| Blepharoplasty - corrective eyelid surgery |
| Transconjunctival lower blepharoplasty |

Blepharoplasty - corrective eyelid surgery

Wrinkles and bulges on the eyelids occur either because of hereditary factors or aging. Protrusions of fat above and below the eye produce pouches.

Such excessive fat is removed along with excessive skin. At times, the excessive skin hanging from the upper eyelid may be, to some extent, caused by a sagging of the eyebrows. In some cases, it is advisable to perform a forehead lift with a lifting of the eyebrow or a direct eyebrow lift prior to or at the time of the corrective eyelid operation (Fig. 16).

Upper and lower eyelid surgery is not only combined on frequent occasions with a forehead lift but also with a lower face lift, in order to achieve a better aesthetic balance of all the facial features.

Figure 28-a (click image to enlarge)

Figure 28-b (click image to enlarge)

Before surgery, an eye physician will be asked to perform an intra-ocular examination to establish that there are no contra-indications to the proposed procedure.

The operation is usually carried out under a local anaesthetic following sedation. Only minor disability accompanies the early recovery from surgery. Dark sunglasses can be worn from the second post-operative day to camouflage the discoloration and swelling. This usually disappears within ten days. By that time, make-up can be successfully used to cover thread thin scars.

With a proper pre-operative assessment and careful surgical technique, serious complications following this operation are extremely rare. I encourage you to discuss the details of any possible complication during the pre-operative visit.

The scars are placed on the eyelids and designed to blend in well with the surrounding skin. After several months, only very close examination can reveal their presence. Some individuals tend to form pinhead size nodules in the scars. These represent a small dilatation of sweat and sebaceous glands similar to blackheads. They usually dry out within one year and, if troublesome, will be evacuated in the doctor's office with very little discomfort.

The surgery can remove excess skin and bagginess. It cannot prevent the remaining skin from forming small folds with the underlying muscle contraction during smiling or other facial expressions. The "crows feet" and the fine wrinkles require chemical peeling or laser correction.

Transconjunctional Blepharoplasty

Lower eyelid correction with skin tightening using incision under the eyelash.

Note: practically invisible scars under the eyelashes.

Figure 16-a (click image to enlarge)

Figure 16-b (click image to enlarge)

Bulges under the eyes can occur as inherited tendencies necessitating
surgery in early life, as in this patient.

Figure 20-a (click image to enlarge)

Figure 20-b (click image to enlarge)

This young executive had a tired appearance caused by inherited
"bags" under the eyes. This has been fully reversed by a
lower blepharoplasty.

Figure 68-a (click image to enlarge)

Figure 68-b (click image to enlarge)

Prominent eyes present a special difficulty while correcting the lower eyelids
in order to obtain a natural and rejuvenating result.