Blepharoplasty is performed to reduce the excess skin and / or eyelid bags. Not all patients need to remove both their skin and their excess fat (bags). In most cases, you need just one of the two things. It’s not possible to remove every wrinkle or fold of your skin around the eyes.
It is necessary a surgeon’s opinion on the amount of skin that can be removed without consequences, to obtain the best result for that specific problem. The result of a plastic surgery is determined by a variable number of factors such as the physical conditions of your face, the presence or absence of fat, your age skin, the amount and the quality of the actual wrinkles, the underlying bone structure and the hormonal influences.
The duration of the result of the surgical procedure differs from individual to individual. In many cases, the bags of the lower eyelids do not reoccur, but over time your skin becomes looser, more redundant and in the following 5-10 years you may need a further reduction of your skin. The surgery will be performed in a private hospital and you can go back home the same day or the following day.
Pre–Operative Preparation
It is recommended not to take aspirin or medicines that contain it for two weeks before and two weeks after . Aspirin can cause bleeding thus increasing the risk of complications . On the day of the surgery it is also recommended to avoid any make -up on your face.
To patients on oral contraceptives therapy it is recommended to stop taking these medicines a month prior to the surgery.
The surgery
The surgery can be performed under local anesthesia under sedation or under general anesthesia. The type of anesthesia will depend on the wishes of the patient and the physician's judgment.
Local anesthesia, if necessary, consists of of an intravenously sedation performed before the surgery by the anesthetist during the surgery. The region will be infiltrated with a small amount of local anesthetic.
General anesthesia consists of sedation administered by injection before going into the operating room and then by the administration of intravenous anesthetics by the anesthetist.
It takes about two hours.
The lower eyelid: the incision is made on the lower eyelid to about 2 mm from the ciliary margin parallel to the lid margin and it slightly extends beyond the outer part curving in a few wrinkles for about 1 cm. The skin is gently detached from the underlying tissues. The peribulbar appropriate quantity of excess fat is removed; if necessary, the excess skin is removed, and then your skin is sutured with very thin stitches. Sometimes, a sterile plaster is applied at the ends of the incision.
The upper eyelid: before the incisions are performed on the upper eyelid, the excess skin is assessed and designed. The drawing is performed so that the final scar may fall into a normal skin fold when the eye is open. In the region of the outside corner the incision slightly curves upward. The amount of skin established is removed . An adequate portion of the exceeding fat is removed and the skin is sutured with very thin material.
Post –Operative Treatment
After the surgery and for the first 24 hours, a light dressing, that will be frequently changed, and some cold tablets will be applied on the eyes. The day after the surgery the patient can go home and continue to apply cold compresses for the following two days. The sutures are removed 4-5 days after the surgery.
Possible complications
Complications are rare . Occasionally there may be the formation of an hematoma ( accumulation of blood under the wound ) . In some cases a clot has to be removed to improve a faster healing . Infections are very rare . Occasionally the eyelid may be slightly stretched away from the eyeball . This can be caused by an abnormal healing of deep scars . This problem is usually temporary , but it may require surgical correction at a later time . Small swellings along the lines of incision may occur 2-3 weeks after the surgery . These may be cysts or clogged sweat glands. In principle , they disappear spontaneously, but occasionally it is necessary to open them . These are minor treatments that can be performed on an outpatient basis .
What to expect after the surgery
This the surgery produces a slight pain that can be controlled with standard analgesics.
Edema, bruising and dyscromia (swelling, reddening, colour change) these three manifestations differ from patient to patient and can be modest or substantial.
Edema, bruising, dyscromia (swelling, reddening, colour change) disappear between the fifth and tenth day, but it is not unusual that the changes of the colour last longer. During this period the eyelids may appear swollen, irregular and asymmetric
Downward displacement of the lower eyelid: the lower lid may be slightly stretched down away from the eyeball. This may be due to an edema and it disappears as soon as the swelling will be reduced. Because of this phenomenon, it is not unusual an increasing tearing.
Conjunctival hyperemia (red eyes) may appear due to the swelling of the eyelid tissues and bruise. It is not dangerous and it is not painful. Stitches will be removed from the eyelids 4-6 days after surgery.
Resumption of physical activities
Driving a car can be resumed after 1 week ; sports activities after 2 weeks ; make-up for women after 2 weeks . You have to avoid exposure to the sun of the eyelids for at least 3 months.