- type: correction of excess skin on the eyelids and elimination of the grease responsible for bags under the eyes
- anaesthetic: local
- length of operation: 1 to 2 hours
- length of stay: several hours (outpatient)
- social isolation: 8 days
The benefits: Allows elimination of sad look, “beaten dog”, tired look, with restoration of appearance as it was some years ago.
COSMETIC SURGERY OF THE EYELIDS
The purpose of a blepharoplasty is to correct the signs of ageing in the eyelids and replace the “tired” look with a more restful, relaxed appearance.
DEFINITION, OBJECTIVES AND PRINCIPLES OF COSMETIC EYELID SURGERY
“Blepharoplasties” are the name given to cosmetic eyelid surgery operations aimed at eliminating unsightly features present whether hereditary or due to age.
They may relate solely to the two upper or lower eyelids or even to the four eyelids at the same time.
A blepharoplasty may be conducted in isolation or combined with another cosmetic surgery operation on the face (frontal lifting, temporal lifting, cervico-facial lifting), and even a medico-surgical therapeutic operation (laserbrasion, peeling, dermabrasion). These operations are likely to be carried out during the same operation or during a second operating phase.
THE MOST COMMON UNSIGHTLY FEATURES IN QUESTION ARE AS FOLLOWS:
- Heavy, falling upper eyelids, with excess skin forming a fairly prominent fold,
- Lower lips sagging and withered, with small horizontal wrinkles due to cutaneous distension,
- Fat hernias responsible for “bags under the eyes” level with the “puffy” lower or upper eyelids..
The purpose of the operation is to correct these abnormalities permanently by surgically removing the excess skin and muscle as well as the fatty protrusions without of course altering the essential functions of the eyelids.
It should be noted that numerous other alterations may be present but that their treatment is only possible using more complex techniques than simple standard blepharoplasty, or by conducting supplementary surgical procedures. This applies to the collapse of the forehead and drooping of the eyebrows, frown wrinkles between the eyebrows, crows-feet wrinkles at the corner of the eyes, rings round hollow eyes, “sad” eyes with corner of the drooping eyes, as well as minor surface imperfections of the skin (superficial wrinkles, scars, spots, etc.).
The operation, conducted on both men and women, is currently practised in patients in their forties. However, it is sometimes conducted much earlier if the abnormalities are constitutional (hereditary factors) and are not associated with age, such as certain “grease spots”.
The cosmetic surgery of eyelids (or blepharoplasty) cannot be covered by health insurance.
BEFORE THE OPERATION
Questioning, followed by an examination of the eyes and eyelids, will have been carried out by the surgeon in the search for anomalies that could complicate the operation, even contraindicate it.
A specialised ophthalmological examination, will be frequently requested as a supplement in order to detect possible ocular pathology.
A pre-operative examination is carried out according to the applicable rules.
The anaesthetic doctor will be seen in consultation 48 hours before the operation at the latest.
No medicine containing aspirin must be taken in the 10 days preceding the operation.
It is strongly recommended that the patient stop smoking (or reduce his consumption as much as possible) one month before and one month after the operation (tobacco may be the cause of a delay in healing).
Depending on the type of anaesthesia, you may be asked to keep fasting (eat or drink nothing) for 6 hours before the operation.
TYPE OF ANAESTHESIA AND CONDITIONS OF HOSPITALISATION
TYPE OF ANAESTHESIA
Three procedures may be considered:
- Pure local anaesthetic, where analgesic product is injected locally to ensure the insensitivity of the eyelids.
- Deep local anaesthetic by tranquillisers administered intravenously (“vigil” anaesthesia). .
- General anaesthesia where you will sleep throughout the procedure.
The choice from among these different techniques will be the result of a discussion between you, the surgeon and the anaesthetist.
CONDITIONS OF HOSPITALISATION
The operation may be practised on an “outpatient” basis, i.e. with discharge the same day after a few hours of monitoring.
However, brief hospitalisation may be preferable in some cases. The patient will therefore be admitted in the morning and discharge will be authorised the day afterwards.
Every surgeon adopts a technique which suits him and which he adapts to each case to achieve the best results. However, certain common basic principles may be applied:
Upper Eyelids: these are concealed in the furrow halfway up the eyelid, between the moving part and the fixed part of the eyelid.
Lower eyelids: these are placed 1 to 2 mm below the eyelashes and may be extended a little beyond that. The line of these incisions corresponds of course to the location of the future scars, which will therefore be concealed in natural folds.
Note: For the lower eyelids, in the case of isolated “bags” (without any excess skin to be removed), a transconjunctival blepharoplasty may be performed, i.e. using incisions inside the eyelids, thus leaving no scar that will be visible on the skin.
From these incisions the unsightly fatty hernias are removed and the excess muscle and skin released is eliminated. At this stage, numerous technical refinements may be applied to adapt to each case, according to the normal practices of the surgeon.
These are carried out with very fine stitches which are normally non-resorbable (to be removed after a few days).
Depending on the surgeon, the number of eyelids to be operated on, the extent of the improvements to be made and the necessity to perform any additional procedures, the operation may last from half an hour to two hours.