Dr. Alberto Henao M.
Facial Plastic Surgery
BLEPHAROPLASTY
Blepharoplasty is a type of surgery that is performed to repair droopy eyelids and may consist of removing excess skin, muscle, and fat.
As you get older, the eyelids stretch and the muscles that support them weaken. Consequently, excess fat can accumulate above and below the eyelids, causing sagging eyebrows, drooping upper eyelids, and bags under the eyes.
Aside from looking older, a significant sagging of the skin around the eyes can reduce lateral vision (peripheral vision), especially in the upper and outer parts of the visual field.
Blepharoplasty can reduce or eliminate vision problems and make the eyes appear younger and more alert.
Diagnostic Appointment
P reviously to any type of surgery we must assess the existence of any eyelid abnormality , which can be corrected in the same act and, as for upper eyelid blepharoplasty, we must assess any associated eye pathology.
With the previous assessment and after a correct assessment of the excess of the different tissues we will arrive at a correct indication. In this case "the pinch test" has a relative value , and less reliability than in the upper eyelid. To assess possible fatty hernias, we will apply light pressure on the eyeball through the upper eyelid, evaluating the three compartments (internal, middle and external), finally with the patient looking up or with the oral opening, we will assess muscle hypertrophy, which will be the type of surgery to follow and what may be the details of this procedure.
Before Blepharoplasty you must perform:
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A physical examination. The surgeon will perform a physical examination that could include an analysis of tear production and measurements of some parts of the eyelids.
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An eye exam. The ophthalmologist will examine your eyes and evaluate vision, including peripheral vision. This point is necessary to support an insurance claim.
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Photographs of the eyelids. Photographs of the eyes will be taken from different angles. These photos help schedule surgery, assess immediate and long-term effects, and support an insurance claim.
Process
It is an intervention that is carried out to repair sagging or drooping upper eyelids (ptosis) and remove excess skin from this area. The surgery is called blepharoplasty.
Droopy or sagging eyelids appear as you get older. Some people are born with droopy eyelids or contract a disease that causes them to droop.
Description:
Eyelid surgery is performed in a surgeon's office. Or in a medical center like outpatient surgery.
The procedure is done as follows:
They give you medicine to help you relax.
The surgeon injects an anesthetic around the eye so that you do not feel pain during the surgery. You will be awake during the procedure.
The surgeon makes small incisions in the natural folds or folds of the eyelids. The flabby skin and excess fatty tissue are removed. Then the eyelid muscles are secured. At the end of the surgery, the incisions are closed with sutures.
Why the procedure is performed:
Eyelid surgery is necessary when the droopy eyelid reduces vision. You may be asked to have your vision checked by an ophthalmologist before having surgery.
Some people undergo this surgery to improve their appearance and in this case it is called elective or cosmetic surgery. Eyelid surgery can be done alone or in conjunction with other facial surgery, such as eyebrow lift or face lift.
Eyelid surgery does not remove wrinkles around the eyes, nor does it raise drooping eyebrows, nor does it remove dark circles under the eyes.
Risks:
The risks of anesthesia and surgery in general include:
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Drug reactions
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Bleeding, blood clots, infection
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Damage to the eye or loss of vision (extremely remote possibility)
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Difficulty closing your eyes when sleeping (rarely permanent)
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Blurred or double vision
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Dry eyes
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Temporary swelling of the eyelids
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Small white spots after stitches are removed
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Slow healing
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Uneven healing or scarring
The medical problems (pre-existing patient pathologies) that make blepharoplasty more risky are:
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Diabetes
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Dry eye or insufficient production of tears
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Heart disease or vascular disorders
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High blood pressure or other circulatory disorders
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Thyroid problems such as hypothyroidism and Graves' disease
After the procedure:
Generally, you can go home the day of the surgery. Arrange ahead of time for an adult to drive you home. Before your departure, the surgeon will cover your eyes and eyelids with an ointment and a bandage. The eyes may feel tight and sore as the effect of the anesthesia wears off. The discomfort is easily controlled with pain relievers.
Keep your head elevated as much as possible for several days. Put cold compresses on the area to reduce swelling and bruising. Wrap the ice pack in a towel before applying it. This helps prevent cold injury to the eyes and skin.
An antibiotic or drops will be recommended to lubricate the eyes to decrease burning or itching. You will be able to see well after 2-3 days. You should not wear contact lenses for at least 2 weeks and minimize activities for 3-5 days, avoid strenuous activities that raise blood pressure for approximately 3 weeks. This includes lifting heavy objects, bending over, and strong sports.
Your stitches will be removed 2 to 7 days after surgery. You will have some bruising or bruising, which can last 2 to 4 weeks. During the first few weeks, you may notice an increase in tears, increased sensitivity to light and wind, as well as temporary changes in vision, such as blurred vision or double vision.
Expectations (prognosis):
Scars may remain a little pink for 6 months or more after surgery. These scars fade away leaving an almost invisible thin white line. The appearance of looking more alert and youthful can last for years and these results are permanent for many people.
Postoperative and care after a Blepharoplasty
If you are considering this surgery but you are concerned about the image of the postoperative period, read our following recommendations:
Regarding inflammation, keep in mind that the eyelids are easily inflamed and that the old trick of applying cold is very effective. We recommend to our patients to make an infusion with 5 bags of chamomile in a saucepan of water and then store that water in the fridge, soak gauze pads and apply them to the eyes.
To increase the vasoconstriction caused by cold and therefore the decrease in edema, you can also use cold gel glasses that are sold in pharmacies or gadget stores or make bags with frozen peas.
In order for the inflammation to reduce faster, it is very important not to lie completely down, but to lie down with 3-4 cushions to sleep or rest.
Any hematoma has an evolution time of 10 to 15 days, the surface and the duration are a very personal aspect because it will depend on blood pressure, medication that is usually taken and the vascularity of the entire area. What we can do in addition to applying local cold is to apply a venous decongestant at first and then if there is any pigmentation, a depigmenting agent with chelators. Arnika pills or creams can also be a good preventive treatment.
With blepharoplasty it is perhaps a good time to resume the habit of radio; In addition to all these tips, I also recommend that you become radio fans, the eyes, despite not having touched them, are more sensitive and if we read or watch television, they can become more inflamed.
Good headphones and a fun station will be the best ally to spend the first 3-4 days of rest and care at home.
From the week when the stitches are removed, the appearance has already improved, if any purple is still visible, you can use makeup to disguise that it has yellow tones that are the best disguise. The best sport to leave until 20-30 days.
