Eyelid surgery

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Eyelid surgery

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Eyelid surgery

Blepharoplasty is a cosmetic or restorative method which makes it possible to rejuvenate and enhance the eyes. This cosmetic surgical procedure is one of the most commonly practised in France and throughout the world. Its popularity is due to the speed of the procedure and the postoperative process just as much as it is due to the fact that eyelid surgery makes it possible to refresh the eyes without actually modifying them

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Dr Hayot, chirurgien et médecin esthétique à Paris 8

A WORD FROM DOCTOR HAYOT

Dr Hayot gives his invaluable advice on blepharoplasty and eyelid surgery with regards to different eye shapes and concerns:

Some say that the eyes are the window to the soul and there is no denying that they are an indication of age. The skin around the eye is the thinnest and therefore the most prone to ageing.

With a blepharoplasty surgery, the main aim is to preserve the natural expression. I find this approach results in an overall more youthful and fresh appearance.

With years at the helm of my plastic surgery clinics in Paris, combined with my extensive expertise in oculoplastic microsurgery and blepharoplasty (eyelid surgery), my patients expect results

Different types of eyes

Blepharoplasty is adapted to the type of eyes: for doe eyes, hollowed, bulging or round eyes or cock eyes, the operative techniques vary. Only an astute surgeon who is an expert in the anatomical structures of the eyes and eyelids can provide a precise operative diagnosis and rectify eye problem areas.

A pioneering eyelid surgery in Paris, Doctor Hayot proposes multiple innovative techniques and uses cutting edge tools (CO2 scalpel laser) in order to prevent risks during the procedure and to reduce the post-surgery process time as much as possible.

This cosmetic surgical procedure makes it possible to obtain a natural-looking result when it is managed and carried out by an eyelid surgery specialist. It does not present any risk to the moving function of the eyelids and does not affect the eyeball. Cosmetic eyelid surgery is not eye surgery, it does not have any impact on the eyes.

Les différents types de regard à Paris 8 - Dr Hayot, chirurgien esthétique

THE DOE-EYE’D LOOK VERSUS THE “STAR EYE”

In theory, this eye shape is the easiest one to operate on.
The upper eyelid scar must stretch upwards and outwards, and should be easily hidden in one of the crow’s feet (wrinkles around the eye contour). It is imperative not to make a short eyelid scar (this makes the double eyelid look smaller) on an eye shape that points downwards, which would give the impression of a smaller eye.

Les différents types de regard à Paris 8 - Dr Hayot, chirurgien esthétique

THE HOLLOW EYE :

The “hollow eye” has the appearance of having sunk deep into the eye socket.
Given that the socket may be too big for the eye, one must avoid hollowing it out even further by removing too much skin from the eyelid and orbicularis muscle at the upper eyelid level. Removing pouches at the lower eyelid level should also be avoided.
During the natural ageing process for the hollow eye, the upper eyelid becomes longer, the palpebral fold (which is already high) moves upwards, further intensifying the hollowness of this particular eyelid shape.
There is also a greater risk of senile ptosis with the presence of hollow eye. With this in mind, one should avoid creating too much weakness in the eyelid levator muscle. Here, overly invasive eyelid surgery should also be avoided.

Les différents types de regard à Paris 8 - Dr Hayot, chirurgien esthétique

THE BULGING EYE :

This is evident when the eye appears too big for its socket framework.
For this type of eye, it is imperative that not too much skin is removed at upper eyelid level. Similarly, not too much fat should be removed at lower eyelid level to ensure that the problem is not intensified.
Given that the lower eyelids are frequently distended on this morphological type, “classical” surgery (cutting the lower eyelid skin) gives bad results. In this case, there is an extremely high risk of resulting in an overly round eye or even ectropion.

Les différents types de regard à Paris 8 - Dr Hayot, chirurgien esthétique

THE LAZY EYE :

This type of eye frequently comes in conjunction with a visible eyebrow collapse.
With this eye shape, removal of too much skin at upper eyelid level is to be avoided so as not to create disharmony or emphasize the collapse of the eyebrow tail.
“Classical” lower eyelid surgery may present a risk of overly round eyes and cause the soft parts to droop.

Les différents types de regard à Paris 8 - Dr Hayot, chirurgien esthétique

ROUND EYE/ SCLERAL SHOW :

This is when white space is clearly visible between the cornea and the lower eyelid. Round eye is also known as “scleral show”.
It can be the consequence of a badly-performed eyelid surgery and it can be hereditary.
When performing blepharoplasty surgery on this type of eye shape, the condition can get worse if the skin on the lower eyelid is cut.

Eyelid Surgery

This eye rejuvenation can involve the upper or lower eyelids or can be carried out on all four eyelids simultaneously. Eyelid surgery can consist of several procedures that are adapted to the instruction of each patient:

  • Addition blepharoplasty
  • Pinch blepharoplasty
  • Eradication of bags under the eyes
  • Surgery on circles under the eyes or lipofilling
  • Classic blepharoplasty to remove surplus skin and smooth the eye contour

Eyelid surgery can also make it possible to correct eye imperfections or problem areas, such as lazy eyes, round eyes or even bulging eyes. Carried out using a laser scalpel for greater precision, the eye surgery removes skin surplus that makes eyelids appear wrinkled, as well as excess fat present in the bags under the eyes or in the upper eyelids which ends up covering the eye.

This cosmetic surgical procedure makes it possible to obtain a natural-looking result when it is managed and carried out by an eyelid surgery specialist. It does not present any risk to the moving function of the eyelids and does not affect the eyeball. Cosmetic eyelid surgery is not eye surgery, it does not have any impact on the eyes.

Addition Blepharoplasty

The majority of surgeons believe that with the upper eyelid the problem comes down to an excess of skin and they excise the surplus skin which, as a result, hollows and modifies the eye, ageing them even more

I believe that the upper eyelid is full and filled with fat when we are young, and that it ages by emptying and flattening like an empty bag. That is why I systematically ask my patients to show me a photo of their eyes when they were young and I analyse the upper eyelid when I practise upper blepharoplasty. When I carry out an addition blepharoplasty I more often than not combine an eyelid microlipostructure with skin resection.

Pinch blepharoplasty

A technique which involves pinching the lower eyelid skin and excising a few millimeter of skin without removal.

This technique is being used more and more in the treatment of surplus lower-eyelid skin because it has two significant advantages:

  • The scarring is completely invisible because it is hidden in the eyelashes and there is no visible end to the scar on the external side.
  • There is no risk of modifying the eyes because there is no skin removal

Surgery for bags under the eye

Bags under the eyes are due to fat hernias situated below the eye. They are hereditary or appear as a result of skin ageing. The bags give an appearance of “swollenness” that is also known as “puffy eyes”. Even though there are several ways to reduce swollen eyes, eyelid surgery is the only effective treatment to eradicate bags under the eyes.

Carried out on an operating table in an outpatient ward, treating bags under the eyes is not painful and there is virtually no disruption to social interaction.

Surgery for circles under the eyes : Lipofilling

Hollowed circles under the eyes are defined by a valley that starts at the internal corner of the eye and descends vertically towards the cheekbones. Particularly unpopular, hollowed circles under the eyes give them a sad and tired look and often make people self-conscious.

Dark circles under the eyes can be treated using various methods, such as depigmenting peelings or laser sessions. For newly developing hollowed circles under the eyes, hyaluronic acid injections can suffice to cancel out the difference in the levels and make the lines and wrinkles on the lower eyelid disappear. On the other hand, only lipofilling can eradicate circles under the eyes in the long term.

lipofilling is a cosmetic surgical procedure that aims to fill the circles under the eye with the patient’s own fat. The fatty material is most often taken from the abdomen and then injected using a very fine cannula, directly into the lower eyelid.

This technique can also be practised on the upper eyelid when the patient has hollowed eyes.

Eyelid blepharoplasty

Eyelid surgery makes it possible to remove the excess skin on the lower or upper eyelids using a laser scalpel. Ageing causes the skin in this area of the face to sink. The eyelids drop and seem heavy. Several small folds appear on the eyelid and accentuate the fine and deeper horizontal lines. A healthy lifestyle, Anti Wrinkles Treatment® injections and hyaluronic acid make it possible to delay the marks of time on the eyelids, but only blepharoplasty makes it possible to significantly rejuvenate the eyes.

Eyelid lifting makes it possible to give patients more relaxed and rested eyes. It requires a precise and delicate cosmetic operation that must be carried out by a specialist in facial rejuvenation. Lower-palpebral lifting necessitates a longer post-surgery process than treating the bags under the eye by the ciliary edge

Eyelid Surgery combined other treatments

After eyelid surgery, the cosmetic surgeon can propose several treatments with cosmetic medicine such as:

  • Anti Wrinkles Treatment® injections to lift the tail end of the eyebrow, smooth the forehead, treat inter-eyebrow wrinkles or eradicate crow’s feet.
  • Hyaluronic acid injections to fill newly developing hollowed circles under the eye and to re-plump the face at the temples and the cheekbones to rejuvenate the higher levels of the face.
  • Laser treatments, such as fractional laser treatment, to fill out the lower eyelid skin or even to treat the reoccurrence of this phenomenon using a CO2 laser to eliminate wrinkles and decrease the skin.
  • Thread lifts to redesign the contours of the face or to lift the eyebrows in a natural and reversible way.

Eyelid surgery can also be accompanied by other facial rejuvenation procedures such as:

  • Mini lift of the facial contour and the neck
  • Eyebrow-pinching or forehead lifting
  • Temporal lifting

Precautions to take for eyelid surgery

Before eyelid surgery

As with any surgery carried out on the operating table, it is necessary for the patient to take several measures:

  • A preoperative consultation with the cosmetic surgeon in order to establish a precise diagnosis in accordance with the indications and the type of ageing of each patient. During this consultation, informed consent as well as a precise cost estimate must be delivered and accepted by the patient.
  • The patient must be given the results of their blood analysis in accordance with the request of the surgeon in preparation for eyelid surgery (CBC + Platelets – PT/KCCT – Hepatitis C antibodies – HIV)
  • It is necessary to stop taking anticoagulant medicines – such as aspirin – one week before eyelid surgery.
  • The patient must not have eaten anything for 6 hours before reaching the operating table.

Duration of eyelid surgery

As a general rule, eyelid surgery lasts for between 45 minutes and 3 hours depending on the number of eyelids being operated on and the possible complications encountered during the procedure:

  • Simple eradication of bags: 45 minutes
  • Upper blepharoplasty: 45 minutes
  • Lower blepharoplasty: 1 hour
  • 4-eyelid laser surgery: 1 hour
    Lower palpebral lifting/Classic blepharoplasty: 1 hour 30 minutes

+ Add 1 hour to each procedure if it is accompanied by lipostructure (fat injection).

After eyelid surgery

Eyelid surgery is not a painful procedure. As the patient is totally anaesthetised during the operation, they do not feel any pain. On waking up, it is commonplace to feel discomfort around the eyelids accompanied by eye dryness and blurry sight. These reactions are completely normal and will wear off in a few days.

The first post-surgery consultation will take place the day after the procedure with the cosmetic surgeon. Localised treatment will be necessary in the days following the eyelid surgery.

It is recommended to relax in the days that follow the procedure and to refrain from doing intense physical activity in order to avoid any significant rushes of blood around the face (risk of oedema, opening of wounds, haematomas, etc.). Disruption from social interaction lasts from 3 to 21 days depending on the procedure undergone and the surgery technique used.

In classic blepharoplasty, the scars are hardly visible and are hidden in the crow’s feet.

The eradication of threads happens after the 6th day. The application of makeup is possible when tissue is completely healed (at least 15 days).

Another post-surgery consultation is organised 1 month after the procedure.

Results of eyelid surgery

The results are not always immediately visible. It is sometimes necessary to have patience before seeing the desired result. Healing is a long and complex process that sometimes results in slight asymmetries before complete stabilisation. There is no need to worry if you have swollen or oedematous eyes or if there is a noticeable asymmetry in the days and weeks that follow, it is completely normal!

The before/after photos make it possible to observe the rejuvenation of the face through eyelid surgery. The bags will have disappeared, the skin is tight again and the wrinkles will have disappeared. With lipofilling, the lost volumes will have been recreated so as to also eradicate circles under the eyes and the bone structure of the socket. The face is rejuvenated by more than 10 years whilst still remaining in total harmony with the rest of the face.

The result of eyelid surgery is permanent, even if no one can stop the effects of time on the face. Bags under the eyes or hats over the upper eyelids will never reappear! No other procedure on the eyelids will be necessary in the 15 years to come.

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