UPPER BLEPHAROPLASTY

Upper Blepharoplasty is the type of surgery which corrects the excess skin in the upper eyelids.
As time passes by, the eyes are the first point on our face appearing weary, feeble and aged. With the improvement of a person’s eye look one can say that the person is improving overall, since the applicant 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 we have had a surgery, since the incisions heal very quickly.

Indications

Aesthetic

  1. Brow fall
  2. Excess skin and upper eyelid fat.

Reconstructive

  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 in the upper eyelids, since very often the main problem lies in the point of the eyebrow. The eyebrow, due to the general loss of skin elasticity, is lowered, resulting in more excess skin of the upper eyelid. Such cases are not rare and often go unnoticed. In these patients, 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 more prominent in the aesthetics of every woman.
The most important points of the position of an eyebrow 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 is 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 relatively to women.

All these criteria are important, in order to avoid major mistakes, as well as for plastic surgeons to be better guided, when called to judge surgical indications. 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, at the same time of the upper blepharoplasty.
Upper Blepharoplasty, UPPER BLEPHAROPLASTY

What needs to be done pre-operatively.

At first, the Plastic Surgeon, receives a full medical history of the applicant and then informs the applicant about the potential of the technique and what to expect from that procedure. It is important to take photos before the operation, in order for the doctor to discuss them with the applicant.
Then, the following guidelines should be followed:

  1. Classic preoperative check-up.
  2. We don't eat anything 12 hours before the operation; as well we don't drink anything 6 hours before.
  3. We 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 prior to the operation.
  5. Meeting with the anesthesiologist before the operation. The person interested should inform the anesthesiologist about previous anesthetic experiences, either positive or negative ones and also he/she should inform the anesthesiologist about medical problems or medications, if any.
  6. We don't take aspirin, anti-inflammatory medicines or herbal supplements 10 days before the operation, because they might increase the possibility of bleeding during and after the operation.
  7. We wash our face with a medicinal soap once a day, 3 days before the operation.
  8. Women should not wear any make-up at the day of the operation.

Those patients that have glaucoma or dry eye, are not good candidates for this operation, 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 surgery.

Type of anesthesia

The below operation can be held under local anesthesia and light sedation.

Hospitalization

The applicant can return home at the same day, 2-3 hours after the operation, since hospitalization is not necessary, but he / she must be accompanied by someone intimate, when leaving the hospital.

Operative technique

Before the surgery, the surgeon estimates and designs the excess skin eyelid, as well as the location and extent of the cuts. Then the surgeon performs local anesthesia with a fine needle. The extra skin and fat is removed, if necessary, always based on the preoperative planning. Most of the times we choose the section to extend slightly outward in order to have a better aesthetic result, but we prefer to have it on a wrinkle, so that it passes completely unnoticed. Finally the surgeon sews the skin and places small dressings that don’t impede vision.

Postoperative instructions

The visit to the plastic surgeon one day after surgery for a first follow-up, is essential.
During the first 48 hours you will need to apply ice on the upper eyelid in order to avoid large swelling and the recovery to be shorter as much as possible. We advise the applicant not to bend and not to lift weights for 48 hours after the surgery. Medical drops are placed in the applicant’s eyes for 48-72 hours. The stitches are removed 7 days after the surgery and the applicant can return to daily activities after 6-7 days.

Complications
The possible side effects or complications of this operation are the following:

  1. Bleeding: The surgeon must be very careful in handling during the surgery, and the applicant must obey the instructions and not bend or lift weights for the first 48 hours.
  2. Excessive skin or fat removal: This is prevented by a good design preoperatively, bearing in mind that the best aesthetic results are not coming after an aggressive skin and removal, but after a proper technique, having seen the face overall.
  3. Conjunctivitis: In order to prevent such a complication, we provide medical, both during after the operation.
  4. Inflammation: We are rarely confronted with Inflammation cases after upper blepharoplasty. The antibiotic treatment we give during surgery, almost always protects the patient.

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

This text can bring new questions. We are at your disposal for any other information.