Lower eyelid correction

Eyelid surgery is performed for aesthetic and functional reasons. The aging process involves facial changes that change the shape of the eye socket from round to oval, flabby and disappear the fibers of the orbicularis muscle of the eye. Adipose tissue in the buccal-zygomatic area disappears and falls downwards, no longer supporting the tissues of the orbit. As a consequence of this process, the so-called " eyebags" 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 "tears trough" runs from the inner to the outer corner of the eye, emphasizing the boundary between the lower eyelid and the cheek. Sometimes a "tears trough" also runs down the cheek, dividing the cheek in half with a slanting furrow.

The approach so far has been to remove excess skin, muscles and fat pushing out through the hernias of the orbital septum. The incisions on the lower eyelid are made just below the eyelash margin, 2-3 mm, and the scars are hidden in the natural fold.

The current approach is different from the previous one. The skin incisions are carried out as before. However, it involves a very conservative tissue resection. The intraorbital or periocular lipstick of the lower eyelids dislocates and only in selected cases is slightly resected. The displacement of the fat results in blending. cheek with eyelid and restoration of the smooth transition of both areas of the face. The rejuvenation of the eyelid area is based on eyebrow lifting and conservative surgery in the above-mentioned areas of the face. This approach restores the lost youthful appearance of the face and does not change it as before. Very often, the muscle is tightened strongly by sewing it over the upper edge of the eye socket to the fascia of the temporal muscle, which is called dynamic canthopexy, and it gives an image of a cheek lift, but it is NOT a mid-face lift.

After the treatment, there is swelling and bruising, which disappears after 2 weeks. The vision may be slightly blurred, especially when using the ointment, and there is a slight regurgitation of the eyelid fissure due to postoperative edema. During this period, when leaving the house, you should use sunglasses to protect your eyes from wind and sun. Return to professional activity may take place already one week after the surgery. Remains of absorbing bruises can be corrected with makeup.

The procedure of the correction of the lower eyelids themselves is performed under local and / or general anesthesia and takes about 1.5 hours. In the case of the 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 with 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 lower eyelid blepharoplasty:

1. Swelling and bruising - this is a consequence, not a complication.
2. Asymmetry, we are not symmetrical, so perfect symmetry cannot be obtained.
3. Hematoma in subcutaneous tissue, accumulation of blood in the dissected space, forcing the surgeon to re-evacuate the hematoma to find the source of the bleeding and close it. Failure to do so may cause further consequences, such as shrinkage and hardening of the lower eyelid tissues, lowering the ciliary edge of the eyelid, the so-called scleral show.
4. Hematoma inside the eye socket causing exophthalmos, pressure on the optic nerve and blindness.
5. Lower eyelid eversion, the so-called ectropion, with conjunctivitis and conjunctival suppuration not subject to pharmacological treatment
6. Wound infection, non-wound dehiscence, prolonged healing and poor aesthetic result with a wide scar, hypertrophic or even keloid scar.
7. Subcutaneous unevenness resulting from the healing and scarring process
8. Pain and stinging in the operated area and sometimes the eye.
9. 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.
10. Inability to remove all wrinkles and change the skin structure!
11. Allergies to drugs used
12. Venous thrombosis with pulmonary embolism and death