Sagging eyelid treatment with cosmetic blepharoplasty eye surgery

Cosmetic Blepharoplasty Introduction

Eyes go through an aging process just like our body. This is especially true of the tissue around the eye. Cosmetic blepharoplasty gives the eyes a cosmetic uplift. This type of plastic surgery is performed on both the lower and upper eyelids. It is very popular as people recover quickly and the improvement in appearance is immediate. It is also an operation that can be performed on an outpatient basis using only oral sedation. This makes it a comfortable and expedient operation.

Upper eyelid blepharoplasty

Individuals who are bothered by sagging upper eyelids can benefit from a blepharoplasty. When the skin above the eye sags it is called blepharochalasia. It becomes flabby and droopy as part of the aging process.

Upper eyelids droop when they lose their elasticity and suppleness. This causes the skin and associated forehead skin to loose tension. The result is that the eyebrow drops over the eye socket and sits on top of the upper eyelid.

Other causes of drooping eyelids are too much fat in the brow (protruberances of adipose tissue and a condition called hypertrophic orbicularis muscle. A rare cause is lateral fullness caused by dysfunction of the ptotic lacrimal gland. One or more of these conditions can also cause the sagging. It is crucial to define the causes of the sagging upper lids before deciding on an approach to remedy it.

Preoperative planning

Once the cause of the upper eyelid sagging has been determined there are a few other procedures that must take place before surgery can be scheduled. They are:

A routine overview of medical history: This includes looking for a history of Graves’ disease, a history of bleeding or a history of connective tissue diseases associated with a clinical or subclinical sicca syndrome.

Physical check-up: A detailed physical examination of the eye, along with photography to evaluate any imbalance in the features is also mandatory. The doctor will also examine your eyes thoroughly for any trace of macular disease or glaucoma. The integrity of your tear film is also looked at it to make it is intact.

A session of instruction: Patients will also have a discussion with their doctor about the to expect during the operation and the various procedures that the will undergo. This includes a discussion of how much skin will be removed and how the crease of the eye will be restructured. Complications and side effects associated with the operation will also be discussed. Usually patient will also be told that they cannot wear their contact lenses while recovering from the operation.
Surgical assessments include an examination of the redundant tissues of the forehead and eyelids and an evaluation of the patients brow, forehead and condition of the skin based on the person’s gender. The needs of males and females differs when it comes to a brow lift.

Preoperative marking of eyelids

Just before the operation a surgical incision is marked on the eyelids. This is crucial as it ensures that both eyelids will look even and that they will possess some conformity.

The surgical procedure

The surgical procedure itself consists of three steps -

1. Lifting the myocutaneous flap on the surface
2. Removal of excess fat if required
3. Sealing of the wound with sutures or laser treatment

Lower eyelid blepharoplasty

A lower eyelid belpharoplasty removes bags under the eye. These bags can make a person look haggard or older. The bags are technically defined as s ‘herniated retro-orbital fat that is protruding anteriorly’. This also gives a haggard and aged look to the face. Gentle palpation often gives temporarily relieves the look of bags but the best way to improve the look of the eye is to have a lower eyelid blepharoplasty

There are two approaches to achieving a lower eyelid blepharoplasty. These are the transcutaneous or subciliary approach and the transconjunctival blepharoplasty.

The transconjunctival blepharoplasty generally helps conceal scars from the surgery better. Redundant skin is removed and the scar hidden in the crease of the eye. However a side effect of this procedure is called scar contracture or scar ectropion which actually increases the look of the under eye bags. This problem is not easily corrected.

Surgical and pre-surgical steps

The subciliary or transcutaneous approach to surgery consists of the following steps:

1. Preoperative markings applied to the eyes
2. Surgical procedure under oral sedation
3. Removal of surplus skin using a laser or surgical knife
4. Sealing of the wound using sutures or a laser

The transconjunctival approach involves the following:

• Preoperative markings applied to the eyes
• Operative process
• Postoperative wound care with the use of ophthalmic ointment and artificial tears

Both these procedures also involve a mandatory correction of the tear trough of the eye or the patient could appear to be crying all of the time.