Blepharoplasty

Please make sure to watch the video about blepharoplasty

What is blepharoplasty?

Eyelids and the area around the eyes are among the first areas that change over time with aging. Several times, these signs are inversely proportional, underlying the effects of aging. For example, a sense of tired look, difficulty in applying make-up, or heavy, puffy upper lids.

These symptoms, in most cases are a combination of excess skin and protruding periorbital fat pads (the well known “under eye bags”).

Blepharoplasty, is a surgery which can provide a solution and rejuvenate the shape of eyes, giving a more youthful and less tired look.

In which cases, does blepharoplasty can be performed?

In general, blepharoplasty can treat:

• sagging skin of the eyelids, creating creases disturbing the natural contour of the upper eyelid, even sometimes obstructing normal sight
• excess skin and fat deposits that appear as swelling in the eyelids
• “under eye bags”
• drooping lower eyelids (eyelid being pulled down) that create ectropion
• excess skin and fine wrinkles of the lower eyelids

Upper eyelid blepharoplasty

Upper blepharoplasty or upper eyelid blepharoplasty, is performed under local anaesthesia and through an incision along the upper eyelid, excess skin and/or fat is excised, in order to achieve the ideal result. The operating time is 45-60 minutes. The wound is closed with fine stitches, which are removed in 5-7 days.

Sometimes excess skin on the upper eyelids can be caused by insufficient function of the frontalis muscle (drooping eyebrows). In this case, an additional brow lift is necessary, in order to achieve the best result.

Lower eyelid blepharoplasty

Lower blepharoplasty or lower eyelid blepharoplasty, is performed under local anaesthesia or sedation. Depending on the case, a subciliary (incision along the lower lashline) or a transconjunctival incision can be made. Of course, the second technique is chosen only in cases where excess skin does not need to be excised.

Who is a good candidate for a blepharoplasty?

Candidates for a blepharoplasty are the following:

• people, whose concern is their eyelids appearance
• people, who have functional problems such as a large amount of excess inelastic skin along the upper eyelid (dermatochalasis) that can affect even their field of vision
• people without ophthalmological conditions such as glaucoma, precedent detachments, dry eyes etc.
• people without medical conditions which delay recovery
• people with realistic expectations

Blepharoplasty techniques

Classic (Traditional) blepharoplasty

Classic blepharoplasty aims to improve upper and lower eyelid contour. Restoration is performed by excising excess skin, fat and/or both of them, without affecting eyelid anatomy, the shape of the eyes, as well as the natural upper eyelid crease.

• It is performed under local or general anaesthesia and the operating time is 60 – 90 minutes. An external incision is performed on the lower eyelids, which takes place closely to the eyelids or through conjunctival internal incision (the thin translucent

membrane that covers the “white part of the eye”).

Laser eyelid surgery

Laser eyelid surgery is a minimally invasive technique and is essentially the same as classic blepharoplasty. The only difference is that in this case, the initial incision is performed with laser, instead of a scalpel.

Surgery is performed under local anaesthesia, in one session and the operating time is 60 – 90 minutes, without requiring an overnight stay in the hospital.

During the operation, excess eyelid skin and fat are excised, either through an external incision or through a transconjunctival incision.

The stiches are almost indistinguishable and they are removed in 5 – 7 days. Cold compresses are recommended in the early post-op period.

Eyelid surgery with plasma

If the problem is on an initial stage, and upper eyelid skin excess is very small, plasma can be used.

Eyelid surgery involving plasma, can be performed using a special laser, where each “laser beam”, is reducing fat and tightens loose skin that gives the tired look.

In order to achieve the best results, plasma eyelid surgery, should be performed in 2 – 4 sessions, with an interval of 6 – 10 days.

It’s important to state that this particular method is indicated only for cases with early blepharochalasis and the results are not permanent.

What to expect at your first appointment?

At your first appointment, you will discuss:

• what exactly is your concern in the appearance of the eyelids, and if blephapolasty is the appropriate treatment for you
• your past medical history, if you are on any medication, vitamins or other herbal supplements, if you have any allergies or any other operations in the past.
• if you smoke (if the answer is yes, how many cigarettes per day)

Afterwards, Dr Karmiris:

• will evaluate your general health condition and any other risk factors
• will examine you and will take all the detailed measurements from your eyelids, he will evaluate your excess skin as well as your skin quality.
• will take preoperative photographs
• will discuss with you all the possible surgical options,depending on your case

• will discuss with you all the possible results of the surgical procedure and any risks or potential complications,as described in the international literature and finally

• will discuss with you about the anaesthetic plan

Preoperative check

Preoperative check includes mainly blood tests, chest X-ray and electrocardiogram (ECG) if general anaesthesia is necessary. Any other specialized tests may be required, depending on the case.

Also, it will be necessary to stop smoking preoperatively, and immediately post-operatively as well as avoid taking aspirin and any anti-inflammatory medicine, since they increase the risk of bleeding.

How is blepharoplasty performed and how long does the whole procedure take?

Blepharoplasty may concern upper eyelids, lower eyelids or even combining both operations together.

The surgery is performed under local or general anaesthesia. The doctor, after excising excess fat that creates puffy eyes, may, in some cases proceed to fat redistribution, in order to achieve the best result.

The operating time is 1 – 1.5 hour. Dr Karmiris will explain you, in detail, the whole surgical procedure and will discuss with you the appropriate technique, depending on the case.

Post operatively

Immediately after the surgical procedure, you will have some fine sutures that will be removed in 5-7 days. Scars will be placed within the natural creases of the eyelids in order not to be noticeable after 6 months. Swelling and bruises are healed in 7-14 days. For faster recovery apply cold compresses (therapy eye masks).

In most cases, patients are discharged the same day. Dr Karmiris will give you particular instructions on how to take care of your incisions immediately post op, what medication you should take and when you will be seen for a follow up.

Risks and safety information

In general, blepharoplasty is a safe procedure which is performed with great success. However, like any other surgical procedure, blepharoplasty has some risks, as well as potential complications that every patient should be aware of and should understand fully, before entering operating room.

The most important potential complications are the following:

• Bleeding, haematoma, bruises
• Wound infection
• Dry eyes
• Poor healing
• Transient light sensitivity
• Lagophthalmos
• Ectropion
• Double vision
• Need for revision

Dr Karmiris will explain you, in detail, the whole surgical procedure and will answer any questions related to that.

Blepharoplasty benefits

Blepharoplasty is an operation with multiple benefits, such as the appearance, functionality, as well as psychological benefits. Blepharoplasty will help patients to have a more youthful look, as well as improving their vision.

Some of blepharoplasty major advantages are the following:

• Bags under the eyes are eliminated
• Visual field is extended, having as a result vision improvement
• Overall eye shape is improved, promising a rejuvenating look
• Skin irritations due to friction of creases are reduced
• Youthful and refreshed look
• Under eyes bags are improved or eliminated
• It improves “hooding” to the lower eyelid
• Discomfort caused on the forehead due to strain on muscles, is reduced thanks to the lifting of saggy skin
• Minimizes fine lines on the crow’s feet and lower eyelids
• Natural effect

Blepharoplasty cost

Blepharoplasty cost, depends on the type and the complexity of the performed operation, as well as the surgeon’s fee.

However, it is important to know that the price is different in case of an upper blepharoplasty, if you have a lower blepharoplasty or in case of a combined operation.

Also, the price varies in case of blepharoplasty with simultaneous correction of true blepharoptosis, or in case of a revision blepharoplasty.

Which other operations can be combined with blepharoplasty?

Blepharoplasty can be combined with the most aesthetic operations performed on the face. In fact, sometimes is recommended for patient’s convenience, but it requires a Plastic Surgeon with experience to various techniques.

The major aesthetic operations which can be combined with blepharoplasty are the following:

• Face lift
• Rhinoplasty
• Genioplasty (the operation which is performed to the jaw)
• Fat transfer on the face

In case of a combined operation, it is advisable to discuss it with Dr. Karmiris in order to give you the appropriate advice, depending on your case.

Should I choose classic blepharoplasty or non-surgical blepharoplasty?

Non-surgical blepharoplasty seems to be an ideal and “new” facial treatment. Due to the fact that many patients are interested in bloodless eyelid surgery and have questions, we should clarify that the term “bloodless” refers to a non invasive technique with rapid recovery and significantly shorter range results which last for a shorter period of time.

In fact, all surgical and non surgical techniques, depend on an experienced Consultant Plastic Surgeon who is highly trained in the whole field of blepharoplasty and can perform a classic blepharoplasty of high standards.

All other methods, are preferred only in cases of slight saggy chin, while the results cannot stand the test of time.

For more information about blepharoplasty, book your appointment today with Dr Nikos Karmiris.