The blespharoplasty of the upper lids often assimilated to forehead rejuvenation should be distinguished from the blesharoplasty of the lower lids which is linked to the check bones.
Thus the lids are not operated upon but the around the eye area, an essential element relating to the non-verbal communication is rejuvenated.
The removal of the eye lids’ excess skin only leads to the ‘just operated upon’ aspect of the eye. Indeed working on the frontal orbital area to retrieve its original aspect will re-open the eye and restore its charm.
Upper lids
With the passage of time the upper lids drop and redundant skin accentuated by the eyebrow’s natural curvature give the eye a permanent ‘tired’ aspect.
Lower lids
With the passage of time the lower lids develop bugling fat pockets often more visible in the morning under a thin layer of wrinkled skin.
It is not possible to just to, pull the skin to tighten it since the lids naturally go in that direction.
The anaesthetic
Surgery is either performed under light anaesthetic, or, exceptionally, general anaesthetic. The choice is determined by the extent of surgery and individual patient wishes.
The surgery
• Excess skin on the upper lid makes the use of make-up difficult and gives the eyes a sad _expression, which makes the patient’s look older. In order to remove excess skin, an incision of a few millimetres will be done in the lid crease. Afterwards it will barely be noticeable since the lid skin heals so well. A thin pink line may be noticed for a few weeks but can easily be camouflaged with make-up. Using this incision, excess skin is removed and the fat causing the swelling around the eye is reshaped. This requires meticulous care often necessitating the use of magnifying loops. Sometimes the patient can choose to have the external angle of the lid moved upwards to enhance the almond shape of the eye.
• In the case of lower lids rejuvenation, the incision lies along the lower lash line. It rapidly becomes unnoticeable. Fat pads are removed and possible skin excess is eliminated by redraping the skin. The skin is never tightened; it is retailored so as to “fit” the shape of the face .
In some cases, fat pads may be removed through an incision done inside the lower lid using a conjunctival route; the skin is then treated with the carbon dioxide laser. A small bandage is applied for a few hours and the patient can go back to his home in the evening or on the day after surgery, depending on the extent of the procedure and on the type of anaesthetic.
A lipostructure carried out at the same time will restore the curve in harmony with the cheekbone and fill the dark ring in.
Post-operative care
Moderate bruising can occur. The conjunctival oedema sometimes feels like a “bubble” in the eye, but will subside in a few days. If the patient has been treated with laser, his skin will be pink for a few days.
The patient can always contact the surgeon for reassurance or to discuss concerns. A consultation is planned three to eight days after surgery. With self absorbing sutures there is no need to remove any stitches.
Make-up can be worn four days after surgery.
Problems and complications
Problems are unusual but can occur even with a highly qualified surgeon: i.e. substantial bruising requiring prompt removal so as to avoid visual impairment, eye pain due to minor scratching, and temporary retraction of the lid.
These problems rarely occur. However the patient must be informed exhaustively about this surgery, which provides excellent long-term results.
