Eyelid Surgery (Blepharoplasty)
Eyelid Surgery (also known as Blepharoplasty) is a cosmetic surgery procedure to reshape the eyes. The purpose is to remove excess skin, fat and tissue around the eyes. Depending on your lid features, eye lid surgery can help firm the skin around your upper eyes and/or remove lower eye bags, taking years off your facial appearance. There are various surgical options available for blepharoplasty, depending on whether you require upper eye or lower eye surgery.
Frequently Asked Questions
Eyelid Surgery Benefits
Blepharoplasty is a very common procedure which can have a drastic effect on your looks. Compared to other surgeries, the operation is simple with little pain and short recovery. The benefits of eyelid surgery can be aesthetic and functional.
The procedure can be used to improve a number of problems including removing excess skin which hangs over the natural fold in your upper eyelids. This hanging or draping skin develops with age as the elastic fibres loosen. As for the lower eyelids, it’s common for the fatty cushion around the eyes to slip, forming under eye bags. Blepharoplasty can remove these bags, correcting the tired, droopy look.
The improved, younger appearance can also have a positive effect on your confidence and self-esteem. Looking at tired eyes every time you gaze into a mirror can exacerbate tiredness and make you feel drowsy. On the other hand seeing youthful, alert eyes can have the opposite effect.
As to function, having droopy skin removed can restore your peripheral vision. This is why some blepharoplasty costs are covered by Medicare or your private health insurer. Ask your doctor for a referral to an eyelid surgeon if your upper eyelids are obscuring your vision.
Upper Eyelid Surgery
When operating on the upper eyelids, the incision is made across the natural crease at the back of the eyelid. If the surgery is minor, the incision is about 25mm long. A longer cut is required if fat is being removed in addition to excess skin. In this circumstance, the incision can extend beyond the eyelid to where your wrinkles are.
The surgeon then removes a thin strip of fat, muscle and/or redundant skin. The surgeon only removes a moderate amount of fat. If too much is taken, the eyes can have a sunken look. The fat is removed from the outer edge of the lids, the middle and also from the inner corner. Most of it collects in the outer edge (near the crow’s feet).
Once the loose or sagging muscle has been tightened, the incision is closed with fine stitches (usually nylon or polypropylene). If your operation involves all four lids (upper and lower), the surgeon usually operates on the upper lids first.
Lower Eyelid Surgery
Also referred to as eye bag removal, lower blepharoplasty can be undertaken using a number of different techniques. The appropriateness of each method depends on the extent of your excess skin and how much fat has deposited under the eyes.
The surgeon needs to be careful when trimming skin from this area. Even a few millimetres can make a huge difference and potentially destroy that natural look. Most surgeons will be very conservative and some may remove fat only.
The two main techniques for lower eyelid surgery are transconjunctival and transcutaneous. In transconjunctival blepharoplasty, the incision is made on the inside of the eyelid. The surgeon removes excess fat only and closes the incision with dissolvable stitches. The wound may also be left to heal naturally without any sutures. Since the supporting structures remain intact, this technique is more suitable for younger persons (whilst the skin and muscles are still elastic). It is not suitable if you have lots of excess skin. Laser resurfacing or chemical peels can be used to treat remaining fine wrinkles.
As for transcutaneous, this procedure allows removal of excess fat and skin. An incision is made in your skin on the outside of your eyelid (a few millimetres below the lower lash line). Once the skin is lifted, the surgeon separates the fat from muscle tissue and removes excess fat.
Removing too much fat can cause the eyes to look hollowed out. This can also happen a few years after surgery as the ageing process continues. To prevent this, some surgeons don’t remove the fat but rather push it back toward the face and stich it in place. Once the fat is removed or pushed back and any excess skin has been trimmed, the skin is pulled back into place and reattached with stitches. The skin can even be stretched wide to eliminate some wrinkles.
Another lower eyelid technique is the SOOF method. This procedure is used to lift up fatty pads under the eye which have slipped downward. This alleviates the sunken appearance. The SOOF technique is not performed on its own. It’s an additional (and more invasive) procedure used with standard blepharoplasty methods to improve the overall result.
Double Eyelid Surgery (Asian Blepharoplasty)
Asian blepharoplasty is commonly referred to as double eyelid surgery. Often Asian eyes lack the crease that is common in the western appearance. Even though all Asian people do actually have double eyelids (a double fold), it’s often not visible due to the upper lid drooping. If the fold of skin is lifted, the double fold can be seen. Usually, the cause is the lack of muscle above the eye.
Asian men and women do not opt for eyelid surgery to look more like westerners. Their motivations are simply to improve their looks by eliminating the single eyelid (lid without a crease). There are several options for Asian eyelid surgery: full-incision, partial incision and no incision techniques. Asian blepharoplasty can also be performed with an epicanthoplasty (removal or reduction of the epicanthic fold) however this procedure is now quite rare because of the scarring involved.
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