Septum must be opened if fat is to be removed, but not the levator. As the surgeon, it is important to be aware of the potential complications of surgery. Ideal candidates for cosmetic lower eyelid blepharoplasty are non-smokers who are in good physical and mental health and who have realistic expectations about their results. This technique is ideal for perking up eyes that require just a touch of alteration. The eyes are one of the first areas of the face where aging becomes highly visible. My mini eye signature procedure is the "Skin/Pinch Blepharoplasty.
It is rare that true bony decompression either at bedside through the inferomedial floor or more fully in the operating room is required. This is effective if you have strong lower eyelid support and only a little extra skin. The cut edges of the skin are then stitched using fine sutures. This patient was bothered by her undereye bags and dark circles. Laser eye protectors are essential if the CO2 laser is utilized, but there must be enough ocular lubrication present to avoid a corneal abrasion when they are inserted or removed. The two fuse low in the upper eyelid, so the inexperienced surgeon is well advised to open the septum high up where there is a good barrier of preaponeurotic fat underneath to protect the levator. You may feel youthful and at the top of your game, but when you look in the mirror, your eyes tell a different story. Just because a procedure is covered by insurance does not mean it is the correct cosmetic procedure. As you can see in the patient example below, there does not appear to be an excessive amount of fat protruding from under the eye. You should be in good general health and not suffering from a serious medical condition, illness, or infection. This young woman felt that she looked tired all the time. If the obstruction is more distal than 8 mm from the punctum (unlikely in blepharoplasty surgery), a canaliculo-dacryocystorhinostomy may reconstruct the system. The same principle applies in lower lid fat removal to protect the inferior oblique.
A skin pinch procedure involves removing the excess sagging skin beneath the eyes in a procedure geared to preserve the delicate undereye structure. Nonlaser-induced postoperative hyperpigmentation can result from hematoma formation and excess sun exposure. In the initial assessment, patients are encouraged to voice their desires and concerns regarding the aesthetic appearance and functional features of their eyelids. This approach is thought to avoid some of the problems associated with surgery that does violate the muscle and orbital septum which has been associated with a higher rate of lower eyelid retraction or pulling down of the lower eyelid due to scar formation in these deeper eyelid layers. As we age, eyelid skin can thin and lose it's elasticity allowing underlying fat to bulge forward on the lower eyelids and can cause the appearance of baggy lower eyelids and contribute to one looking tired. More effect (in terms of lifting skin off the eyelashes) for less skin excision can be achieved by creating a higher lid crease during the blepharoplasty. To smooth eyelid wrinkles and tighten eyelid skin. Skin incisions, hidden under the lashes of the lower eyelids heal imperceptibly. Cosmetic eyelid surgery or blepharoplasty is a procedure to remove fat, and usually excess skin from the upper and lower eyelids. It requires that the surgeon have a keen artistic understanding of what a beautiful eye looks like, expert knowledge of eyelid architecture and function, and the advanced surgical skills to remove, reposition, and/or tighten the eyelid fat, skin, and musculature. Lower blepharoplasty to address under eye bags and dark circles.
As with any surgical procedure, some scarring is to be expected. After sedation is administered by an anesthesiologist, Dr. Abboud injects local anesthetics, which should make the procedure painless. Blepharoplasty is a widely practiced successful operation. Although the effects tend to last a lifetime there are some patients who need further procedures in the future particularly if there is generalised laxity to the lower eyelid. For many, a small amount of Botox can smooth the area nicely. Who is suitable for skin pinch lower eyelid surgery? The results of cosmetic blepharoplasty are designed to be long-lasting. MINI PROCEDURES CAN BE COMBINED: more often than not patients choose to combine two or more procedures to achieve "optimal results. " Because the eyes are often the first feature people notice, it is an important aspect of our overall appearance. She underwent lower lid blepharoplasty removing the fat from the lower lids. Generally, a simple skin pinch procedure or microfat transfer can be performed under local anesthesia. Fillers can also be used to fill in the lines that are underneath the lower eyelids called the tear troughs. You should be able to see your final results from cosmetic eyelid surgery in about 4 to 6 weeks following your surgery.
My Mini Skin/Pinch Blepharoplasty takes about 1 hour: involves some swelling and bruising that resolves by itself over 5 to 7 days, and General Anesthesia is that of choice for this surgery. As you can see in the following before and after photos, patients can have a very nice improvement in their lower eyelid appearance following a skin pinch lower blepharoplasty. G. Y. Shaw and J. Khan, "The management of ectropion using the tarsoconjunctival composite graft, " Archives of Otolaryngology, vol. Will there be noticeable scars on my eyelids? Some individuals can also have droopy eyebrows, which can worsen the appearance of the excess skin.
I underwent surgery, and couldn't be happier with my results. This is the ideal procedure for those who have been Botox-ing away wrinkles under their eyes for years and are no longer seeing much of a result, or for whom ThermiSmooth or Ulthera did not create enough of a result — or for those who simply prefer the minimal maintenance and impressive results of a surgical procedure over other non-surgical options. We won't push you towards surgery if it's not the right choice for you personally and always factor your anatomy, health, and lifestyle into that decision. This patient is 6 months out from surgery. However, because of the complex structure and function of the eyelids, the potential for complications does exist. Lower eyelid blepharoplasty to reduce complication risk. The lower eyelids are a common area of concern patients seek treatment for as excess skin and/or fat can make one look older or more tired than they actually are. The plane of dissection is just beneath the eyelid skin, on top of the orbicularis muscle.
In the traditional approach the eyelid skin is operated on as well as the fat under the skin and muscle to give a smoother lower eyelid. Transconjunctival fat resection alone should be considered in younger patients who may have very little excess skin and whose skin may be resilient enough to tighten itself spontaneously postoperatively. When preparing for lower lid blepharoplasty, important features to note are the amount of excess skin and the presence of fine rhytids (wrinkles), prolapsed fat (quantity and location), malar bags or festoons, lid laxity, scleral show and pigmentary characteristics. It consistently yields highly satisfying patient results, often without leaving any visible trace of a scar. Skin pinch may be in conjunction with upper eyelid surgery. CO2 laser incisions need 7 days to heal, so sutures are removed on day 7 or 8. Some individuals need more skin removed than just a "pinch". She felt that she looked aged and tired. 50 Year Old Female Upper Blepharoplasty. Healing Process Following Blepharoplasty.
Milder eyelid laxity is treated by a form of lateral canthal tendon plication at the time of lower lid blepharoplasty, and dehiscence here is less common and of milder extent, and hence can usually be managed supportively [7]. Results are varied and last approximately six months. A major reason also: our patients have demanded them and we have researched and developed and refined them.
It is, therefore, often wise to avoid further manipulation of the upper lid by taking a donor graft from it. However, certain caution should be taken to avoid and manage postoperative ptosis. Also, avoid excess cautery to the levator. What Should I Do Before Eyelid Surgery? At Reflections, we focus on natural-looking results – and nowhere is this more important or more difficult to achieve than for the undereye. Excessive trauma to the levator muscle, levator aponeurosis, and pre-aponeurotic fat pad can result in upper lid retraction, scleral show, and lagophthalmos.
WHO FAST IS THE RECOVERY AND WILL I SEE THE RESULTS? How Does Blepharoplasty Change My Looks? The skin looks smoother and her eyes look rejuvenated. One starts with a three snip on the punctum of the unobstructed canaliculus, followed by a DCR (to enhance flow through the unobstructed canaliculus), followed by a DCR with Jones tube in refractory cases. This patient was 48 years at the time of her surgery. Preoperative and postoperative oral arnica (a herbal healing agent) has been claimed anecdotally to help when given in normal doses. 56-year-old woman wanted to refresh her appearance. Upper & Lower Blepharoplasty with Fat Transfer to eyelids and cheeks. This 52 year old patient had extra skin that hung from her upper eyelids and fat pads below her eyes.
Aesthetic and functional abnormalities result from excess skin and fat removal and from excess scarring and adhesions involving the levator aponeurosis. She looks refreshed and natural with long-lasting results. As you can see, she is quite youthful and takes great care of her face and skin. Incision and skin removal. This specialty has developed because of the amount of knowledge, expertise and special techniques needed to treat patients with conditions involving the eyelids and eyebrows.
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