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Eyelid Surgery (Blepharoplasty)

There has been a significant change in our approach to the eyelids in recent years. It has been realized that the standard surgical techniques used for the last 30 years have many inadequacies and problems. It is now discussed that interventions such as “removing fat bags” are unnecessary. Our expectations have gone beyond just creating “bagless” eyelids and we prefer to evaluate the face as a whole.

Signs of aging affecting the eye area:

The eyelids are the place where aging is most visible and attracts the most attention. Skin wrinkling on the eyelids, which are both very mobile and very thin-skinned due to their structure, is almost inevitable in later ages. All the sagging and loosening around them also affect the eyelids.

1. The forehead gets lower with age. Along with the forehead, the eyebrows begin to fall on the upper eyelids. Eyelids, which do not have the power to lift such a load, slide down.

2. There is a membrane that surrounds the eyeball and separates the fat bags that support it from the lower eyelids. This is an elastic membrane and acts as a barrier. With advancing age, this membrane loosens and becomes unable to bear the load of the fat bags. So the fat overflows outwards and we see them as “eye bags”.

3. The skin of the eyelids is the thinnest skin in the body. It is also attached to the very mobile muscles underneath. Therefore, with every eye movement, the skin of the eyes wrinkles and sags a little more. Side wrinkles called “crow’s feet” in the corners of the eyes are an example of this.

4. A deep hollow appears at the upper border of the cheeks under the eyes. This is due to the sagging of the cheeks.

In standard eyelid surgeries, the eyelid skin, the thin muscle layer under the skin and the fat filling the eye bags are removed. Although this is a very common surgery, it is usually disappointing for patients. The reason for this is that some of the basic problems I mentioned above do not belong to the operated tissues but to other neighboring structures such as cheeks and forehead. For example, most of the accumulation in the upper eyelids comes from the eyebrows hanging down.

What is the ideal treatment?

The ideal is to approach the eyelids as part of the face. Step by step, the following should be corrected:

1. First of all, if you have a deep hollow under your eye that goes down to your cheek, this hollow must be filled. Standard lower eyelid surgeries do not solve this problem and may even deepen it. This pit should be eliminated by spreading the fat that forms the detention bags downwards and lifting the cheeks upwards. In this way, an uninterrupted flat surface extending from the cheekbones to the lower eyelids should be formed. This is an indispensable rule to look young and fresh.

2. If there is a serious sagging in your cheeks, this must be corrected. For this, it is possible to use endoscopic techniques and lift the cheeks or lift the middle face during lower eyelid surgery.

3. The forehead must be evaluated for the upper eyelid. If your forehead and eyebrows are piled over your eyes, these should be corrected first, and the eyebrows should be moved to the correct position with temporal
lifting. Then, if there is still sagging in the upper eyelid, this should be treated. Crow’s feet also arise from sagging in the temporal region and are largely eliminated with temporal lifting.

After the above-mentioned problems are eliminated in both eyelids, it will be sufficient to remove only the excess muscle and skin.

FREQUENTLY ASKED QUESTIONS

Why is it necessary to perform eyelid surgery together with other surgeries?

Because aging should always be approached as a whole. Eyelids usually carry the problems of other areas on them. If we do not see and correct these problems separately, eyelids alone will only give a slight brightness to the face. For example, if the forehead and eyebrows hang down, correcting only the upper eyelids will make almost no difference.

Does the fat that fills the eye bags increase with aging?

This fat is not actually increasing. The problem is the weakening of the barrier tissues in front of them.

Is the ideal eye shape round or slanted?

I think slightly slanted, almond eyes are much more attractive today. In the 1950s it was fashionable to have big eyes. Likewise, straight eyebrows should be preferred. The old fashioned eyebrows were curved.

TIPS

– This surgery will be much more successful if the hollow under the eyes extending to the cheeks can be filled. Removal of bags

– Removal of eye bags is very common but rarely necessary. You will be very satisfied for the first six months, but then your eyes will start to collapse and this will make you look older. Be sure to ask your doctor about this before surgery.

– Excessive removal of lower eyelid skin can cause the eyelid to pull down and this is a serious complication.

– The cause of eye bags is not the excess fat filling the bags, but the weakening of the barrier in front of them. The treatment should be the correction of this barrier.

WHAT AWAITS YOU AFTER THE OPERATION?

Although this is a minor surgery, the eyelids swell very easily. So organize yourself so that you do not go out in public for about a week. This is not a painful surgery. You do not need to be hospitalized. Your eyes will be open after the surgery. There will only be thin bands on the eyelids.

COMPLICATIONS

Infection is very rare in the eyelids. However, akanam can be a feared complication. Some bleeding under the skin of the eye is normal. This appears as a bruise in the eye and is encountered in almost all eyelid surgeries. However, in cases where the eye bags are removed, a bleeding in the vessels that feed these fats may compress the optic nerve behind the eye and may cause visual defects and even blindness. Although this is a very rare complication, such cases have been reported in the literature.

The most feared and relatively common complication is lower eyelid drooping. This is more likely in patients who undergo surgery for the second time. The problem is usually the excessive removal of eye skin and the treatment is to replace the missing skin. For this, it may be necessary to remove skin from the upper eyelid.

There is also the possibility of damage to the transparent layer of the eye during this surgery. Although this may seem unlikely, it is worth considering that the surgery is performed very close to the eye with sharp and sharp instruments and that there is always a slight risk.

REPORT CARD OF THE SURGERY:

Type of anesthesia: Local or general anesthesia.

Where the surgery should be performed: In a hospital operating room.

Duration of surgery: 1-3 hours.

Length of hospitalization: Can be discharged on the same day.

Postoperative pain – discomfort: There may be a slight tingling for a few days. Simple oral painkillers are usually sufficient.

Swelling, bruising: Between 3-7 days, moderate, sometimes severe.

Dressing: No dressing is applied until the stitches are removed. Everything is removed with the stitches.

Stitches Fifth day

When you can return to work: 3-7 days.

Sports: Long walks after 2 weeks, jogging after 3 weeks. Heavy sports can be started after the 4th week.

Final shape: A slight edema usually persists for the first month. The final shape appears in the third month.

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