What is an eyelid correction?
A blepharoplasty (eyelid surgery) is a surgical procedure to remove excess skin from the eyelids and fill in bags under the eyes with fat or remove excess fat.
- In an upper eyelid correction, a skin incision is used to remove the skin and sometimes the fat. The skin is then brought together with a small stitch and an eyelid fold can be made.
- Lower eyelid surgery can involve skin incisions directly under the lash line or an incision on the inner side of the eyelid, which is called a transconjunctival technique. This technique allows easy access to the eyelid fat without visible incisions, making it perfect for patients who need fat removed or added.
What can an eyelid correction do for you?
Excess skin and fat on the upper eyelid can lead to a heavy-looking eyelid, a deprecated appearance, bags under the eyes and sometimes a blocked vision. An upper blepharoplasty is performed to remove excess skin and fat and can improve the patient's vision.
Lower blepharoplasty is performed to remove excess skin, reduce wrinkles, and improve the shape of the lower eyelid by removing skin and fat. Sometimes, eyelid tightening is necessary to correct droopiness or sagging. Fat is added to improve a “hollowed out” appearance.
Who is a good candidate for eyelid surgery?
People with realistic expectations who are in good health are suitable for eyelid surgery.
How do you prepare for eyelid surgery?
There is no special preparation for this procedure.
How is an eyelid correction performed?
Blepharoplasty is usually performed under local anesthesia. Typical incisions are shown below.
Upper eyelid
For the upper eyelid, it is important that there is enough skin between the eyebrow and the eyelid margin to be able to close the eyes easily. In women, the distance between the eyelashes and the lower incision should be a few millimeters more than in men.
After the skin incisions are made, the excess skin is removed with fine scissors. Sometimes a small strip of muscle is removed to prevent bulging. If there is some hernia in the inner corner of the eye, a small amount of orbital fat may be removed. The skin is then closed with a long nylon suture that must be removed six days after surgery.
Lower eyelid
First it must be determined whether the skin will be removed.
Transconjunctival blepharoplasty
If this is not the case, an incision on the inside of the eyelid is preferred because the scar is then completely invisible. This procedure is called a transconjunctival blepharoplasty.
To fill the tear, a little fat is moved from the inside of the eye socket and sutured down into a pocket that has formed between the bone and the periosteum. Sometimes this can be followed by a little lipofilling.
No stitches are required as the incision will close spontaneously within a few days.
If there is excess skin in the lower eyelid that needs to be removed, an incision is made just below the eyelashes and extends about 1 cm laterally to the corners of the eyes. Fat removal as described above is performed.
To prevent ectropion (= outward rolling of the lower eyelid), a thin nylon suture is passed through the outer corner of the eye and fixed to the periosteum (soft tissue layer covering the bone) of the orbital rim. This raises the lower eyelid and increases the tension on the lower eyelid.
The excess skin is removed conservatively. The skin is then closed with nylon sutures that must be removed six days after the operation.
Recovery period after eyelid surgery?
- The initial swelling and bruising will disappear after one to two weeks, but it will take at least a few months for the final result to stabilize. Depending on the extent of the procedure, the operation takes about an hour per eyelid. Pain is not really an issue and is very manageable with regular painkillers…
- Most people return to their normal activities seven to ten days after blepharoplasty. Most bruising and swelling will disappear two weeks after eyelid surgery.
What are the risks of eyelid surgery?
- Ectropion, the outward rolling of the eyelid (only the lower eyelid). This may improve spontaneously, but corrective surgery may be necessary.
- Difficulty closing the eyes causing dry eyes. This may improve spontaneously, but corrective surgery may be necessary.
How long do the results last after eyelid surgery?
It is likely that the normal aging process will continue and the eyelids will slowly sag again. However, we also expect the difference the procedure makes to last for a very long time, if not forever.