Eyelid Treatment

Eyelid surgery or blepharoplasty is a procedure to rejuvenate the eyelids. This intervention aims to reduce or remove excess skin, remove fat pockets, reduce dark circles, and erase signs of fatigue, giving the eyes a refreshed appearance. The incision is made using a laser that acts as a scalpel, allowing for cutting with minimal bleeding.

Eyelid surgery (or blepharoplasty) is common because eyelid aging is noticeable from the forties and sometimes even earlier, depending on heredity. This aging can be due to various factors and is aggravated by sun exposure, menopause, smoking, or lifestyle.

Eyelid surgery/blepharoplasty can involve either the upper eyelids, the lower eyelids, or all four eyelids simultaneously. It concerns both men and women, and the ideal age for surgery depends on the factors of eyelid aging. The goal is to remove excess skin, remove fat pockets, erase signs of fatigue, and give the eyes a refreshed appearance.

Lower eyelid surgery

For lower eyelid surgery, the appearance of the skin, the excess skin, its tone, and the presence of bags must be considered through a proper clinical examination. Regarding dark circles (skin discolorations forming grooves under the lower eyelids), cosmetics can camouflage the problem. The hollow of the dark circles can be reduced by injecting hyaluronic acid into the tear trough, correcting the hollow that accentuates the perception of hyperpigmented skin.

Under-eye bags are small fat bulges without skin alteration. Under-eye bags are sometimes congenital and can be seen in young people (sometimes as early as 20 or 30 years old).

Surgery for lower eyelid bags (using a transconjunctival CO2 laser) is performed through the inside of the eyelid. Through a very fine incision, the fat pockets are approached and cut with the laser.

Although two techniques are currently possible, the transconjunctival incision technique is more difficult but has the advantages of no visible scars, no stitches to remove, reduced swelling, and, most importantly, no change in appearance. These risks can occur with the more classic technique involving an incision at the lash line of the lower eyelid, extending to the crow’s feet. Here, the surgeon removes the fat pockets, redrapes the skin, and removes the excess skin.

The operation lasts about 1 hour and is performed under local anesthesia preceded by a light anxiolytic. Post-operative effects include bruising and swelling for a few days.

Regardless of the technique used, the scar is generally invisible. The patient wears a dressing for a few hours, then replaces it with cold water compresses to reduce eyelid swelling. In the classic technique, the stitches are removed around the 4th-5th day. After surgery, under-eye bags do not reappear for an average of 10 years.

However, the transconjunctival technique for eyelid surgery/blepharoplasty is not recommended for older individuals with loose, wrinkled skin as this technique does not allow for the resection of the skin lining the eyelids. Post-operative effects are mainly characterized by the appearance of swelling (edema) and bruises, whose extent and duration vary greatly from one individual to another. However, it is expected that one will not be presentable for a week.

Frequently asked questions about eyelid surgery or blepharoplasty.

What is eyelid surgery or blepharoplasty?

Eyelid surgery/blepharoplasty is a procedure to rejuvenate the eyelids. This intervention aims to reduce or remove excess skin, remove fat pockets, reduce dark circles, and erase signs of fatigue, giving the eyes a refreshed appearance.

Who is this type of intervention for?

It is for anyone, men and women, bothered by drooping upper eyelids or under-eye bags. However, in some people, congenital under-eye bags can appear earlier (20 – 30 years old), and surgery may be considered before the forties. Eyelid surgery/blepharoplasty has evolved significantly in recent years, addressing different problems with specific techniques.

Is general anesthesia required?

For eyelid surgery, anesthesia will be local with sedation. Side effects will be minimized, and you can go home the same day.

Do I need a pre-operative examination?

Yes, as with any surgical procedure. For eyelid surgery/blepharoplasty, an ophthalmological consultation will be useful to check for any dry eye or other anomalies, which are not contraindications but require precautions during surgery. A blood test completes the pre-operative assessment.

Are the scars visible?

For the upper eyelids, the scar is placed in the crease of the eyelid called the palpebral fold. It becomes almost “invisible” after a few weeks (3 to 4, depending on the patient).

For the lower eyelid, if the surgeon uses the transconjunctival technique, meaning through the inside of the eyelid (non or slightly stretched skin, isolated bag), the scar is invisible from the outside. However, for the classic technique, the scar is just under the lash line and ends with an oblique and lateral line. This facial area almost always heals very well, making the scars imperceptible over time.

What are the post-operative effects?

Swelling and bruising will vary depending on the patient, the type of intervention, and the nature of the patient’s skin. These will persist for 1 to 2 weeks. Stitches are removed between the 3rd and 5th day. Crusts or secretions that may form are cleaned with a cotton pad soaked in water. Artificial tears also help lubricate the eye in the days following surgery to prevent dryness and corneal irritation.

When can social life resume?

Activities can resume a few days after surgery, provided it is not a job requiring significant physical effort, which should be avoided for at least 2 weeks, as well as sports. There is no particular pain following eyelid surgery/blepharoplasty. However, some discomfort, slight eye irritation, or minor visual disturbances may occur. To ensure proper healing, it is recommended to be very cautious of UV exposure for at least 3 months.

When are the results visible?

The results on the upper eyelid for excess skin are visible the day after the surgery. Once the swelling has disappeared, between 5 and 10 days, for the bags. The final result, as with any surgery, should be evaluated at 3 months.

PHOTOS

Photos of treatment results can be found on many websites, but their presence is now condemned by the Order of Physicians and Belgian law. That is why we do not show them here. However, it is legitimate for you to obtain personalized information on the topics that concern you. During your consultation, many photos will be shown to you so that you can judge and appreciate the results.

Would you like explanations and details concerning you personally? Come and meet us in consultation.