In a healthy person, around the age of 40-50, the support structure of the upper eyelid skin weakens and loosens. The aggregation on the upper eyelid is mostly more pronounced on the outside. However, as a result of the loss of durability of the membrane structure, which is called the “septum” and roughly divides the eyelid into two as anterior and posterior, the fat pads that provide projection to the lid may herniate. If it is structurally located below the eyebrow, the discomfort increases. A similar process works in the lower eyelid, however; there are a few differences. First, the lower eyelid has a more static structure, the upper eyelid is responsible for most of the work of closing our eyes. Secondly, herniated fat pads cause a more striking appearance, which is called “eye bag” among the people. The third is the formation of grooves with the downward displacement of the midface structures associated with the lower lid. Eyelid aesthetics (blepharoplasty) is a surgical procedure that removes excess skin, fat and muscle from the eyelid. With eyelid aesthetics, the “drooping” or “bulky” appearance that may occur on the upper or lower eyelids is eliminated. The appearance of the eye bag, which has serious effects on the general appearance and can give the person a tired appearance, can be corrected with blepharoplasty, which is a very simple surgical procedure.
INFORMATION ABOUT THE SURGERY
Upper eyelid surgery takes an average of 45-60 minutes under local anesthesia and sedation, and lower eyelid surgery takes an average of 1-1.5 hours under local or general anesthesia. Patients are usually discharged the same day after the operation. After anesthesia, the patient is kept under observation for at least 4 hours. There may be temporary drowsiness. In case of intervention on both eyelids, 2 different incisions can be made. An incision is made on the upper eyelid along the natural crease of the eyelid. The incision scar is hidden and invisible. An incision is made on the lower eyelid, below the lower lash line. There may be scars in the procedure performed with this technique. The more the outer agglomeration of the upper eyelid is, the more the incision will overflow into the wrinkles called crow’s feet. What matters is not how much tissue is removed, but how much tissue is left. The discarded tissue may contain only skin, but may also include skin and muscle tissue. If there is excess fat, the septum structure is pierced and the fat is removed, at this stage, maximum attention should be paid to bleeding control. The removed skin tissue should be stored until the end of the surgery because; If more skin is removed than planned, this skin can be life-saving in order not to impair the eye-closing function. In the lower eyelid, the incision is made below the lash line, so the scar is tried to be hidden. If simultaneous operation is performed, at least 1 cm should remain on the outer part of the eye between the two incisions. During the lower eyelid aesthetics, the soft tissue displaced downwards is moved up and the groove image is corrected. Excess adipose tissue can be removed in a similar way, or it can be used to cover the grooves, depending on the situation. It is always good to throw less skin on the lower eyelid than is thought.
WHO CAN HAVE SURGERY?
All men and women over the age of 18 who are dissatisfied with their eyelids, droopy eyelids, discoloration of the lower eyelid, bruising, bagging, and grooves can undergo surgery. The history and physical examination of the patient before the operation is important. It should be questioned before the operation that the patient has realistic expectations, feels mentally and emotionally ready, does not have a disease that prevents surgery, and does not use blood thinners.
INFORMATION ABOUT POST-SURGERY
Recovery is faster in patients who underwent surgery with local anesthesia. If general anesthesia is used, patients must be kept under observation in the hospital. If patients have been given a local anesthetic, the treatment area may feel somewhat numb for several hours. They may also experience a tingling or burning sensation around the eyes as the medicine begins to lose its effect. For this, the patient can be given a pain reliever other than aspirin. Patients receiving general anesthesia should be accompanied. It is recommended that patients rest for a week after eyelid surgery. After having eyelid surgery, patients will experience some pain and discomfort around the eyes, including swelling and bruising in the area. Cold application may be helpful. In the first 2-3 days, tilting one’s head, reading a book, driving a car, watching television may cause discomfort in the eyes. This situation is temporary. To aid healing, it is essential for patients to clean the eye area with clean water. The surgeon may also recommend some ointments or eye drops. Patients should avoid rubbing their eyes after the procedure as this can disrupt the stitches on the eyelids.
RISKS
Blindness is the most feared complication of the upper eyelid. Fortunately, it is quite rare. (0.04%) It occurs due to bleeding after surgery. The first symptom is pain of increasing intensity. Apart from this, burning, stinging and watering in the eye can be seen temporarily. If you have dry eye disease, these complaints can be more annoying. Problems in wound healing can also be seen, although rare. In the lower eyelid, the downward and outward displacement of the eyelid, called ectropion, is one of the biggest problems. It can be mild at first, massaging upwards and outwards is very beneficial in the healing process. If there is no regression between 3-6 months, it can put both the patient and the doctor in a difficult situation. Postoperative swelling and bruising take an average of one week, and complete recovery takes an average of three to six months. Cold application, lying upright, not turning to the right or left reduces swelling and bruising. In the first days, activities such as reading books and watching television may increase eye complaints. It is recommended not to touch the seam lines for the first three days and not to apply make-up around the eyes for two weeks. It is also important to protect the seam lines from the sun. These practices may differ from doctor to doctor.
