Blepharoplasty

Blepharoplasty is an operative procedure when the folds of excess skin and fatty deposits (sacks) are removed from the area of the upper or lower eyelids. The manipulation is still known by the name of transconjunctive plastic (within this procedure of the lower blepharoplasty the surgeon makes an incision in the mucous membrane of the lower eyelid so that the scars are not visible) or the incision made in the area of the natural fold of the eyelid during the upper or lower plastic.

Types of eyelid deformation

• ptosis (lowering of the eyelid with age);
• bags under the eyes;
• fatty hernias;
• the consequence of injuries, inflammatory processes or complications after maxillofacial or ophthalmic surgery;
• no upper eyelid fold;
• epicanthus;
• the turn of the eyelid;
• Colobomas (congenital triangular and semi-lunar defects).

Upper blepharoplasty

The operation is done only on the upper eyelid. Indications: ptosis (lowering) of the upper eyelid, excess skin, correction of the ciliary margin.

Lower blepharoplasty

During surgery, the surgeon only works with the lower eyelid. It removes “sacks”, deposits of fat and excess skin and wrinkles under the eyes, fatty hernias.

Combinated (circular) blepharoplasty

The operation allows to rejuvenate the periorbital area in the upper and lower part, to make the look younger and more open, to remove fat deposits and excess skin from the lower and upper eyelids at once.

Possible complications and how to avoid them

During examination, the surgeon must determine what kind of intervention will help to solve the upper eyelid lowering problem: upper blepharoplasty or forehead lift. Misdiagnosis and blepharoplasty performing, when it is not needed, can result in even greater lowering. To avoid misdiagnosis, the surgeon must be experienced and be able to perform both manipulations to determine the most appropriate for the patient.

The most common complications are deformation of the eyelid or incision, infection, dry eye syndrome. The first problem is the most common for surgeons who just have started their practice and  can be corrected by subsequent surgery. The second complication occurs when violations of the rules of aseptic and antiseptic, the doctor’s recommendations during the recovery period (for example, applying makeup, bathing in the pool, etc.).

And the third complication may be due to anatomical features of the patient or a violation of the recovery guidelines. The problem is solved by medicines prescribed by an ophthalmologist.

List of references used:

1. Bhattacharjee K, Misra DK, Deori N. Updates on upper eyelid blepharoplasty. Indian J Ophthalmol. 2017 Jul;65(7):551-558.
2. Kersten RC, Codere F, Dailey RA. Orbit, Eye-lids, and Lacrimal System. San Francisco: American Academy of Ophthalmology; 2003.
3. Pepper JP, Moyer JS. Upper blepharoplasty: The aesthetic ideal. Clin Plast Surg. 2013;40:133–8. 
4. Branham GH. Lower Eyelid Blepharoplasty. Facial Plast Surg Clin North Am. 2016 May;24(2):129-38.