BLEPHAROPLASTY
Every year, hundreds of thousands of men and women choose blepharoplasty to improve the way they look. Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows.
WHAT IS BLEPHAROPLASTY?
Blepharoplasty is an operation which is indicated for the treatment of excess skin (dermatochalasis) from the upper eyelids and/or orbital fat. Excess skin is often due to ageing changes. The eyelid appeareance may be typical for your family. Sometimes episodes of swelling of the eyelid due to infection or allergy can stretch the skin.
Preoperative evaluation should include a thorough medical and ophthalmic history, along with a detailed cutaneous and eye examination. Physical examination should take into account brow position, eyelid ptosis, lower eyelid position, and cheek projection.
The eye is an important component of facial aesthetics, and blepharoplasty can play a vital positive role in facial harmony and the perception of aging. Blepharoplasty is one of the most commonly performed facial cosmetic procedures. Symptoms such as tired-looking eyes, excess skin, droopy eyelids, or circles around the eyes may benefit from blepharoplasty. Preoperative patient evaluation for blepharoplasty should document medical and ophthalmologic history such as chronic systemic diseases and medications. Ophthalmologic history should be obtained, including vision, corrective lenses, trauma, glaucoma, allergic reactions, excess tearing, and dry eyes.
| ASSESSMENT OF THE UPPER EYELIDUpper eyelid dermatochalasis is the loss of elasticity and support in the skin. This can create a fold of excess upper eyelid skin, which can impair the function of the eye, including super-lateral visual field obstruction. ASSESSMENT OF THE LOWER EYELIDLower eyelids should be assessed for skin excess and fat herniation, which typically presents as medial, central, and lateral fat pads. Lower eyelid fat becomes more prominent in upgaze and less prominent in downgaze.
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THE OPERATION
In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat is removed or repositioned, and then the loose muscle and skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar.
In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures. Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also commonly self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.
ANESTHESIA
Blepharoplasty may be performed under either local or general anesthesia depending upon the surgical plan, patient and surgeon preference. A simple upper or lower eyelid blepharoplasty where only skin or fat is excised can be performed under local anesthesia.
POSTOPERATIVE CARE
| Postoperatively, patients should be advised to use ice packs on the surgical site for three days to minimize postoperative swelling. Non-absorbable sutures, if used, can be removed after 3-5 days. Your surgeon will also list activities and environments to avoid in the weeks immediately following surgery. If your eye feels sore when the anaesthetic wears off, your surgeron will prescribe you simple painkillers like Paracetamol or Ibuprofen. Normally, the discomfort will settle within a day or two. You should not drive yourself home after the operation. Before you leave you will be given drops and ointment to use for a week or so after the surgery. Eyelids normally heal very well and the wound is hidden in the natural skin crease of the lid.
BIBLIOGRAPHY |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840922/
http://www.aafprs.org/patient/procedures/blepharoplasty.html
http://www.plasticsurgery.org/cosmetic-procedures/eyelid-surgery.html
http://www.nhs.uk/Conditions/Cosmetic-surgery/Pages/Procedures.aspx#eyelid