Blepharoplasty - Eyes

Also known as ‘eyelid tucks’, blepharoplasties are designed to reduce the signs of ageing around the eyes, thus giving the face a brighter, more refreshed and less tired appearance. The eyes are often one of the first areas to show age, and there are basically three problems that need to be addressed when rejuvenating the appearance of the eyes.

1. Fine wrinkling - most commonly seen below the lower lids and in the ‘crow’s feet’ at the outer corner of the eyes. These lines are mainly due to sun damage.

2. Heavier wrinkles - due to the activity of muscles acting on the skin, such as the circumferential orbicularis oculi. This muscle surrounds the eye as a flat sheet, and chronic activity causes heavier wrinkling such as the ‘crows feet’ lines.

3. Bags and puffiness - usually caused by accumulated fat in specific areas behind both the lower and upper eye lids.

Understanding how the problems arise, points the way for the surgeon to correct them.

If the major concerns are fine-line wrinkles, the best treatment option would most likely be non-surgical. This may involve skin peels, or simply skin restoration, with the use of the new high dose Vitamin A or C cosmeceutical products and treatments.

If the concerns are about eye-bags, and the skin quality is good, then simple fat repositioning or extraction (since fat is the major component of these bags) may be an adequate solution. Using a transconjunctival approach in which a small incision is placed inside the lower eyelid, there are no external or visible scars at all.

Where the skin is loose, or of poor quality, or where a major concern is heavy wrinkling, then an ‘open’ blepharoplasty is performed, where the lower lid incision runs along the lid, a millimetre below the lash-line. The fat pocket bulges are reduced, excess muscle and skin trimmed and the skin is tightened to give a smoother contour. In cases where lower lid elasticity has been lost we may recommend a lid-tightening procedure as well.

In most cases, the upper lids are managed in a similar way to the lower. Fat pockets are opened and reduced and excess skin is removed. The incisions for the upper lids are hidden in the natural lid crease.

There are several variations and combinations of blepharoplasty, and a range of adjunctive procedures that can be incorporated to provide the perfect solution for your particular problem. The best approach is to discuss your concerns fully with your surgeon and get all the facts before deciding which procedure is the most appropriate for you.