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Understanding the different techniques

Aesthetic eyelid surgery evolved. Nowadays, it considers the whole upper third of the face, from the forehead to the cheekbones. More than an eyelid surgery, Dr Hayot offers a gaze surgery and made-to-measure operations.

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Dr Hayot, chirurgien et médecin esthétique à Paris 8

A Word from Doctor Hayot

« I have been performing eyelid laser surgery for twenty years now.
As a pioneer of eyelid laser surgery in France, I abandoned the classical scalpel and adopted the laser treatment which ensures precision without bleeding during the procedure. The laser treatment also means cleaner scars, which become virtually-invisible in the weeks following the procedure. »

Transconjunctival blepharoplasty

This technique removes the pouches transconjunctivally.

The surgeon enters on the inside the lower eyelid to remove the pouches and to modify the eye expression without causing any bleeding.
Unlike traditional surgery methods, where there is a risk of cutting away too much skin or fat, with this eyelid surgery technique, the surgeon has more control and can achieve the desired result.


  • No visible scar, or stitches or threads to be removed,
  • No risk of modifying eye expression and no risk of round eye,
  • Almost no risk of hematoma or bruising,
  • Post-operative effects are easy-to-deal-with and oedema only lasts for 2 to 4 days.

This procedure is performed in ambulatory surgery, with potentiated local anaesthetic.

Secondly, to improve skin quality and to rejuvenate eye expression significantly, the surgeon may perform laser resurfacing during the same surgery session. This technique consists in softening a majority of wrinkles around the contour of the eye.

This is performed by superficially burning the epidermis which leads to a deeper thermal effect on the dermis itself. This “controlled aggression” causes the cells to regenerate and renders wrinkled skin smoother as a result of the formation of neo-collagen

Classic blepharoplasty

The classical blepharoplasty technique is a procedure that aims to remove excess skin, which exists as a result of skin slackening. It consists, at lower and/or upper eyelid level, in cutting the skin with a scalpel, retightening it and removing fat pouches by making an incision along the ciliary edge.

This procedure is performed using a laser scalpel, which prevents bleeding and enables extremely fine incisions to be made. The scar, which is invisible, is located along the inner ciliary edge.

However, if there is any doubt as to eyelid slackness or its elasticity, blepharoplasty, which consists in cutting the skin, may be risky.

Why do I not perform classical blepharoplasty and what are the risks of this?

Classical blepharoplasty has numerous disadvantages.

The skin is attached to the muscle, therefore it is extremely difficult to detach it. My technique is to make an incision and go behind the muscle to effectively lift the eyelid.

When you cut the skin you can change the shape of the eye. Here I must note that it is important not to create the appearance of round eyes. We call this scleral show.

With Classical blepharoplasty finding the fat pocket is a difficult task. By going underneath the muscle, I can see the fat pocket and am able to judge how much fat to remove and how much fat to leave behind. This precision allows me to avoid hollowing the eye.


The procedure consists of extracting some of the patient’s fat from the abdomen or the inner side of the knees by performing a micro-liposuction. The fat is then centrifuged and refined before being re-injected between the skin and bone using micro-cannulas.

Lipostructure can have considerable post-operative effects when performed on the eyelids (these effects are lessened when performed on temples and cheekbones) because the skin around the eye contour is far more thin and delicate. Oedema and bruising persists for about 12 days post treatment.

Laser resurfacting

I perform CO2 laser resurfacing on eyelids for its extraordinary ability to retract the skin and to make eye contour wrinkles disappear.

These laser skin resurfacing sessions for the eyelids take place in the operating theatre, often following eyelid surgery, lipostructure (fat transfer) or mini-lifting.By using laser treatment, I can also correct the skin quality.

I sometimes use laser skin resurfacing alongside eye bag removal or fat transfer treatment to rectify the hollow eye or dark circles.

As the skin around the eyelid is extremely thin, laser treatment is highly-efficient and just a single session is enough to obtain very good results. The CO2 laser treatment’s abrasive power means that it can remove two layers of superficial skin and retract the tissue.

After the procedure, the skin around the lower eyelid skin may appears red and dehydrated. A thick layer of vaseline must be applied for 8 days, which is the average downtime estimated for this treatment. During the recovery period, the patient must never wear make-up.

Following this for a period of almost 2 weeks, I prescribe moisturizing and healing cream that my patients must apply to their still-pinkish and dehydrated skin. Make-up may now be used to hide any redness.

After 3 weeks, the result is impeccable and the eye shape has been significantly rejuvenated. Wrinkles around the eye have dimished and the skin is both taut and firm.


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