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 sparkle in the eyes” - this is what 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 possibility of carrying out it not only to solve a number of cosmetic defects, but also to restore vision. Often the reason for accessing this operation is the overhanging eyelid. This problem leads to a narrowing of peripheral vision, and further to a deterioration in detailed work. Correcting an aesthetic defect, the doctor thereby restores the functionality of the visual organ.

Hernia sacs, wrinkles, unwanted eyelids and an eye incision - blepharoplasty can cope with all these problems. The procedure has a moderate degree of pain, but today some technologies allow the therapy to be performed with almost no pain.

In Russia and Europe, the operation is mainly decided by women who have crossed the age threshold of 45 years, they want to tighten the skin of the eyelids using the procedure.In Asia, most often clients of cosmetic centers are young 18-year-old girls who are dissatisfied with their open eyes - blepharoplasty can also solve this problem. After the procedure, the eyes of young ladies become visually larger and more rounded.

The swelling of the eyelids, which occurs with age, is an overhanging upper eyelid, dark circles appear under the eyes, each glass of water before going to bed only exacerbates the situation.

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

The operation is carried out:

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

It is required to stay in the hospital for about a day. Sutures are removed about a week after the procedure. The price for the operation service depends on such factors as the variety, the work of the surgeon and anesthesiologist, and hospital stay. At the same time, it is worth remembering that all the tests that must be passed before the procedure, the patient pays 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, blepharolastic is divided into several types:

• Upper eyelid repair. The most common variety. During this operation, the surgeon removes excess tissue and fatty tissue, provoking an overhang of the eyelid.
• Plastic surgery of the lower eyelid. It can cope with swelling of the eyes, lacrimal grooves, sagging skin in the area of ​​the visual organ, bags.
• Circular plastic. Combines procedures on the upper and lower eyelids. Usually, this particular variety is recommended by cosmetologists, since an integrated approach can lead to a complete cosmetic result.
• Kantoplasty. This type of procedure is designed to change the patient’s eye section. Basically, women tend to give their face a European type, but there are also girls who prefer to see themselves with an Asian cut of eyes.
• Cantopexy. It is a pulling of the outer corners of the eyes to the desired level.

The main techniques for the implementation of the surgical process:

• Classical. It is a puncture on the skin of the eyelids and the elimination of the problem through a hole made.
• Transconjunctival. In this situation, an 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 grinding of the skin in the periorbital zone allows you to eliminate scars, bumps, smooth out areas where wrinkles have formed.

To understand what type of blepharoplasty is suitable for a particular 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 resulting fat formations. That is, in fact, the appeared defect is not eliminated, and its fat is transmitted to other tissues around the eye. This method prevents the phenomenon of skeletalization of the eye, which means a tight fit of the skin of the eye socket. This complication often occurs after some plastic procedures.

The method allows you to get rid of xanthelasm. 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 a consequence such as drooping of the eye, is able to smooth out the lacrimal grooves. Thus, the patient’s face after the procedure becomes young and fresh. By filling the periorbital areas with the client’s own fat, the doctor eliminates the excessive amount of skin on the eyelids.

During surgery in a transconjunctival manner, excessive amounts of fat in the eyelids are eliminated. The difference between the methodology is its gentle character. In this case, seamless surgery is used. Intervention is performed through the conjunctiva, the delicate skin of the eyelids does not touch. The doctor performs a puncture on the conjunctiva and eliminates the fat formation through a micro-incision. 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 sutures and scars;
• short rehabilitation period: after a couple of weeks, some standard consequences in the form of bruises and edema are completely eliminated;
• there are practically no complications;
• effective cosmetic result.

It is an injection procedure performed without the help of a scalpel. The main goal of therapy is the elimination of defects caused by facial and age-related processes.

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

Under the areas where wrinkles are located, the surgeon injects a medicinal cocktail. Usually it 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 evens out.

Actively released under the influence of therapeutic agents collagen provides tissue strengthening, and, as a result, consolidation of the result of the procedure. The face takes on a young and fresh appearance.

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

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

After a year, the effect is lost, since the preparations filled under the skin dissolve.

Most preferred blepharoplasty. This is due to the fact that the technology affects the entire area around the orbit. 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-related cracks”, dark bruises, drooping eyelids, and negligence under the eyes, which appear due to age, disappear.

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

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

In this situation, for correction, an accurate cut-off of a small element of the eyelid is carried out, after which the stored parts are connected.

The operation is performed in natural folds, which gives a positive cosmetic effect. But in exceptional situations, the procedure in the 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 skin of the eyelids (its thickness is only one millimeter), it has the property of rapid recovery. 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, which protect the visual organ from laser exposure. The therapy is carried out under local anesthesia, its functions are performed by painkillers.

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

It is a surgical correction of the Caucasian eye incision. It consists in the removal of 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 visual organ, hiding the lacrimal tubercle. This problem may bother the patient from birth, or may be acquired as a result of eye injury. This special fold is removed by the surgeon during the oriental procedure, after which a double supraorbital fold is created.

The objective of the presented plastic surgery is the elimination of excess fat or skin tissue in the area around the eye.

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

• Xanthelasma They form in the area of ​​the eyelids in the form of yellowish flat plaques. By nature, benign. Most often found on the upper eyelid in the inner corner of the eye. First of all, this problem is inherent in patients suffering from diabetes mellitus or high cholesterol.
• Fatty or lipoma. A defect occurs in the area with a lack of adipose tissue. It looks like a small fat formation, inside of which is enclosed fat.
• Papillomas. These are moles that form in the area of ​​the skin around the eyes in the form of hanging formations.
• Halazion. It is a cystic formation. It has a benign character, but if its size exceeds 5 mm, then there is a chance of a malignant one. To prevent this negative process, the neoplasm must be removed.

Other skin problems that blepharoplasty can solve are:

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

These are the most common defects that women who have decided on operative surgery complain to the doctor. After the procedure, the patient's face skin looks fresh and healthy. Using the presented type of plastic, it is possible to change the cosmetic shape or section of the eyes.

It is very important before the operation, during the doctor’s examination of the patient’s medical history, to give him full information about his health condition. Perhaps the woman has serious contraindications to the procedure, which poses a threat not only to her body as a whole, but also to life.

The main restrictions for the operation:

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

This is a very serious operation.

In case of failure to fulfill any conditions, including the lack of consideration of contraindications, the patient may expect complications such as:

• Swelling. This process will occur after surgery even in the absence of contraindications, but if the swelling does not go away within a week, then this is an occasion to seek the advice of the operating doctor.
• Bleeding. Small hematomas can also be a normal option, but if the site of injury increases in size and the blood does not stop, then you need to visit the surgeon again to eliminate 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 unaccounted health factors. If after a month the tissue has not recovered, it is necessary to resort to the introduction of special preparations under the skin through various cosmetic procedures.

To avoid all these unpleasant consequences, it is necessary to take into account contraindications and individual characteristics of the body 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 want to come to work with a fresh and young face. Doctors differ in this regard.

Pros of performing the procedure in the summer:

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

Cons of the operation in the summer:

• direct sunlight should be avoided on the face;
• you can not sunbathe;
• improved blood flow provokes 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 experiencing the following complications:

• Inversion of the lower eyelid. In the event of this phenomenon, a woman cannot completely close her eye, and then the visual organ begins to dry out. The doctor who overdoes the amount of tissue removed is to blame for the problem that arose. To give the eye a healthy position will be able to repeat the procedure or a special massage.
• Infection. A microscopic foreign body can get into the incision site, which will subsequently cause an infectious process. Before the procedure, the operating room should be completely disinfected, the instruments should be decontaminated.
• 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 fat-preserving blepharoplasty, an inexperienced surgeon can overdo it with the addition of tissues. To eliminate a defect is only capable of repeated surgical intervention.

• Divergence of seams. The phenomenon may occur due to errors in the process of their imposition. If a problem occurs, it is necessary to hem the diverged tissues again.
• Asymmetry of the eyes. The reasons can be incorrect suturing, uneven elimination of adipose tissue.
• The omission of the century. It is observed in case of improper therapy technology. Only a repeat operation will help save the situation.
• Epicanthus. It is formed in case of excessive tissue tension. The defect is eliminated through a secondary procedure.

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

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

She expects conversations 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 was silent about any health problems have been written above.

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

• are there any allergies;
• Lifestyle;
• genetic predisposition to any disease;
• alcohol or tobacco addiction;
• skin problems in the eye area throughout life;
• visual impairment;
• previously performed operations.

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

It usually includes the following items:

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

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

• determination of the amount of excessive amounts of skin tissue on the eyelids;
• identification of 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;
• fibrous tissue condition;
• the muscles that control the lifting of the eyelids.

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

• Do not eat or drink at least 8 hours before surgery;
• 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 support;
• Do not smoke before the procedure;
• a few days before performing therapy, it is necessary to refuse to take medications that can reduce blood coagulation;
• you need to bring along an ointment designed specifically for use after this procedure, or Traumeel-S gel, Vizin eye drops.

Choosing 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 technologies vary greatly.

The procedure consists of the following steps:

• the client is asked to lie down and not close her eyes;
• the surgeon deviates 9 mm from the ciliary growth line, 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 marks the instrument;
• the client is anesthetized with local or general anesthesia: in the first case, antibacterial compounds are used, then an injection into the upper eyelid is performed;

• the marked area is eliminated by the device;
• then an incision is made with the removal 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 the fat is eliminated;
• sutures and dressing;
• the patient is transferred to the ward.

If general anesthesia was used, then 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 2 mm from the eyelash growth site;
• then the woman should sit down and close her eyes so that the doctor makes sure the marks are correct;
• anesthesia is performed;

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

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

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

In this situation, skin folds are not excised, which ensures the absence of a lifting effect.

Usually a laser procedure is prescribed for age-related skin defects. On the upper eyelids, folds are removed, with the correction of the lower eyelids, edema, hernia, 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 used;
• a laser cut is performed in a natural fold;
• through the recess, fat and excess skin are eliminated;
• 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 for tightening the tendons of the outer corners of the eyes, as a result of which the incision of the eyes is modified, the sagging lower eyelid is eliminated.

Technique:

• the doctor applies the markup;
• general anesthesia is usually performed, but local anesthesia is sometimes suggested;
• the first puncture is performed 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 carried out under an eyebrow in a natural fold;
• through the recesses on the lower eyelid, fatty hernias are eliminated;
• the periosteum is stitched through the upper incision, then a special suture is performed under the ligament that forms the external angle (all these actions are performed by a self-absorbable thread);
• 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, then the steps of the operation are the same, but at the same time, some of the tendons are removed, their ends are connected and sutured to the periosteum.

The rehabilitation period is usually not long.

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

In the first weeks, the patient is expected:

• small hematomas on the face;
• swelling of the eyes;
• noticeable strips of incisions;
• bruises.

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

Proper care of the area around the eyes that has undergone surgery will accelerate cell recovery:

• 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 hold the package in the face twice a day for 3-5 minutes. Cold minimizes swelling.
• You can use pharmacy ointments for tissue repair in sections of cuts. Suitable "Traumeel", "Bepanten", "Panthenol".
• Microcurrent therapy will help reduce swelling and speed up the regeneration of skin cells.

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

• prohibited physical activity;
• it is worth giving up going to the solarium, bathhouse, sauna, and not taking hot baths;
• it is necessary to do without alcohol and smoking during the rehabilitation period;
• it is better not to eat heavy food;
• Do not wear contact lenses;
• for sleep, you need to choose a high pillow;
• avoid traumatic facial procedures such as peeling or massage;
• it’s better not to wash yourself with tap water, but use special lotions and products based on artificial tears;
• Do not sit for a long time in front of a TV or computer monitor.

Gymnastics promotes accelerated 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 perform several times.
• Raising your face up, we begin to blink as quickly as possible for 40 seconds.
• We close our eyelids tightly and quickly open our eyes, peering at some object in the distance. Perform 5-6 times. It is important to avoid frowning eyebrows.
• Gently place the fingertips on your eyelids. Without removing them, we try to open our eyes. Repeat 5 times.
• Putting your fingers on the temples, we try to gently pull the skin up, slightly raising the incision in the eyes. Exercise do 5-7 times.

Surrendering to the surgeon, the patient completely trusts him with his health and beauty. To avoid medical errors and side effects after surgery, you need to choose a competent specialist.

To do this, listen to the following tips:

• Do not believe advertising on banners. Better find the real ranking of the best surgeons in your city.
• Examine the doctor’s portfolio. Check out before and after photos, but don’t focus on them. Obviously, the doctor will present the most successful work.
• Check out the information about the medical center where the doctor works. Make sure you have licenses. It will be useful to read the reviews operated 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 experience is in conducting blepharoplasty. Perhaps he most recently embarked on this activity. Take an interest in certificates, pay attention to dates in documents.

• Take into account the opinions of friends and acquaintances. If a friend shines with an excellent result of blepharoplasty, then by 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.

Advice to those who decided on the operation, and give cosmetologists:

• Blepharoplasty can be combined with other cosmetic procedures, for example, temporal, frontal or facial lifting. Perhaps the simultaneous correction of the eyelids, as well as dermabrasion or peeling.
• You can start using cosmetics after the procedure after 10 days, but you should choose hypoallergenic drugs. You can return to light physical activity after 7 days, more serious exercise cannot be started earlier than after 2 weeks.
• An effective way to hide scars after correction is eyelid tattoo. 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 a gloomy facial expression that gives age. The presented operation copes well with this task, but the technology of the procedure will differ from the procedure for a woman.

She perfectly fights age-related problems, and her effect can last up to 10 years. However, in order for the procedure to be carried out correctly and the result pleased 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.