Upper eyelid blepharoplasty
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Upper eyelid blepharoplasty is a cosmetic surgical procedure that aims to remove excess skin from the upper eyelid by improving the appearance of "tired" eyes.
As we age, there are changes in our eyelids, the structures at this level become looser and there is an excess of skin, muscle and sometimes excess fat.
We can resort to this surgery for both aesthetic and functional reasons, when the ptosis is so great that it obstructs vision.
Anatomy of the upper eyelid
The structures of the upper eyelid are:
• the orbicularis muscle of the eye
• retroorbital fat
• orbital septum
• medial and central orbital fat
• lacrimal gland - located in the lateral part of the upper eyelid
• the superior oblique muscle
• the lifting muscle of the upper eyelid
• levator muscle aponeurosis
• Muller muscle
How is blepharoplasty performed?
Blepharoplasty surgery is performed under local anesthesia, possibly associated with sedation, rarely requires general anesthesia. The areas will be marked first, there is excess skin and the incisions are placed in the natural folds of the eyelids, from the internal angle of the eye to the external angle, but they can also be continued laterally (approx. 1-2 cm) to improve " goose foot "(wrinkles in the corner of the eye).
The incisions heal very well, after a few months they will be visible only when looked at very closely (and only for those who know where to look for them).
Recovery after blepharoplasty
Immediately after the operation, the patient feels minimal discomfort, the eyelids being swollen.
Postoperatively you may feel mild pain and stinging, your eyelids will be swollen and bruised, a few days you will experience a few drops of blood. It is possible to cry harder and have some vision problems ("foggy" vision, increased sensitivity to light, double vision). For these you will receive proper medication, cold compresses will be applied and you will have to sleep with your head and chest higher. A very rare complication is bleeding that may require reoperation to resolve.
Recommendations after blepharoplasty
It is very important that patients follow the postoperative recommendations:
• In case of pain or discomfort, analgesics will be administered
• avoid the administration of aspirin, other anticoagulants and postoperative antineuralgic
• it is recommended that the patient sleep with his head in a higher position than the rest of the body
• it is recommended to rest in the next 2-3 days after the operation and to avoid activities that may require eyesight: reading, writing, watching TV / computer
• the removal of sutures and dressings is done between 5 and 7 days postoperatively
• in the first 2-3 weeks after surgery it is recommended that the patient avoid bending the body, heavy physical exertion and lifting weights
• after about 7-10 days the patient can return to normal activities
• Swelling of the eyelids may persist for up to several months postoperatively, especially in the morning
• avoiding local traumas
The results are visible immediately and are long lasting. Aging can cause lowering of the eyebrows and the appearance of excess skin on the upper eyelids, a situation in which an eyebrow lift is recommended.
Swelling of the eyelids may persist for up to several months postoperatively, especially in the morning.
Complications of blepharoplasty
• bleeding - the risk of bleeding is higher in people who use anticoagulants or antiplatelet agents, so it is recommended to stop the medication at least one week before the operation
• soft tissue necrosis
• chemosis (swelling of the white of the eye)
lagophthalmia (inability to close eyes)
• dry eye sensation
• ugly scarring
• wound dehiscence - the skin on the eyelids being very thin, wound dehiscence can sometimes occur, but it is not a major problem
• eyelid malposition - occurs when too much skin and muscle is removed
• ptosis (fall) eyelid
• turning the eyelid inwards or outwards
• extremely rarely impaired vision.