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Blepharoplasty

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Indication: 

Over the years, the tissues that make up the eyelids become looser, causing excess skin and protrusion of fat bags under the eyelids. As we are talking of an extremely thin skin, this protrusion becomes increasingly visible. Such changes are usually evidenced in the eyelids by the folds of skin and bulging caused by fat bags, giving an aspect of sadness and tiredness in this region of the face. 

Eyelid surgery (blepharoplasty) aims to correct aging effects, remove excess skin and reduce the fat pockets. As the eyelids acquire a flatter and smoother appearance, the person may look more rested and cheerful. 

Anesthesia Type: 

Local anesthesia with sedation. General anesthesia is rarely performed. 

Surgical technique: 

In upper blepharoplasty, the surgical incision is in a natural bend located in the eyelid, so that with the eyes open, the scar will not be seen, and even with the eyes closed, the scar will look fine and of good quality. This scar will remove excess skin and bulging fat pockets on the eyelid. In the lower eyelid, the scar is close to the eyelashes and looks good, becoming imperceptible over time. The good quality of the scars is largely due to the thickness of the eyelid skin, one of the thinnest in our body, aiding surgical recovery. No keloids are described in the eyelid scars due to this factor. 

In some very specific situations, where there is no sagging in the lower eyelid, but fat pouches protrude, a type of blepharoplasty may be performed in which there is no external scar. In these situations, the scar will be held in the conjunctiva, the reddish skin located on the inner part of the eyelid. This procedure is usually performed in younger patients, in whom the absence of eyelid sagging does not justify external scarring. Check out the following illustrations how eyelid surgery is performed. 

Surgery Time: 

If only the upper eyelids are operated, average duration of 45 minutes. If the upper and lower eyelids are operated, average of 90 to 120 minutes. 

Length of hospital stay: 

Usually 12 hours. In rare situations in which general anesthesia is used, hospitalization is prolonged up to 24 hours. 

Postoperative: 

Blepharoplasty is a fast recovery surgery, and about 48 hours after surgery the patient can perform their daily activities (except physical activities). In Blepharoplasthy, there is always formation of swelling (edema) and purplish patches (bruises) that vary in intensity. The bruising is absorbed over a period of up to 10 days and the swelling disappears almost completely by the 2nd postoperative week. To speed up the recovery of edema and blemishes, it is recommended to use compresses with water or cold serum within the first 7 days after surgery. 

In addition, it is important to avoid contact with hot water or vapors. It is forbidden to bathe in very hot water and cook, for example, in the first week, as steam increases swelling and slows the absorption of bruises. As a result of these factors, physical activity rest is recommended for a period of 10 to 14 days. Sun exposure should be avoided for at least 3 months by using sunscreen and sunglasses. The scar, as stated earlier, looks very good and is barely noticeable after 1 month of surgery. 

Possible complications 

Possible complications in the blepharoplasty procedure, also known as eyelid surgery, are very rare; however, they can occur, as in any surgical procedure. Among them, we can mention: 

  • Occurrence of hematoma and infection;
  • Insufficient skin or fat removal;
  • Occurrence of ectropion, known as lower eyelid inversion;
  • Occurrence of dry eye syndrome;
  • Corneal abrasions occur;lagophthalmos, known as inability to close the eyes and diplopia, also known as double vision;
  • And anesthetic complications.

The outcome of blepharoplasty, as in all cosmetic surgeries, will depend on the reaction of the patient's body and zeal with pre and postoperative indications. 

 

Preoperative Recommendations 

  • The patient should inform if they are using any medicine that has anticoagulant effect;
  • Communicate changes in health status on the eve of surgery;
  • Do not use any anticoagulant for ten days before the surgery.
  • Do not wear dark colored nail polish on the day of the surgery and avoid wearing jewelry and watches;
  • On the day of surgerydo not use creams;
  • And attend surgery with a companion.

 

Definitive Result: 

Peculiar characteristics of the eyelids, such as the thin skin thickness, accelerate the absorption of local swelling and the time to reach the result. We can say that by the 2nd month about 90% of the local edema will have already been absorbed, however the definitive result will be reached around the 6th month, as in most plastic surgeries. 

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