Facial cosmetic surgery
Cosmetic eyelid surgery / blepharoplasty
The appearance of the eye is an essential component of the characteristics of the face. It conveys the emotion and energy that inspire us
Blepharoplasty in Asian patients (also called "Asian Double Eyelid Surgery") aims to create a natural -looking crease in the eyelids of Asian patients.
Incisionnal or non-incisionnal methods can be used depending on each cases.
An epicanthoplasty can be associated. The result is a more energetic appearance and a more or less caucasian-looking.
Over time, the eyes don’t stand out as much ; they become sad and tired, communicating a false negative impression of the actual state of mind.
This is the time to seek advice from a plastic surgeon. Cosmetic eyelid surgery (blepharoplasty or eyelid lift) is certainly an option for upper eyelids (upper blepharoplasty) or lower eyelids (lower blepharoplasty), or both at the same time (blepharoplasty of 4 the eyelids).
Principle of aesthetic blepharoplasty
With the upper eyelids, an excess of wrinkled skin gives an unsightly appearance. It weighs down the eyelids and plays a part in the closure of the palpebral fissures. In extreme cases, this excess skin can hang over the eyelids and partially hinder the field of vision. In addition, there is the variably noticeable protrusion of the little bulb of fat of the upper eyelid near the nose. Incisions in the natural crease of the upper eyelid and crow’s-feet are made to surgically remove excess skin and fat.
With the lower eyelids, excess skin gives a withered look to the eyelid. The excess fat is responsible for the "puffiness". These pockets are removed by a trans-conjunctival incision located on the far side of the eyelid on the side of the eye. The excess skin is removed through an incision located 2 mm below the lashes.
Your plastic surgeon considers your eye as a whole, and insome cases, he will propose additional procedures to get a better result :
- Botox injections are used to raise the tail of the eyebrow and smooth frown lines and crow's feet. The result is temporary, injections are repeated every 5 to 6 months to maintain the results ;
- The temporal lift can permanently raise the tail of the eyebrow ;
- Fat injections or hyaluronic acid injections can correct the hollows under the eyes and plump up the lateral half of the eyebrow. The result after fat injections is permanent. However, hyaluronic acid injections need to be repeated every 8-12 months ;
- A centro-facelift can correct round eye (or scleral show) and fill eye hollows. It also helps to raise cheekbones and correct nasolabial furrows, even if it is beyond the scope of the eye surgery. Fat injections, the temporal lift or centro-facial facelift are performed in the same operation as blepharoplasty. Botox injections or hyaluronic acid injections are given inthe doctor’s office 15 days before or after eyelid surgery.
The blepharoplasty is performed on an outpatient basis under assisted local anesthesia (type analgesia). The procedure lasts from 45 minutes to 1 and a half hours depending on the number of lids treated and any associated procedures included.
The procedure can be carried out under general anesthesia with a hospitalization of 24 hours when combined with one or more complex procedures (cervical-facial lifting...) or for reasons of comfort.
After surgery, the patient leaves the operating room with cold compresses applied to the eyes for an hour. There is normally no pain, however some discomfort is common (stinging eyes, impaired vision, feeling of tension in the eyelids).
The after effects are characterized by edema (swelling) of the face and ecchymosis (bruises) of varying degrees depending on the patient. The eyelids may not close completely for a few days.
Makeup is permitted after removal of the stitches from 6 to 8 days following the procedure.
The patient can resume professional and social activities 1 to 3 weeks after the operation, depending on the type of job.
The result is very satisfactory, sustainable and natural. The scars are located in the natural folds and are almost invisible after a few weeks. For lower eyelids without excess skin, the removal of pockets of fat through the trans-conjunctival approach leaves no scars on the skin.
Risk of complications
As with any surgery, a number of complications can occur. But the likelihood of these complications is reduced in the hands of a qualified plastic surgeon and in the presence of a competent anesthetist. The patient’s compliance to instructions given by the surgeon is also essential and include :
- stopping smoking 1 month before and after the procedure (reduction of all risks) ;
- not taking aspirin for 10 days before and after the procedure (reduced risk of hematoma).
Fortunately, postoperative effects are generally manageable following a blepharoplasty that has been carried out properly, so serious complications are rare.
In spite of the fact that complications are so rare you must be aware of the following problems :
- A hematoma : this must be rapidly drained.
- Infection : this is extremely rare when the procedure is carried out in sterile environment.
- Abnormal scarring : this is very rare for the eyelids where the skin usually heals leaving no trace of surgery. Tha scars can however sometimes be more pronounced than hoped.
- Ptosis and ectropion : very rare with a good technique.
In case of a complications, your surgeon will treat them successfully if necessary.
In practice, the vast majority of cases take place without any problem and the patients are satisfied with the result.
Health insurance coverage
As this procedure is considered purely for aesthetic purposes, no coverage is provided by health insurance.
For the upper eyelids and in case of excess skin reducing the field of vision that is proven through testing by an ophthalmologist, partial coverage may be granted. You will be responsible for the additional surgeon and the anesthesiologist fees which may be redeemable in whole or in part by your health insurance.
Author: Dr. Christophe Laveaux
Specialist in aesthetic surgery - Antibes
Reproductions, even partial, of the texts are allowed on the express condition cite the author (Dr. Christophe Laveaux) with a direct link to the article mentioned.