Blepharoplasty: features and technique

Due to the fact that the skin of the eyelids is very thin and delicate, age-related processes are manifested primarily in the area around the eyes. “There is no longer a sparkle in the eyes” - this is how they say about a woman who has undergone age-related changes on her face. Therefore, ladies should know that cosmetic centers are currently offering a universal procedure designed to solve many aesthetic problems in the eye area - blepharoplasty.

The main advantage of the procedure is the ability to carry it out not only to solve a number of cosmetic defects, but also to restore vision. Often the overhanging eyelid becomes the reason for resorting to this operation. This problem leads to a narrowing of peripheral vision, and subsequently to a deterioration in detailed work. By correcting the aesthetic defect, the doctor thereby restores the functionality of the optic organ.

Hernial sacs, wrinkles, unwanted eyelid shape and eye shape - blepharoplasty can cope with all these problems. The procedure has an average degree of pain, but today some technologies allow the therapy to be performed with almost no pain.

In Russia and Europe, it is mainly women who have crossed the age threshold of 45 who decide to undergo surgery., they want to tighten the skin of the eyelids with the help of the procedure.In Asia, most often the clients of cosmetic centers are young 18-year-old girls who are dissatisfied with their eye shape - this problem can also be solved by blepharoplasty. After the procedure, the eyes of young ladies become visually larger and more rounded.

The puffiness of the eyelids, which occurs with age, is an overhanging upper eyelid, dark circles appear under the eyes, each glass of water before bedtime only aggravates the situation.

This condition makes a woman irritable, she is unhappy with her appearance. Her eyes always look tired and are actually tired of the puffiness. This situation spoils the mood, and difficulties in applying makeup also arise. After blepharoplasty, you can forget about all these problems for a long time.

The operation is carried out:

• under local anesthesia;
• under intravenous anesthesia with local anesthesia;
• under general anesthesia.

In this case, it is required to stay in the hospital for about a day. The stitches are removed about a week after the procedure. The price for the service of the operation depends on such factors as the type, the work of the surgeon and the anesthesiologist, and the hospital stay. It should be remembered that all tests that must be passed before the procedure are paid by the patient separately. The average price in Moscow is 60 thousand rubles. In other regions, the maximum cost reaches 50 thousand rubles.

Depending on the type of problem that has arisen and some other factors, blepharoplasty is divided into several types:

• Upper eyelid surgery. The most common variety. During this operation, the surgeon removes excess tissue and fatty formations that provoke the overhanging of the eyelid.
• Lower eyelid surgery. Can cope with puffiness of the eyes, lacrimal grooves, sagging skin in the area of ​​the visual organ, bags.
• Circular plastic. Combines upper and lower eyelid treatments. Usually, this particular variety is recommended by cosmetologists, since an integrated approach can lead to a full-fledged cosmetic result.
• Cantoplasty. This type of procedure is intended to change the shape of the patient's eyes. Basically, women strive to give their face a European look, but there are also girls who prefer to see themselves with an Asian eye shape.
• Cantopexy. It is a lifting of the outer corners of the eyes to the desired level.

The main techniques for the implementation of the surgical process:

• Classical. It is the execution of a puncture on the skin of the eyelids and the elimination of the problem through the hole made.
• Transconjunctival. In this situation, the incision is made on the inner lining of the eyelid. The method is good because it does not leave visual seams on the skin.
• Combined. Combines the traditional method with a scalpel and the use of a laser device. Laser resurfacing of the skin in the periorbital zone allows you to eliminate scars, irregularities, smooth out areas where wrinkles have formed.

To understand which type of blepharoplasty is suitable for a specific problem, you need to familiarize yourself with the most common types in more detail, learn about their advantages and disadvantages.

The essence of fat-preserving blepharoplasty is the same distribution of the emerging fat formations. That is, in fact, the defect that has appeared is not eliminated, but its fat is transferred to other tissues around the eye. This method prevents such a phenomenon as the skeletonization of the eye, which means a tight fit of the skin of the orbit. This complication often occurs after some plastic procedures.

The method allows you to get rid of xanthelasma. This phenomenon is the formation of a yellowish tinge in the form of a plaque on the upper eyelid at the inner corner of the eye.

In addition, the technology prevents such a consequence as falling eyes, is able to smooth out the tear grooves. Thus, the patient's face after the procedure takes on a youthful and fresh look. By filling the periorbital areas with the client's own fat, the doctor removes excess skin on the eyelids.

During the operation, using the transconjunctival method, the excessive amount of fat in the eyelid area is eliminated. The difference between the technique is its gentle nature. In this case, sutureless surgery is used. The intervention is performed through the conjunctiva, the delicate skin of the eyelids does not touch. The doctor makes a puncture on the conjunctiva and eliminates the fatty formation through the micro-incision made. In the same way, it is possible to modify the areas of fatty sacs, to correct the shape of the eyelid.

The main advantages of the variety:

• complete absence of internal and external seams and scars;
• short rehabilitation period: after a couple of weeks, some of the standard consequences in the form of bruises and swelling are completely eliminated;
• there are practically no complications;
• effective cosmetic result.

It is an injection procedure performed without the aid of a scalpel. The main goal of therapy is to eliminate defects caused by mimic and age-related processes.

During the operation, the woman is fully conscious, external anesthetics are used as anesthesia.

Under the areas where the wrinkles are located, the surgeon injects a drug cocktail by injection. It usually contains hyaluronic acid. The crack formed with the advent of age is filled from the inside with the drug, thereby the skin around the eyes is leveled.

Collagen, actively released under the influence of therapeutic agents, strengthens tissues, and, as a result, consolidates the result of the procedure. The face acquires a youthful and fresh appearance.

This type of surgery is appreciated by patients for the following benefits:

• instant tightening effect;
• short recovery period;
• painlessness;
• absence of scars and other consequences of skin injury;
• affordable price in comparison with other methods.

Within a year, the effect is lost, since the preparations filled under the skin are absorbed.

The most preferred option for blepharoplasty. This is due to the fact that the technology affects the entire area around the eye socket. Thus, the procedure is able to cope with all the existing problems.

The method can be considered a radical measure of rejuvenation, since it eliminates age-related defects. "Age cracks", dark bruises, drooping eyelid, seeming unkempt under the eyes due to age disappear.

Incisions are made in the lower eyelid area under the eyelashes and in the natural folds. Through the punctures, the surgeon takes out fatty hernias, evenly distributes fatty formations, lifting or strengthening the muscles under the eyelids is possible. Excess skin is also removed.

After surgery, subtle scars may remain on the face, which eventually become invisible or completely disappear.

In this situation, for correction, a small element of the eyelid is carefully cut off, after which the preserved parts are connected.

The operation is performed in natural folds, which gives a positive cosmetic effect. But in exceptional situations, carrying out the procedure in a natural fold is impossible. And in this case, there is also a high probability of achieving an ideal result without aesthetic defects.

Despite the fragility of the eyelid skin (its thickness is only one millimeter), it tends to quickly recover. During the rehabilitation period, the use of various creams, massage and gymnastics is required, all these measures also contribute to accelerated healing.

Before the procedure, special lenses are put on the patient's eyes to protect the optic organ from laser exposure. The therapy is carried out under local anesthesia; its functions are performed by anesthetic creams.

The bottom line is that the incision is carried out using a special laser device. Further, through the puncture, fatty formations and excess skin are eliminated. In addition, under the influence of the laser, the skin cells are heated, which has a beneficial effect on the tissues of the eyelids. Muscle tissue is strengthened, collagen production is activated.

It is a surgical correction of the Caucasian eye shape. It consists in removing the epicanthus, which leads to a weakly expressed natural fold of the upper eyelid.

Epicanthus is a fold located at the inner corner of the optic organ, hiding the lacrimal tubercle. This problem can bother the patient from birth, or it can be acquired as a result of eye injury. This particular fold is removed by the surgeon during an oriental procedure, after which a double supra-orbital fold is created.

The objective of the presented plastic surgery is to eliminate excess fatty or skin tissue in the area around the eye.

The most common problems with which patients turn to a plastic surgeon for this procedure:

• Xanthelasma. Formed in the area of ​​the eyelids in the form of yellowish flat plaques. They are benign by nature. Most often found on the upper eyelid in the inner corner of the eye. First of all, this problem is inherent in patients with diabetes mellitus or high cholesterol levels.
• Fats or lipomas. A flaw occurs in an area with a lack of adipose tissue. It looks like a small fat formation with fat inside it.
• Papillomas. These are moles that form in the skin around the eyes in the form of hanging formations.
• Chaliazion. It is a cyst-like formation. It has a benign character, but if its size exceeds 5 mm, then there is a likelihood of a malignant one. To prevent this negative process, the neoplasm must be removed.

Other skin problems that blepharoplasty can solve:

• sagging century;
• epicanthus;
• excess skin in the lower eyelid area;
• wrinkles;
• heaviness of the eyelids, which provokes the appearance of tired eye syndrome.

These are the most common defects that women who decide to undergo surgery complain to the doctor. After the procedure, the patient's face looks fresh and healthy. With the help of the presented type of plastic, it is possible to change the cosmetic shape or shape of the eyes.

It is very important before the operation when the doctor examines the patient's anamnesis to give him full information about the state of his health. Perhaps a woman has serious contraindications to the procedure, which poses a threat not only to her body as a whole, but also to her life.

The main restrictions for the operation:

• exacerbated chronic diseases;
• myopathy;
• high pressure inside the skull;
• oncology;
• diabetes;
• impaired blood clotting;
• anemia;
• blepharitis or keratitis;
• hypertension;
• corneal infections;
• critical days.

This is a very serious operation.

If any conditions are not met, including the lack of taking into account contraindications, the patient may expect such complications as:

• Puffiness. This process will occur after the operation, even if there are no contraindications, but if the swelling does not go away within a week, then this is a reason to seek advice from the operating doctor.
• Bleeding. Small hematomas can also be a variant of the norm, but if the area of ​​injury increases in size, and the blood does not stop, then you need to visit the surgeon again so that he eliminates the cause of the bleeding.
• Scarring. After performing transconjunctival or laser therapy, they should not be. During other varieties, scars may appear in the case of unrecorded health factors. If after a month the tissue has not recovered, then it is necessary to resort to the introduction of special preparations under the skin through various cosmetic procedures.

To avoid all these unpleasant consequences, contraindications and individual characteristics of the organism should be taken into account when performing the operation. Usually, the operation does not have a seasonal focus, so many people prefer to see doctors in the summer, when they really want to come from vacation to work with a fresh and youthful face. Doctors differ in this regard.

Advantages of performing the procedure in the summer:

• summer vacation allows you to sit out the entire two-week rehabilitation period at home;
• During the summer months, blood flow improves in the dermis tissues, which has a positive effect on the activation of collagen production and tissue healing.

Cons of the operation in the summer:

• it is required to avoid direct sunlight on the face;
• you can not sunbathe;
• improved blood flow provokes the active formation of scar tissue;
• Because of the summer heat, the bandages applied to the face will cause discomfort.

Most likely, he will focus on the individual characteristics of the patient's body.

An important stage of preparation is the choice of a plastic surgeon and a medical center where the operation will be performed. If the procedure is offered by an unscrupulous doctor with little work experience, the patient runs the risk of facing the following complications:

• Inversion of the lower eyelid. In the event of this phenomenon, the woman cannot completely close her eyes, and then the visual organ begins to dry out. The doctor is to blame for the problem, who overdid the amount of tissue removed. A repeated procedure or a special massage can give the eye a healthy position.
• Infection. A microscopic foreign body can enter the incision site, which will subsequently cause an infectious process. Before carrying out the procedure, the operating room must be completely disinfected, the instruments must be disinfected.
• Bags under the eyes. They are a variant of the norm during the recovery period, but sometimes they can arise due to the unprofessionalism of the doctor. For example, during a fat-conserving blepharoplasty, an inexperienced surgeon may overdo it with the addition of tissue. Only repeated surgical intervention is capable of eliminating the defect.

• Divergence of seams. The phenomenon may occur due to an error in the process of overlaying them. If a problem arises, it is necessary to hem the loose fabrics again.
• Asymmetry of the eyes. The reasons may be incorrect suturing, uneven elimination of adipose tissue.
• Descent of the century. Observed in case of incorrect therapy technology. Only a second operation will help to save the situation.
• Epicanthus. Formed in the case of excessive tissue tension. The defect is eliminated through a secondary procedure.

When choosing a doctor, pay attention to his experience in carrying out a specific type of operation - his practice must be at least two years.

Having chosen a doctor, the woman proceeds to the next stages of preparation.

She will have talks with at least three doctors:

• plastic surgeon;
• anesthetist;
• ophthalmologist.

It is important not to hide anything in a conversation with specialists. The complications that await the patient, who kept silent about any health problems, was written above.

Before talking with your doctor, prepare information about the following information:

• are there any allergies;
• Lifestyle;
• genetic predisposition to any disease;
• alcohol or tobacco addiction;
• lifelong eye problems;
• visual impairment;
• previous operations.

After talking with the doctor, the patient will be assigned a list of tests.

It usually includes the following items:

• KLA and blood biochemistry;
• OAM;
• blood group and Rh factor;
• analysis for HIV, syphilis and hepatitis;
• coagulogram;
• ECG;
• fluorography.

A clinical examination of a woman who consulted a doctor for the presented procedure includes the following stages:

• determination of the volume of an excessive amount of skin tissue on the eyelids;
• identifying the exact position of excess subcutaneous fat;
• examination of the structure of "crow's feet";
• position of the outer third of the century;
• the stage of ptosis, if any, and the likelihood of its formation;
• condition of fibrous tissue;
• the work of the muscles that control the lifting of the eyelids.

Direct preparation for the procedure usually consists of the following conditions:

• you can not eat and drink at least 8 hours before the operation;
• the procedure is carried out no later than 4 days before the critical days or after menstruation;
• it is necessary to come to the operation with one of the relatives for further escort;
• no smoking before the procedure;
• a few days before performing therapy, it is required to stop taking medications that can reduce blood clotting;
• it is necessary to take with you an ointment specially developed for use after this procedure, or Traumeel-S gel, Vizin eye drops.

Having chosen a highly qualified doctor and carefully preparing for the operation, the patient comes to the procedure. Each individual problem requires a specific type of blepharoplasty. Their technology varies considerably.

The procedure consists of the following steps:

• the client is asked to lie down and not close her eyes;
• the surgeon retreats 9 mm from the line of ciliary growth, marking the bottom of the lowered fold;
• then the patient sits down and slightly covers her eyes;
• the doctor determines the upper edge of the fold and makes a mark with the instrument;
• the client is anesthetized with local or general anesthesia: in the first case, antibacterial compounds are used, then an injection is performed into the upper eyelid;

• the marked area is removed with the device;
• then an incision is made with the elimination of small muscle tissue;
• in the center of the recess, the circular muscle is separated from the fibers and through the fascial septum they penetrate into the central pocket, through which fat is eliminated;
• stitches and a bandage;
• the patient is transferred to the ward.

If general anesthesia was used, the client remains in the hospital for a day.

The procedure is carried out in the following sequence:

• the doctor notes the areas necessary for correction, starting from the area under the lacrimal opening at a distance of up to 2 mm from the place of eyelash growth;
• then the woman should sit down and close her eyes so that the doctor can make sure that the marks are correct;
• pain relief is performed;

• along the marked line, the surgeon makes an incision and separates the tissue from the muscles;
• through muscle fibers, the instrument penetrates into the central fat pocket, from where fat accumulations are eliminated;
• deposits from internal and external pockets are eliminated in an identical way;
• the most important stage of the procedure is the assessment of the amount of excess tissue: the likelihood of complications in the form of shortening of the lower eyelid depends on the correct actions of the doctor;
• suturing and bandaging.

In this case, the markup is not needed, so the doctor immediately proceeds to the procedure:

• the surgeon retreats 2 mm from the bottom of the conjunctival sac and makes a puncture on the conjunctiva 1.5 cm long;
• through a horizontal incision, fat deposits are removed from the hernial pockets;
• sutures are applied.

In this situation, the skin folds are not excised, which ensures that there is no lifting effect.

Usually, a laser procedure is prescribed for age-related skin defects. On the upper eyelids, folds are removed, while correcting the lower eyelids, edema, hernias, bags are eliminated.

The work uses a carbon dioxide or erbium laser:

• first, the doctor makes the necessary markings;
• special lenses are put on the patient's eyes;
• local anesthesia in the form of a cream is applied;
• a laser cut is made in the natural fold;
• fat and excess skin is eliminated through the depression;
• the wound is treated, a suture is applied;
• then a cold compress is applied to the injured area.

It was already noted above that the operation is intended to tighten the tendons of the outer corners of the eyes, as a result of which the cut of the eyes is modified, the sagging lower eyelid is eliminated.

Technique:

• the doctor applies the markings;
• general anesthesia is usually given, but local anesthesia is sometimes offered;
• the first puncture is made on the lower eyelid at a level of 2 mm from the place of eyelash growth;
• a second incision up to 1 cm long is made under the eyebrow in a natural fold;
• fat hernias are eliminated through the depressions in the lower eyelid;
• the periosteum is stitched through the upper incision, then a special suture is made under the ligament that forms the outer corner (all these actions are performed with a self-absorbable suture);
• the periorbital muscles are fixed, after which the thread is returned to the periosteum;
• the ends of the thread are connected and fastened;
• excessive skin tissue formation is removed;
• sutures are superimposed, while only two nodules should remain above the epidermis.

If cantoplasty is performed, the stages of the operation are the same, but some of the tendons are removed, their ends are connected and sutured to the periosteum.

The rehabilitation period is usually short.

Women should prepare for some of the consequences that cannot be avoided after surgery.

In the first weeks, the patient is expected:

• small bruises on the face;
• puffiness of the eyes;
• noticeable stripes of notches;
• bruises.

All these problems are the norm, they should completely disappear in 2-3 weeks. If during this period there is no improvement, then it is worth contacting the operating doctor for advice.

Taking proper care of the area around your eyes that has undergone surgery will speed up cell regeneration:

• In the early days, it is recommended to apply ice to the face. To do this, wrap the ice in a towel or place it in an airtight bag and keep the bundle in the face area twice a day for 3-5 minutes. Coldness minimizes swelling.
• You can use pharmacy ointments to restore tissue at incision sites. Suitable "Traumeel", "Bepanten", "Panthenol".
• Microcurrent therapy will help reduce swelling and accelerate skin cell regeneration.

In addition to skin care, it is recommended to observe a few more conditions after the procedure:

• physical activity is prohibited;
• it is worth refusing to go to the solarium, bathhouse, sauna, not to take hot baths;
• it is necessary to do without alcohol and smoking during rehabilitation;
• it is better not to eat heavy food;
• you can not wear contact lenses;
• for sleeping, you need to choose a high pillow;
• traumatic facial treatments such as peeling or massage should be avoided;
• it is better not to wash your face with tap water, but to use special lotions and products based on artificial tears;
• do not sit in front of a TV or computer monitor for a long time.

Exercise promotes faster healing of bruises and puffiness and improves the final result.

The following exercises are recommended:

• We look straight ahead. We look to the left, then to the right. We carry out several times.
• Raising our face up, we begin to blink as quickly as possible within 40 seconds.
• We close our eyelids tightly and quickly open our eyes, peering into some object in the distance. We carry out 5-6 times. It is important to avoid frowning at the same time.
• Place your fingertips gently on your eyelids. Without removing them, we try to open our eyes. It is required to repeat 5 times.
• Putting our fingers on our temples, we try to gently pull the skin up, slightly lifting the cut of the eyes. Do the exercise 5-7 times.

Putting herself in the hands of the surgeon, the patient completely entrusts her health and beauty to him. To avoid medical errors and side effects after surgery, you need to choose a competent specialist.

To do this, heed the following tips:

• Do not trust banner ads. Better find a real ranking of the best surgeons in your city.
• Explore the doctor's portfolio. Look at the before and after photos, but don't be guided by them. Obviously, the doctor will present the most successful works.
• Check out the information about the medical center where the doctor works. Make sure you have licenses. It will not be superfluous to read the reviews of those operated on by the selected specialist. The opinions of clients about the medical center itself also matter.
• If the doctor reports that his work experience is 15 years, it is worth clarifying what the experience in performing blepharoplasty is. Perhaps he just recently started this activity. Ask for certificates, pay attention to the dates in the documents.

• Consider the opinions of friends and acquaintances. If a friend shines with an excellent result of blepharoplasty, then on her "tip" you can contact the same specialist. However, if a friend is satisfied with the result after breast augmentation surgery, this does not mean that the same doctor professionally performs blepharoplasty.

Cosmetologists also give advice to those who have decided on an operation:

• Blepharoplasty can be combined with other cosmetic procedures such as temporal, frontal or facial lifting. It is possible to simultaneously perform eyelid correction, as well as dermabrasion or peeling.
• You can start using cosmetics after the procedure after 10 days, but you should choose hypoallergenic products. You can return to light physical activity after 7 days, more serious sports should not be started earlier than after 2 weeks.
• An effective way to hide scars after correction is eyelid tattooing. However, you can contact the medical center for this service no earlier than six months later, when the scars are completely healed.
• Blepharoplasty is recommended not only for women, but also for males. Many men want to get rid of the gloomy facial expression that gives age in adulthood. The presented operation copes well with this task, however, the technology of the procedure will differ from the procedure for a woman.

It fights well with age-related problems, and its effect can last up to 10 years. However, in order for the procedure to be carried out correctly and the result to please the patient, it is worthwhile to approach the choice of a competent specialist with all responsibility.

For more information on the procedure for lower eyelid blepharoplasty, see the video.