Blepharoplasty

Cosmedica Clinic Blepharoplasty

This cosmetic surgical procedure intends to reshape the upper eyelid or lower eyelid by the removal and/or repositioning of excess tissue.

The procedure also reinforces the surrounding muscles and tendons.

Medical needs

When an advanced amount of upper eyelid skin is present, the skin may hang over the eyelashes and cause of loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected. Such condition may result in difficulty with activities such as driving or reading.

Cosmetic needs

Patients with a less severe amount of excess skin may still wish to undergo similar procedure for cosmetic reasons. Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid “bags” and reduce the wrinkling of skin.

The procedure

Blepharoplasty is performed through external incisions made along the natural skin lines of the eyelids. Such location may be the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid.

Duration

The operation takes one to three hours to complete, depending on the scope of the procedure. Initial swelling and bruising take one to two weeks to resolve. However, until the final result becomes stable, it needs at least several months to heal.

The outcome

The cosmetic outcome of the procedure depends on the anatomy of the upper/lower eyelids, the patients` skin quality, the patients` age, and the bony tissues and soft tissues which are adjacent to the location the Blepharoplasty took place.

Complications

There are factors known to cause complications after surgery. Failure to recognize such factors before the operation may result in undesired outcome.

For example, such factors may be:

• Pre-existing dry eyes. The situation after operation may become worse, by disrupting the natural tear film;
• Laxity (looseness) of the lower lid margin (edge), which caused lower lid malposition;
• Prominence of the eye in relation to the malar (cheek) complex, which causes lower lid malposition.

Asian Blepharoplasty (double-eyelid surgery)

Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat–usually along with excess skin and muscle from the upper and lower eyelids.

Asian blepharoplasty (double-eyelid surgery), is a surgery designed to place a pretarsal crease in Asian eyes that are absent a fold.

Patients are typically looking to remove the puffy and tired look associated with a fatty upper lid.

In America today, the majority of Asian patients do not seek to “westernize” their appearance. Plastic surgeons should be careful in modifying a patient`s ethnic appearance, even in the rare case when it is requested.

Asian patients with a puffy upper lid and an absent crease may wish to improve such an appearance. The patient may have difficulty in applying eyeliner (because of the overhanging fat), and may wish to have a crease similar in appearance to other Asian people who were born with such a crease.

Approximately 50% of Pacific Asians (Koreans, Japanese, Chinese) have a pretarsal crease.

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations.

Most commonly, patients are female teenagers or in early 20s. Occasionally there are also male patients, aged late 20s to early 30s. Female patients may report difficulty applying eyeliner. There are many cases where females apply cellophane tape to create a fold as part of their daily makeup ritual.

In Asians with a fold, the height of the normal lid fold lies 8-10 mm from the lash line with the skin gently stretched. In contrast, folds in white individuals tend to be larger and have less orbitopalpebral fat.

The primary difference between white versus Asian eyelids is the inferior level of the fat. In whites, the supratarsal fold marks the inferior limit of the fat. This inferior limit is also the point at which the levator aponeurosis attaches to the dermis, creating an upper lid crease.

In the Asian eyelid, this dermal attachment rests lower, resulting in a smaller crease, or it does not attach to the skin at all, resulting in an absent fold.