treatment Of Dermatochalasis
The standard treatment for dermatochalasis is blepharoplasty, which tightens eyelid muscles and tissue, and removes excess fat and skin. If dermatochalasis is not causing vision problems, surgery is usually unnecessary, unless it is requested for cosmetic reasons.
Also known as a forehead lift, a brow lift is a surgical procedure performed to reduce signs of aging in the forehead area. It aims to remove or minimize deep horizontal creases across the forehead and bridge of the nose, and the frown lines between the eyebrows. It also lifts the eyebrows, making the eyes look more open.
Common Brow-Lift Techniques
There are two techniques used for performing brow lifts. The classic lift requires a long incision that runs across the top of the head, at the hair line, and down to the ears. However, for a woman who has a high forehead, a coronal incision, which is made behind the hairline, may be used. The endoscopic lift requires three to five small incisions that are made across the forehead, at the hairline. These shorter incisions mean a shorter recovery time and less scarring than those from a traditional brow lift.
Which technique is chosen depends on the thickness, texture and elasticity of the skin, the bone structure of the face, the overall appearance of eyebrows and eyelids, and the position of the eyebrows.
The Brow-Lift Procedure
Brow-lift surgery usually takes about one to two hours to perform, and takes place at a hospital, an office-based surgical suite, or an ambulatory center. Either general anesthesia or intravenous sedation is used. Depending on the surgical technique used, one long incision or a series of small incisions is made. Tissue and muscle underneath the skin are moved or repositioned as necessary. At the end of the procedure, the incision(s) is closed with sutures, screws, adhesives or surgical tape; a drain may be put in to collect excess blood and fluid. Postsurgery, the patient is moved to a recovery area for observation.
Recovery From A Brow Lift
A patient typically returns home on the day of the brow-lift surgery, although an overnight stay may be necessary for some. Swelling may be pronounced for the first day or two after surgery, although most swelling goes away within 2 weeks. To prevent post-operative bleeding, bending and heavy lifting should be avoided for a few days. It can take up to 6 months for swelling to fully subside and scars to fade.
Results Of A Brow Lift
Depending on the patient’s presurgical appearance and goals, a brow lift’s results, which can be seen immediately, can be either subtle or dramatic. Eyes will appear more “open,” and creases across the forehead, bridge of the nose, and between the eyes will be much less prominent.
Risks Associated With A Brow Lift
Prior to scheduling surgery, the patient and surgeon should fully discuss the risks associated with a brow lift. In addition to those associated with any type of surgery, a brow lift’s risks include the following:
- Hair loss around the incision site(s)
- Facial asymmetry
- Higher hairline
- Injury to facial nerves
- Eye dryness/irritation
The chance of complications is minimized by choosing a board-certified plastic surgeon who has experience in performing brow lifts.