Upper eyelids correction

Corrections of eyelids are performed both due to aesthetic and functional reasons.

In case of young patients the deformities usually show up in the form of swelling in the tear duct area. Correction is performed by applying a specially pre-prepared fat (a so called „nano fat”). The recuperation lasts 2 weeks and after this time the swelling and visible yellow pigmentation of the eyelids shall subside.

In case of older patients, the flaccidity of the skin in the upper eyelid area and drooping of the eyebrow area could be observed due to the aging processes. A drooping upper eyelid could sometimes even narrow the field of vision and put pressure on the ciliary margin, which effects in the irritation of cornea due to „curling” of eyelashes (trichoma). Within the upper eyelid, the intraorbital fat disappears in the medial part just below the brow, and sometimes lumps of intraorbital fat is visible above the movable part of the eyelid in inner corner of eyelids. The shape of the orbit is changes from round to oval, fibres of orbicularis muscles are slacking and disappearig. In the buccal-zygomatic area, adipose tissue disappears and falls downwards, no longer supporting the tissues of the orbit. As a consequence of this process, the so-called "eye bags" with a clearly marked border between the eyelid and the cheek appear in the lower eyelids, without a smooth transition, as in a young person. The tear trough runs from the inner to the outer corner of the eye, emphasizing the boundary between the lower eyelid and the cheek.

Foregoing approach consisted in the removal of all excessive skin, muscles and fat tissue through the outpouchings of the orbital septum. The incisions on the skin of the upper eyelid have been made in such a way, that scars from suturing would hide in laughter lines and natural skin folds. The incisions on the skin of the lower eyelid have been made right below the ciliary margin and scars have been hidden in the natural skin folds.

Current approach is way different. Skin incisions are made the same way as before, but the procedure is based mostly on the conservative resection of tissues. Only the skin is affected by the procedure - muscles and fat tissue usually stay intact, only in certain cases the fat tissue in the lower eyelid area may also be relocated. The procedure is focused on eyebrow lifting and filling in the fat tissue in the face areas mentioned above. Such an approach enables the surgeon to restore the young appearance without changing patient’s facial features.

After the procedure the patient could feel swelling and bruising, which would fade after 2 weeks. The vision may be a little bit blurry, especially after applying the ointment, and the palpebral fissure may not close completely due to the post-op swelling. After the procedure the patient should wear sunglasses when leaving home in order to protect the eyes from sun and wind. Patient can get back to work after 1 week. Remaining bruising could be covered with make-up.

The correction of the upper eyelids is performed under local anesthesia and lasts up to 45 minutes. In the case of a combined correction of the upper and lower eyelids, general anesthesia or deep sedation is rather recommended. The procedure takes about 2 hours. After the procedure, the patient is put on a dressing and an elastic bandage over his eyes and it is recommended to keep this dressing for at least 6 hours after the procedure, which results in significantly less bruising and subsequent swelling

Consequences and possible complications of blepharoplasty of the eyelids:

1. Swelling and bruising - this is a consequence, not a complication.
2. Asymmetry, we are not symmetrical, so symmetry cannot be obtained
3. Hematoma in the subcutaneous tissue, accumulation of blood in the prepared space, forcing the surgeon to re-evacuate the hematoma to find the source of the bleeding and close it. Failure to do so may have further consequences such as abscess formation.
4. Hematoma inside the orbit causing exophthalmos, pressure on the optic nerve and blindness, also requires surgical intervention and evacuation of the hematoma from the periocular space.
5. Wound infection, non-wound dehiscence, prolonged healing and poor aesthetic result with a wide scar, hypertrophic or even keloid scar.
6. Regurgitation of the eyelids, causing the cornea to dry out, ulceration, corneal opacity and loss of vision.
7. Dry eye syndrome caused by mistaken removal of the lacrimal gland.
8. Unsatisfactory aesthetic effect or lack of the expected effect, which is only a subjective assessment of the patient. You will miss the patient's expectations of the surgeon's operational capabilities.
9. Lower eyelid eversion, so-called ectropion, with conjunctivitis and conjunctival suppuration, not subject to pharmacological treatment. Requires revision surgery or extension of the treatment to a mid-face lift.
10. Pain and stinging in the operated area and sometimes the eye.
11. Inability to remove all wrinkles and change the skin structure!
12. Allergies to medications used.