What is Blepharoplasty (Eyelid Surgery)?
Blepharoplasty is a type of surgery that repairs droopy eyelids and may involve removing excess skin, muscle and fat. This makes the eyes seem more alive and the surrounding skin smoother. Blepharoplasty is an old surgical approach that has been successfully applied for many years. With the development of modern plastic surgery, blepharoplasty techniques and approaches have also changed and improved.
Focusing on the locating the cause for the condition plays a key role in achieving natural and long-lasting results in the blepharoplasty procedure, just as is the case in other cosmetic interventions
Which Methods are Available to Solve Problems Related to Eyelids?
The problems that may bother you in the eyelid area and their solution alternatives differ according to the upper and lower eyelids. Each problem should be addressed separately.
The upper eyelids can often sag over eyelashes, the excess skin can cover the area in which eyeshadow is applied. This may also be accompanied by the formation of fatty tissue causing the appearance of bags around the eye region. This tissue surrounding the eye socket is termed "periorbital fat tissue".
Non-operative methods may provide satisfactory results when there is only a small amount of excess skin and no bags caused by fatty tissue around the eye region. Fractional-YAG laser applications, which work with the plasmapheresis method, can achieve good outcomes for eligible patients.
Even a simple Botulinum Toxin application without any other intervention used in the eyelid region can provide a good outcome and be a possible solution offered. Botulinum Toxin treatment which can slightly lift the eyebrows, can relieve a small amount of excess skin and provide the desired appearance in the upper eyelids.
However, in the case of more excessive skin together with the presence of fatty bags around the eyelid area the most effective solution is an upper eyelid lift, or upper eyelid blepharoplasty, the medical term used for this procedure.
The lower eyelid with its anatomy creates a significant impact on the effect created on our facial features. The common problems that are experienced in the lower eyelid area are the presence of either a slight amount of excess skin or a larger concern of excess fatty tissue that is present in the lower eyelid. Because the fatty tissue causes that area of the skin to protrude, the baggy appearance is created. This causes an indentation beneath the "bags" under the eye, and the dark and purple colouring in the under eye area.
The indented appearance that is caused by the bagging under the eyes is called a "tear pit" and can be of varying severity. Devices with Fractional-YAG Laser or plasmapheresis method in cases of low severity can give satisfactory results.
Also, if the bagging under the eye is not very advanced, and there is only a small amount of excess skin, autologous fat transfer may be enough to solve the problem in this area. This method uses the patient's own fat tissue to fill in the under eye area including the "tear pit".
In cases where the excess skin (wrinkles) is not excessive, but where there is more "bagging" present, a good outcome can be achieved by removing the fatty tissue from the under eye area by making small incisions from the inside of the eyelid only. No external incisions are used in this procedure. However, in cases where the "bagging" is more excessive, there is more excess skin (wrinkles), the Lower Eyelid Blepharoplasty is the surgery that would be better suited.
An "under-eye filler" can also be considered as an alternative to the resolution of the problem. In this method Hyaluronic Acid, a dermal filler is applied to the undereye area. This procedure has a high complication risk depending on; the quality of the filler material used, whether or not the under eye region is suited to this procedure, and the experience of the specialist doctor applying the procedure. Although it appears to be a simple procedure, it has the potential to create long-term or permanent problems. Therefore, the suitability of the under eye filler method can only be decided for you by a specialist, after a personlised evaluation.
Apart from the methods described here, it is too optimistic to say that you can get results with cosmetic products or other medical methods. The results to be obtained from such applications are inadequate and short-term.
As can be seen, there are several alternatives and combinations of eyelid interventions that can be used to achieve a youthful appearance. At Istanbul Surgical Arts, we work to determine the ideal way to answer your needs, by conducting a specific evaluation.
How Does Eyelid Surgery Work?
The interventions for the eyelids can be divided into two categories, the lower and upper eyelids.
The Lower Eyelids
There are two different surgical methods for the lower eyelids:
1. Subconjunctival Blepharoplasty: If there is minimal excess skin, wrinkling and if the problem is more related to bagging under the eye area, satisfactory results can be obtained by simply removing the fatty tissue from the under eye region.
This method is usually more suitable for younger patients. If there is a lot of slackness in the skin but genetically excessive amounts of fatty tissue in the surrounding area, this procedure is applied.
In this case, the excess fat can easily be removed by entering through the inside of the eyelid. This method is called "Subconjunctival Blepharoplasty". It is the most advantageous method in terms of healing time and post-operative swelling. In addition, there are no visible traces of the incisions as they are made inside the eyelid.
2. Classical Lower Blepharoplasty (Lower Eyelid Blepharoplasty): If excessive skin and wrinkles are present, focussing on only the removal of fatty tissue will not be suitable. For this reason a classic lower eyelid blepharoplasty is the procedure of choice. Excess fatty tissue and excess skin are removed by an incision made under the eyelashes. Adjustments are made to the skin and muscles to create adequate tension and the incision is closed. It takes 2-3 days for the incisions to heal and after a few weeks it will become noticeable only if you look closely or very carefully. After a period of months the incisions often disappear completely.
The Upper Eyelids
As noted, the second category for eyelid interventions is the upper eyelids. Excess skin and fatty tissue found in the upper eyelid area is removed through Upper Eyelid Blepharoplasty. The excess fat is removed through the an incision made in the crease of the upper eyelid. The wrinkled and surplus skin causing the bags are removed and the incision is sutured. The healing of the incision takes 2-3 days, and after a while it is with only careful and close attention that the incision is noticeable. In a few months it disappears almost completely.
What Causes Irregularities in the Eyelids?
The bags formed under and over the eyelids are formed anatomically by the displacement of the fatty tissue normally found around the eyes. In normal anatomy there is a membrane-shaped structure (Septum) which holds the fatty tissue around the socket of the eye, where they should be. The tension of the septum is reduced due to genetic predisposition, stress, chronic fatigue and sleep disorders, cigarette use, and many other reasons, causing the fatty tissue to be displaced and move forward causing the "bags".
This is actually a case of medical hernia. If the correction of bags around the eyelid is done by only by removing the excess fat, the looseness of the septum will continue. This will soon lead to a recurrence of the problem. These details aside, removing excessive amounts of fatty tissue and ignoring the problem in the septum will cause unwanted conditions in later age. This is because if excessive fat is removed from the eye area, the task that the fat has in this area is diminished which causes a "collapsed eye" appearance.
That is why it is very important to adopt appropriate approaches when applying the modern plastic surgery. The cause of the problem being experienced must be identified and addressed. In line with these modern principles, only the necessary amount of excess fat should be removed while the loosened septum is restored to its original tension. Thus the desired, natural and long-term result is achieved.
Which Type of Anesthesia is Used in Eyelid Surgery?
General anesthesia is not required for eyelid surgery. With the technique known as "sedoanalgesia", sedation and local anesthesia is provided together so that the surgery can be carried out without the patient feeling any pain.
You will be completely awake within half an hour of the surgery in the sedoanalgesia method. Following the procedure you will be given some liquid (soup) and then some solid food to eat. After a few hours of rest at the hospital you can return home.
How Long on Average does the Eyelid Surgery Take?
On average the surgery takes 1 to 1.5 hours.
What Can I Expect at My First Doctor's Consultation?
When you consult a Plastic Surgery specialist for a problem with your eyelids, before the examination, the doctor will first ask you about your general medical condition and record your information. Information regarding your age, previous surgeries or illnesses, whether or not you have chronic conditions such as diabetes, hypertension, any medications you use regularly, your use of cigarettes and alcohol, will be required by your doctor.
Following this, your eyelids will be examined and your expectations for the procedure will be assessed. Your doctor will share with you which method or methods are most appropriate for you, their alternatives, and their advantages and disadvantages.
As a result, the treatment or combination of treatments that will provide you with an attractive and youthful result, and also meets your expectations, is determined and carried out by your doctor.
What Should I be Aware of Before the Procedure?
• Smoking is a risk factor for any surgical procedure. It is recommended that you do not smoke for a month before and after the procedure, especially because it can cause discomfort and additional complications in wound healing.
• It is recommended that you do not take aspirin or medications that contain aspirin 2 weeks prior to surgery.
• It is recommended you do not take alcohol the night before the operation so that dehydration does not occur.
• You should not eat or drink anything 8 hours prior to the surgery.
• Following the surgery, we recommend that you have comfortable clothing with you for your stay in the hospital (tracksuit, nightgown with buttons down the front etc).
What Can I Expect Following the Eyelid Surgery Procedure?
The healing period following the blepharoplasty procedure when applied to the upper eyelid or both eyelids is very short. The healing of the incisions takes a few days. Bruising that may occur following the surgery will subside within 4 to 7 days and can be hidden with the use of a concealer.
Will There be Scarring Following the Procedure.
The interventions for the eyelid area are divided into two categories, the bottom and the upper eyelids. There are either no visible incisions created, or the incisions made disappear to near invisibility within a few months following the surgery.