These are procedures done to reduce the baggy lower eyelids or puffy lower eyelids or loose upper eyelids. These bags under the eyes produce an aged or tired look to the face.
The upper eyelid bags can restrict peripheral vision reducing the field of vision and hence needs to be corrected.
In the upper lids its usually more of the excess skin which needs to be excised also called a “Pinch Blepharoplasty”. The sutures are out in a week and the scar is well hidden.
In the lower blepharoplasty, the procedure involves making a cut under the eyelids and removing the excess skin and fat is excised or redraped as the case may be under the eyelids to give a better look. The incision is just under the eyelashes and heals well. It requires proper evaluation and planning. Sometimes a Mid face lift may be planned together. Or, the blepharoplasty can be combined with regular facelifts.
Procedure can be done under local anaesthesia and the patient can go home on the same day. Sometimes sedation maybe required.
Sometimes, if excess skin is removed, there may be an everted eyelid called “ectropion”, hence the surgeon may err on the side of leaving a little behind rather than removing more and causing this problem.
If ectropion occurs, it may have to be corrected at a later date. Though all care is taken to prevent such complications, rarely bleeding can occur, where in blood collects behind the eyes, called a retrobulbar haematoma which can even lead to blindness in rare cases. If a haematoma, occurs then it has to be evacuated.
Tear Trough Deformity:
A common problem which is an early sign of ageing, manifested by a depression under the inner aspect of the lower lid this is called a “Tear Trough Deformity”.
This is more because of lack of volume or volume loss with aging. If not properly evaluated, might lead to aggravation of the deformity after a blepharoplasty. This can be corrected with the use of fillers (Juvederm/Restylane/Esthelis) or fat grafting and is more because of volume loss rather than lax lower eyelid skin.
Asian Eyelid Correction:
A common finding in people of south asian descent or from the north eastern states of India. Here there is a lack of a fold in the upper eyelids.
The procedure is to create the attachment of the skin to the underlying muscle by an incision in the upper eyelid.
Done as an outpatient procedure and the patient can go home the same day. Procedure is done under Local Anasthesia or LA plus sedation.
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