Eyelid surgery together with face lift, forehead lift and eyebrows’ lift are the most frequently performed so-called "rejuvenating treatments”. The appearance is significant in both private and professional life. The procedure is also performed due to functional reasons in order to improve the function of the eyelids and improve vision.
Eyelid surgery is a cosmetic correction which may be conducted on both upper and lower eyelids. Blepharoplasty usually solves the problem of ptosis (eyelid drop), herniated fat or both defects combined. During the procedure, surgeon will remove the excess of skin and so-called fatty bags under the eyes (prolapse) and, if necessary, also some parts of increased orbicularis oculi muscle. The procedure will improve changes on the face responsible for old and tired face look. Patient may at the same time undergo surgery of lower and upper eyelid. If the issue involves only lower eyelid and fatty bag under the eyes, removal of the excess skin is not necessary. Surgery may be performed through incision made inside the eyelid from the side of conjunctiva, i.e. conventionally (percutaneously).
Upper eyelid surgery:
Surgery consists in resecting excess of skin and sometimes also a part of perioccular fat which forms a kind of "hernia”. Medical indications for the procedure include:
- Ptosis (dropping upper eyelid which reaches to the edge of the cornea. Ptosis may be a congenital defect. In most cases, this disease is caused by underdevelopment of the elevating muscle of upper eyelid or damage to innervation of this muscle.
- Herniated fat
- Excess of skin (dermochalasis)
- Strongly developed part of orbicularis oculi muscle
Lower eyelid surgery:
Indications for lower eyelid surgery are the same as in the case of upper eyelids surgery. Their surgery may be done in two ways. The first method involves incision made 2 mm under the eyelashes (subcillar incision), whereas the second one involves incision made by laser from the conjunctival side of the eyelid (conventional method of access). Access method is similar for the surgery of the upper eyelid. Its aim is also to remove excess skin and fat. In conventional access, cover for the cornea and loose insert to the eyelid are used to make the patient feel more comfortable. The advantage of this method is invisible scars.
Initial consultation with a surgeon is very important. Honest discussion about the reasons for the surgery and consultation aiming at determining whether this procedure is really appropriate for the patient. During the consult, physician determines whether the surgery is to be performed on all four eyelid or only on upper or lower. Physician will also explain the procedure, including discussing anaesthesia. Do not hesitate to ask about anything, especially if you have any doubts.
Medicines, such as Acylpirin, Aspirin, Alnagon, or Mironal, should not be used before the surgery as they may cause undesired bleeding during surgery and after it. The condition necessary to conduct surgery includes general well health condition of the patient.
Surgery is usually performed under local anaesthesia. It may be performed under general anaesthesia as well if it is reported by the patient or surgeon. In the case of the anaesthesia, it is important not to drink, eat and smoke cigarettes five or six hours before the surgery. If local anaesthesia is used, after the surgery patient goes home, whereas in the case of general anaesthesia patient stays in the hospital for a determined period of time.
If patient decides for eyelid surgery, he or she must know everything about possible complications which may occur during this surgery. One of them is the oculocardiac reflex caused by pressure acting on the eyeball. It manifests as decrease in blood pressure and heartbeat. The condition may be very serious but in most cases this is all about small decrease in pressure. Sometimes wound created after removal of stitches may extend. The most important complication is the so-called ectropion. This is a condition, in which reversal of the eyelid occurs or when conjunctiva protrudes from the eye. Patient is constantly watering and the skin around the eyes are always wet and irritated. A person feels like something has fallen into the eye. Ectropion shows symptoms early after the surgery as a results of swelling. At that time it may be temporary and absorption of the swelling results in improvement. Resection of too much skin or complications related to deep scars in the area of the muscle and ligament.