Here are some interesting facts you likely didn’t know about Blepharoplasty
31 October 2019| Last updated on 25 November 2019
Eyes are known to be the “windows to the soul”. Unfortunately, they are also one of the first areas to show signs of ageing which are not easy to hide, and they make you look fatigued and older than you are.
Maybe you've tried everything to correct eye puffiness and sagging eyelids, but you've just gotten nowhere. Or maybe your drooping eyelids have become such a problem that they're affecting your vision. No matter what is causing your eye issues, it may be time to consider eyelid surgery. Also known as blepharoplasty, this simple procedure can leave you feeling and looking better than ever.
As we age, our skin naturally loses some of its elasticity. This can cause a build-up of loose skin around the eyelids that, in the upper lid, can fold over, producing a hooded effect. In the lower lid the effect may be deepening furrows or creases.
Advancing years also result in a weakening of the muscles in our face, including around the eyes. This can encourage the fat that naturally sits around the eye, protecting and cushioning it, to protrude through the weak muscle, producing puffy lids and eye-bags.
Blepharoplasty, commonly known as "Eyelid Surgery" can drastically enhance the appearance of droopy, puffy and tired eyes. This procedure involves removal of excess skin and pockets of fat from the lower and upper eye lids. This in itself will immediately improve a person's appearance by removing the constant tired look.
Also, if vision was affected by drooping, puffy eyelids, then following surgery this will also no longer be a problem and the eyelids will be firmer and tighter. Wrinkles will also be noticeably reduced. The overall affect is that a person's eyes will look brighter and clearer resulting in a more youthful and alert appearance.
When Should You Consider Blepharoplasty / Eyelid Surgery?
- When It's become increasingly difficult to put on eye makeup
- Even after you've had a good night's sleep people ask you if you're tired
- When you have puffiness under your eyes that never goes away
- When you are developing bulges in the corners of your upper eyelids
- When you have trouble keeping your eyes open
- When your upper eyelids are hooded and always feel heavy
- When your eyes appear to have become smaller
- When your eye makeup smudges very easily
- When you've lost the fold of your upper eyelid
- When your peripheral vision is decreased
- When you have excess skin and wrinkles beneath your eyes
- Ever since you can remember you've had baggy eyes
- When you have skin breakdown or irritation at the area of excess skin
The decision to undergo any type of procedure, including Eyelid Surgery, is very personal, and it’s necessary to have a one to one, thorough consultation with a qualified and experienced surgeon to discuss your treatment options, based on your medical history, indications for surgery and lifestyle.
It is only then; you can decide whether surgery is right for you. Having more information and a clear expectation about what’s next will help you make an informed decision and to better manage your post-op recovery so that you have the best possible experience out of your surgery.
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Blepharoplasty Techniques & Procedure
Your eyes are one of the most important aspects of your appearance, and one of the first areas to show signs of ageing. Excess skin and fat can make eyelids feel weighed down and cause eyes to appear tired or older. If the eyes are more open and relatively free of creases and folds, you will probably seem more rested and youthful.
Advances in eyelid surgery have allowed patients to have the surgery with little to no visible scars. By making incisions in the natural creases of the upper and lower eyelids, surgeons are able to keep most scars from being visible to others. Depending on the severity of the condition of the eyes, different techniques are used in Eyelid surgery.
Upper Blepharoplasty / Eyelid Surgery
In the upper eyelids, excess skin and fat can create a heavy looking eyelid, aged appearance, puffiness, and sometimes it can even block one’s vision. Upper eyelid surgery results in the improvement of two characteristics of the ageing upper eyelid area.
The first is removal of the excess skin and reformation of the lid crease which was obscured by the folds of excess skin. The second is removal, if necessary, of herniated (or pushed forward) fat that leads to a "puffy" appearance. A thin suture is then used to bring the skin together allowing for the creation of an eyelid crease.
Upper Blepharoplasty, however, does not correct crow's feet or lift sagging eyebrows, a combination of other treatments is required to address these concerns.
Lower Blepharoplasty / Eye Bag Removal
Lower eyelid surgery can also involve removal of excess eyelid skin, but more often the appearance of swelling or "puffiness" of the lower eyelids is the reason for patients electing this surgery. In this case, fat pockets in the lower eyelids are pushing forward and this fat is removed.
There are two different surgical techniques for this procedure. If there is excess lower eyelid skin that needs to be removed in addition to the fat, an inconspicuous incision that runs just beneath the lash line is used. Alternatively, if there is no excess skin, the fat pockets can be accessed through an incision made in the inner lining of the lower eyelid, this technique is known as Transconjunctival Blepharoplasty with no external incision.
Asian Blepharoplasty / Double Eyelid Surgery
There is a number of anatomic differences between Asian and Caucasian eyelids. In the Asian upper eyelids, the skin and subcutaneous fat tend to be thicker with an overhanging upper eyelid skin pushing down on the eyelashes. The goal with an Asian Blepharoplasty is to create a crease in the upper eyelid. It is often used to create a more Caucasian look in the patient.
- The operation may be performed under local anaesthetic alone, local anaesthetic with sedation, or general anaesthetic
- Either the upper or lower lids, or both, may be treated during the same operation
- Incisions are made in the natural lines of the eyelids allowing for both skin excision and fat removal
- If only fat removal is required, then the surgeon may opt to remove the fat through an incision hidden on the inside of the lower eyelid (transconjunctival blepharoplasty)
- It takes about 45 to 90 minutes, depending on technique and extent of surgery
- Many times, patients are discharged from the hospital the same day, however some may need to stay overnight at hospital.
Blepharoplasty Results should Look Natural
Patients who undergo cosmetic surgery wants to achieve natural results and Blepharoplasty patients are no different. Correct patient selection and technique is key in achieving this. If the patient does not have indication for surgery but has the surgery regardless, then if she or he is lucky, there won’t be much difference in the appearance of their eyes but in worst case scenario the anatomy of the eyes can be changed and not for the better!
That’s why it is important to find an honest surgeon who is straight with you and performs the procedure only if you have the right indications and not because you ask him to!
Following every surgery, there will always be some inflammation and swelling that usually dwells for a couple of days to a week. You just need to be patient and wait for it to subside. The final results may take up to a few months to be seen but the result will improve week after week and is better appreciated once everything is healed.
For the majority of patients, the result of eyelid surgery is long lasting and many times permanent, however, it will not stop ageing and of course, the younger a patient undergoes surgery, the more likely it is that a further eye surgery may be needed further down the line. The person’s heredity along with external factors and lifestyle, play a big role in how the person ages. Avoiding sun exposure, reducing stress, limiting one’s smoking and drinking will help to maintain the youthful look of the eyes for longer.
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Blepharoplasty May Be Covered By Insurance
Some patients seek Eyelid Surgery purely for aesthetic reasons whereas others have medical concerns and seek surgery for functional reasons. If you need upper eyelid surgery because sagging eyelids are obscuring your vision, then your health insurance may provide coverage for the procedure.
In most cases, a functional eyelid surgery is performed to remove loose skin from the upper eyelid if it droops low enough to impair one’s vision for driving or other visual activities.
Other problems addressed with functional eyelid surgery are:
- Baggy upper or lower eyelids causing difficulty wearing glasses or contact lenses
- Excess folds of eyelid skin rubbing together causing Irritation
- Forehead discomfort from overused muscles that strain to lift sagging skin in the eyelid area.
Functional Eyelid Surgery is normally covered by insurance whereas Blepharoplasty for Aesthetic reasons is not.
Bespoke Approach to Eye Rejuvenation
Before deciding to undergo surgery, it is important to determine the underlying issues causing the concerns you have with your eyes. Sometimes it may be due to a medical condition or it might not even be your eyelids causing the problem, thus requiring another type of treatment. For example, the sagging of eyebrows can sometimes be the root of droopy upper lids, rather than the lids themselves and this should be addressed with a lateral brow lift and not an eyelid surgery.
Sometimes you may not be a good candidate for surgery, your eye concerns may be addressed with non-surgical procedures or you may need to combine blepharoplasty with other surgical or non-surgical procedures to achieve optimum results. Rejuvenating the delicate area around the eyes can be a challenging task.
In order to achieve optimum results, you must identify the problems and address those conditions with a specific technique or a bespoke combination of techniques. The best way to determine the right Eye Rejuvenation procedure to help you achieve the look you want while protecting your delicate eye area, is to have a thorough consultation with a plastic surgeon experienced in both surgical and non-surgical eye rejuvenation procedures. This is an important first step.
Eye Rejuvenation Treatments, surgical as well as non-surgical, can be performed separately or in combination to enhance their effectiveness and to achieve an overall youthful, vibrant look.
In general, surgical results will always be more extensive and last longer than non-surgical ones. However, minimally invasive procedures cost less, require little to no downtime and prove to be very effective if chosen correctly.
Thorough consultation and assessment with a qualified and experienced surgeon is necessary to determine your suitability for treatment and to also discuss all the implications of the procedure including the possible risks and complications.
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The following are the 7 most common Eye Concerns patients seek to treat at Elite Plastic & Cosmetic Surgery Group:
- 1. Crow’s Feet: Lines and wrinkles on the corner of the eyes, is a problem caused by the orbital muscle action below the surface. Best treatment would be to relax the orbital muscle with Botox or Dysport injections. MesoNatural Therapy (Dermapen Microneedling + PRP) and Exilis Elite RF treatments are also effective in improving the appearance of Crow’s feet but not as effective as when combined with Botox / Dysport injections.
- 2. Deep Tear Troughs: These result from volume loss in the area between the lower eyelid and upper cheek. This creates a hollow that is perceived as a dark circle below the eye. It also creates a division between the lower eyelid and cheek that is an early sign of ageing around the eyes making the person look chronically tired. This problem can be addressed by replacing the volume loss. Previously surgery was the only option but nowadays excellent and simple remedies include hyaluronic acid dermal fillers alone or and PRF (Platelet Rich Fibrin).
- 3. Dark Circles Under the Eyes: This can be from the shadowing of the deep tear troughs mentioned above or it can be from Excess Pigment or Vascularity (small blood vessels) or even blue reticular veins. If caused by the latter 3, an effective treatment would be Pigment Treatment with the MesoNatural Therapy (Dermapen Microneedling + PRP) alone or in combination with Exilis Elite RF Eye Treatment. PRF (Platelet Rich Fibrin) Therapy would also be recommended for this area.
- 4. Loose or Crepe’ Skin Around the Eyes: This condition can be corrected by tightening the skin through boosting the collagen and elastin within the dermis. This can be accomplished in a couple of effective ways. Exilis Elite RF Eye Treatment alone or in combination with MesoNatural (Dermapen Microneedling + PRP) Eye Therapy and/or Laser Treatment is very effective at remedying loose or crepe skin. Profhilo, PRP (Platelet Rich Plasma) and PRF (Platelet Rich Fibrin) treatments are also proven effective.
- 5. Excess Fat below the Eyes: As we age, weakening of the eye muscles can encourage the fat that naturally sits around the eye, protecting and cushioning it, to protrude through the weak muscle, producing eye-bags. This fat can show as an unsightly bulge below the eye making you look chronically tired. Various treatments can be effective depending on the extent of the eye bag. In mild to moderate cases, RF & Ultrasound Eye Treatment can be an effective solution, however in severe cases the best way to treat this is to remove this excess fat with Blepharoplasty surgery.
- 6. Excess Skin or droopy Lids: Excess skin is commonly present among older patients. Eyelid Surgery would be the most effective and a permanent solution in removing the excess and unwanted skin.
- 7. Puffy upper eyelids: Puffy eyes are not always a result of sleeplessness. Some people have genetically inherited naturally puffy-looking eyes, and sometimes, blepharoplasty is the only solution.
Blepharoplasty – “A Summary”
- Indication: Droopy, heavy upper eyelids, Eye bags, excessive lose skin around the eyelids, deep wrinkles, creases and folds around the eyelids.
- Types: Upper or Lower Eyelid Surgery, Upper & Lower Eyelid Surgery, Double Eyelid Surgery (Asian Eyelid Surgery)
- Technology: Excess skin and fat around the eyes are removed and skin is tightened.
- Recovery: 3-7 days.
- Effects: Any swelling or bruising will gradually subside, healing process may take from few weeks to 3 months when final result is expected.
- Lasts: Long lasting, however, ageing and unhealthy lifestyle may alter the results.
- Combination: Can be combined with Brow lift and/or Facelift.
- Doctors: Blepharoplasty Procedures at Elite Plastic & Cosmetic Surgery Group are Performed by Dr Allen Rezai
and Dr Riccardo Frati
With any Cosmetic Surgery Procedure, gathering the right information, knowing your reasons and having a clear expectation about what’s next, and what to expect in terms of outcome, will help you make an informed decision. Your eyes express a lot about who you are, the decision to undergo Blepharoplasty should not be taken lightly and it is important that you are aware of all implications involved and have a realistic expectation of what can and cannot be achieved, prior to making any decision.
The decision should be yours, and yours alone; and this should be founded upon appropriate advice from a highly experienced plastic surgeon. Here we shared some Interesting facts about Blepharoplasty which, hopefully you found useful. If you are still considering having Eyelid Surgery, Eye Bag Removal or any other Eye Rejuvenation procedure, then next step would be a Thorough Consultation with an Experienced Plastic Surgeon to help you understand the procedure in more detail and to discuss your options with you.
For more information about Blepharoplasty surgery, or other types of Facial Procedures offered at Elite Plastic & Cosmetic Surgery Group or to book a Consultation with Dr Allen or Dr Frati please visit Elite Plastic & Cosmetic Surgery Group’s website. or call +971 4 431 2396.