Patients usually complain about the tired expression of their eyes caused mainly from the loose skin of the upper lid.
Often excess skin is so much that it covers the lashes and reduces the field of view.
However, the eyebrow drop at greater ages must be estimated, in order to measure the real excess skin in eyelids.
The basic technique of the upper blepharoplasty in removing excess soft tissue in order to create a natural eyelid fold.
Regarding the quantity of skin to be removed, careful planning is required so that the shape of the upper lid is ideal and we avoid lagophthalmos and eye dryness.
In men it is not desirable to create a deep eyelid fold as it is characteristic for female eyes.
The operation is done under local anesthesia either with a scalpel or very thin diathermy or with CO2 laser.
Upper blepharoplasty with excessive skin removal could be carried out at the doctor’s office, however sometimes it is necessary to remove fat from the upper lid, which will be done carefully in the upper and middle part of the eyelid and lifting of the outer corner of the eyebrow where necessary.
We will have the best scar quality which finally will not be visible with careful intradermal fine seams.
The sutures are removed after 4 days while edemas are mild and vary among patients with a duration of 8 – 10 days.
The aesthetic role of lower blepharoplasty is to overcome the tired and heavy look of the lower lid in order to make the eye area bright and renewed.
The philosophy of the operation has developed further in recent years and so we have predictable and aesthetic results.
It is important to create an almond shape in the eye and its outer corner to be slightly higher than the inner one.
Not much fat and skin must be removed from the lower lid so that the eye does not look “empty” and the possibility of drawing the lashes downward (ectropion) does not increase.
Consequently, the operation aims in recent years to create a more youthful and fuller lower lid by maintaining or transferring fat to other places, using laser and resolving the lack of volume in the middle part of the face.
Selection of transdermal or internal (through the mucous membrane) blepharoplasty, εif required the incision is done 2 – 3 mm below the lashes which is slightly extended outwards.
The lower lid skin and muscle are carefully dislocated in order to determine the excess that will be removed.
Where necessary, the inner and middle fat deposit will be reduced, paying attention to hemostasis.
If pre-operatively insufficiency of tissue has been observed in the area of the cheekbones, this area will be filled with fat.