90% of adults consider eyelid-eyebrow expression the center of facial appearance. Therefore, any defect in these conditions affects the appearance of the rest of the face. The eyebrows and eyelids are very important in non-verbal language, indicating moods and feelings.
There are some processes such as sunken eyes, dark circles, dark pigmentation around the eyelids, where surgery can not achieve good results. In these cases
fillers can be employed.
Oculoplastic surgery is part of the specialty of Ophthalmology. Ophthalmologists therefore are trained in their formative years to operate in the area around the eyes, eyelids and lacrimal region. The orbital area is part of the middle third of the face and therefore they are qualified as oculofacial surgeons. Your surgeon is fully qualified and specifically trained to perform these surgeries.
The main factors that damage the skin of the eyelids and give an aged appearance are:
Hereditary and genetic factors, continued exposure to the sun, smoking, obesity, rubbing of the eyelids and certain metabolic diseases.
Most oculoplastic surgeries that are performed are covered by insurance. There are anyway some processes that may not be fully covered (fillers, Botox, some types of blepharoplasty, etc). Your surgeon will explain to you in detail which surgeries are covered.
Oculoplastic surgery can be divided into two main areas: one we call cosmetic, where we try to improve the look and comfort of the eyelids, and the other we call reconstructive, which acts on a defect or disease.
Drooping eyebrows accentuate upper eyelid aging. It does not include blepharoplasty surgery. They are different conditions. Most patients want to undergo only eyelid surgery. Eyebrow surgery gives greater importance to the upper eyelids.
Blepharoplasty surgery corrects the excess skin and fat from the eyelids. It always has the eyebrow as a limit. We cannot remove all the skin at first seems to spare as this may compromise ocular occlusion, or lowering the brow.
Drooping eyelid is different from bags or excess skin. It is called
ptosis surgery is different and also of blepharoplasty, although the latter is sometimes also added to the eyelid lift surgery. The drooping eyelid skin does not improve by removing, as with blepharoplasty.
It is important to remember that, like any other surgery, it is not devoid of risks. Although serious complications are extremely rare.
extraordinariamente raras.
There may be some degree of bleeding that soaks the gauze. Major bleeding is unlikely. Bruises are common and may last up to a month. Inflammation and pain are very rare. Most of these problems are temporary and resolve within a few weeks. As an ophthalmologist who specialises in oculoplastic surgery has operated, will be safer when detect any eye problem that may arise.
Upper eyelid blepharoplasty:
15-30 minutes in each eye
Lower eyelid blepharoplasty: 20-40 minutes depending on the approach in each eye
Dacryocystorhinostomy: 30-50 minutes
Eyebrow surgery: 20-40 minutes in each eye
Tumour surgery: up to 2 hours
Orbital surgery: up to 2-3 hours
Eyelid surgery is not contraindicated in these cases but you should be aware that it could accentuate your dry eye symptoms, at least in the first few weeks. These patients must follow a more intense treatment with artificial tears.
Although a laser scalpel exists, oculoplastic surgery is performed with a normal scalpel by most surgeons in all countries, since it is the type with which the least amount of swelling occurs since it producing very clean cuts. Therefore the use of laser is not necessary and offers no better results.
In eyelid surgery the types of anesthesia which are used are local anesthesia and sedation. General anesthesia is rarely used in this field.
Occasionally general anesthesia is employed in surgery of lacrimal pathways: dacryocystorhinostomy, orbital surgery and in some cases of tumours. Also in children.
There is no ideal age for eyelid surgery. In cases of purely cosmetic surgery, it is not recommended below 30-40 years of age, since changes due to aging are not still noticeable.
In lacrimal surgery, it depends on the patient's degree of discomfort, but there is no age limit. There are people over 80 who undergo dacryocystorhinostomy to improve their symptoms of tearing.
In children with obstruction of the lacrimal duct surgery is usually performed before the age of 5.
In cases of congenital ptosis without visual impairment and with purely cosmetic purposes it is acceptable to wait for the child's entry into school or when they reach adulthood. Parents must accept the risk of general anesthesia in these cases.
In cosmetic eyelid surgery results can last a lifetime. In the lower eyelid they are more lasting. In the upper eyelid they usually last at least 10 years, although there is great variability.
In ptosis surgery, the results also are variable and not always lasting. In congenital ptosis relapse is common.
Oculoplastic ophthalmologists generally tend to be conservative when designing of surgery. We understand that the eyelids are designed to protect the eyes and that this more important than the cosmetic result. Thus the final appearance in these surgeries is very natural, eliminating the risk of "frightened eyes".
According to statistics satisfaction in surgery of the upper eyelids reaches 80-90%.
In the lower eyelid it is approximately 70-80%
A slight asymmetry in results is considered normal.
In the sidebar the options
BEFORE-AFTER and
PHOTOS are available. Here is a sample of the main types of surgery and their outcomes is available.
Generally you can be operated. Your surgeon will assess what type of treatment you have, recent lab results, and the possibility of suspension or modification of treatment.
Pain in eyelid surgery is minimal. It is a very comfortable surgery for the patient. In lower eyelid surgery sedation is usually required. During surgery, the patient should not feel pain at any time.
You will be permanently supervised by an anesthesiologist at any oculoplastic surgery.
Surgery of the tear ducts (dacryocystorhinostomy) is performed under local anesthesia and sedation in 90% of cases.
Should avoid, if possible, taking aspirin or anti-inflammatory agents 2 weeks before.
If you are being treated with anticoagulants, your surgeon will explain the protocol for these cases.
You should fast for at least 6 hours before.
You will take your usual medication.
You should arrive to your hospital at the appointed time with all the necessary documentation, including that pertaining to your insurance.
You should not wear jewelry, makeup or clothes containing lycra.
Outpatient surgery (by this we mean without hospitalisation) allows a easier recovery, less risk of infection and lower costs when compared to surgery that requires hospitalisation.
In some interventions, such as lacrimal and orbital surgery, the patient may be hospitalised for 24 hours.
Stitches are removed between 7-10 days. It is not a painful procedure and is performed in the office.
Each surgery requires a type of
post-operative care. Your surgeon will give a protocol with the necesary instructions. They consist mainly of the application of compression bandages or with ice, and applying some ointment or eye drops. It is recommended that in the first 48 hours the patient is accompanied.
You should wait at least a week. Depending on the type of surgery your surgeon will advise you when to do it.
Reading or watching TV can be done 24 hours after eyelid surgery. You will be allowed to drive after 48-72 hours, depending on the degree of swelling and bruising. Exercise is not recommended during the first week.
You should wait at least 20-30 days before using makeup. There is a risk of inflammation, tattoo or allergy if done before this period of time.
Patients undergoing eyelid surgery can return to work after one week. The remains of the hematoma may be visible for 2-6 weeks depending on each patient.
Scars will be barely noticeable. Most of them will remain hidden in the natural folds of the eyelids and face. There are people with higher risk of abnormal scarring, such as highly pigmented skin, black race, or those with a history of keloids.
BEFORE-AFTER