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Upper Blepharoplasty

Upper Blepharoplasty – Description

Upper Blepharoplasty is a type of surgery that corrects the excess skin in the upper eyelids.

As time passes by, the eyes start to appearing weary, feeble and aged. With Upper Blepharoplasty the surgeon improves the patient eye look, and he/she looks more refreshed and renewed. In Upper Blepharoplasty the excess skin and/or excess fat is removed, the eye opens substantially, without making clear that the person had surgery since the incisions heal very quickly.

Upper Blepharoplasty – Applications

  • Aesthetic Applications
    1. Brow fall
    2. Excess skin and upper eyelid fat.
  • Reconstructive Applications
    1. Restoration of eyelids, after a removal of a malignant tumor.
    2. Restoration of ptosis.

 

In many cases, the problem is not simply based on the excess skin of the upper eyelids. The main problem lies in the point of the eyebrow. The eyebrow, due to the general loss of skin elasticity, is lowered and causes excess skin of the upper eyelid. Such cases are not rare and often go unnoticed and a simple blepharoplasty will not have satisfactory results.

Which is the correct position of the eyebrow?

This question is now becoming more relevant and important as permanent tattoos have become a “must” in every woman’s life.
The most important points of an eyebrow position are:

  1. The medial brow line should be in the same straight line with the side edge of the nostril of the nose.
  2. The outer edge of the eyebrow should be on the straight line that joins the outside edge of the eye and the outside edge of the nostril.
  3. The inner and the outer end of the eyebrow should be in line with each other.
  4. The upper limit of the eyebrow is usually in line with the outside limit of the eyelid.
  5. The brow arc shape must be above the alleged bone on women and the bone level for men.
  6. In men, the eyebrows are richer and have less arc shape compared to women.

 

All these criteria are important, in order to avoid major mistakes, as well as for plastic surgeons to be better guided when are called to decide which surgical application is the best. But every person is unique and should all be taken into account before deciding on an operation. In cases that the eyebrow is below the desired position, the doctor should perform a brow lift, while he is doing an upper blepharoplasty.

Upper Blepharoplasty – What needs to be done pre-operatively

It is important to take photos before the operation, so the doctor can make his comments about them, with the applicant.

The following preoperative guide should be followed:

  1. Classic preoperative check-up.
  2. Don’t eat anything 12 hours before the operation and don’t drink anything 6 hours before.
  3. Don’t take any medicines the day of the surgery, without the anesthesiologist’s permission.
  4. Smoking and drinking alcohol should be stopped at least 3 weeks before the operation.
  5. Meet with the anesthesiologist before the operation. The patient should inform the anesthesiologist about previous anesthetic experiences, either positive or negative ones. Also, he/she should inform the anesthesiologist about any medical problems he/she is facing or any medications he/she is taking.
  6. Don’t take aspirin, anti-inflammatory medicines or herbal supplements 10 days before the operation, because they might increase the possibility of internal or external bleeding during and after the operation.
  7. Wash your face with medicinal soap once a day, 3 days before the operation.
  8. Women should not wear any make-up on the day of the operation.

 

Patients that have glaucoma or dry eye, should not have Upper Blepharoplasty, because the surgery may exacerbate the disease. Also, patients with high blood pressure, heart disease or bleeding disorders are likely to develop serious complications during or after surgery.

Upper Blepharoplasty – Type of anesthesia

The below operation can be held under local anesthesia and light sedation. The patient can return to his/her home on the same day, 2-3 hours after the operation since hospitalization is not necessary, but he/she must be accompanied by a relative when leaving the hospital.

Upper Blepharoplasty – Operative technique

Before the surgery, the surgeon designs the excess skin eyelid and decides the extent and the point of the cuts. Then the surgeon performs local anesthesia with a fine needle. The extra skin and fat are removed, if necessary, always based on the preoperative surgical plan. Most of the time the surgeon chooses the section to extend slightly outward in order to have a better aesthetic result because the wrinkle passes completely unnoticed. Finally, the surgeon sews the skin and places small dressings that don’t impede vision.

Upper Blepharoplasty – Postoperative instructions

The patient is essential to visit the Plastic Surgeon one day after surgery for a first follow-up. During the first 48 hours after surgery, you will need to apply ice on the upper eyelid in order to avoid swelling and to recover as soon as possible. It is better not to bend and lift weights for the first48 hours after surgery. Medical drops can help the eyes for the first 48-72 hours. The stitches are removed 7 days after surgery and the patient can return to daily activities after 6-7 days.

Upper Blepharoplasty – Complications

The possible side effects or complications of Upper Blepharoplasty are the following:

  1. Bleeding: The surgeon must be very careful during the surgery, and the patient must follow all the instructions and not bend or lift weights for the first 48 hours.
  2. Excessive skin or fat removal: This complication can be prevented by a good design preoperatively. The best aesthetic results are coming after a proper technique, having seen the face overall.
  3. Conjunctivitis: In order to prevent this complication, the doctor provides medicines, during and after the operation.
  4. Inflammation: Inflammation cases are rare after Upper Blepharoplasty. The antibiotic treatment which is given during surgery almost always protects the patient.

 

With the proper surgical technique and proper postoperative follow-up, the complications are minimal.

Preparation before surgery

  1. Photographs of the area are taken.
  2. Classical preoperative check-up includes blood tests, chest X-ray, and cardiac evaluation.
  3. 12 hours before surgery do not eat anything.
  4. 6 hours before surgery do not drink anything.
  5. On the morning of the operation do not take any medication without the anesthesiologist's approval.
  6. Alcohol should be stopped 1 week before surgery.
  7. In the case of general anesthesia, it is necessary to meet with the anesthesiologist before the surgery.
  8. Report previous anesthetic experiences, either positive or negative and inform him/her of any health problems or medication you are taking.
  9. Do not take aspirin, anti-inflammatory drugs, or herbal supplements 10 days before the surgery, as they increase the possibility of bleeding during and after surgery.
  10. 3 days before the surgery and every day after washing your face or body with medicated soap, depending on the planned surgery.

General Complications after surgery

Complications in plastic surgery operations are not common but it is necessary to be aware of them at the first appointment.

  • Hematoma: A hematoma is the accumulation of blood in the wound.
  • Inflammation: To prevent inflammation, antibiotics are administered during surgery.
  • Poor wound healing: If the incision in the operated site is more prominent than expected, it can be corrected 6 months to a year after surgery with local anesthesia. In some cases, the appearance of keloids is possible where specific treatment is needed.
  • Skin necrosis: It is more likely in heavy smokers.
  • Pulmonary embolism and thrombosis.

This text may give rise to new questions. We are at your disposal for any other information.