Blepharoplasty - Technique, Preparation Bandage and Cost

Upper Eyelid Aesthetic Surgery

Eyelid aesthetics or blepharoplasty is a set of surgical procedures for removing sagging skin and excess muscle tissue and stretching the eyelid tissue in the aging process and in patients with genetic predisposition. These are the methods applied to the lower and upper eyelids. I would like to add here from the beginning that although I have performed a lot of upper eyelid aesthetics; I don't do lower eyelid aesthetics much and I recommend a physician to my patients on this subject. In the aging process, skin and subcutaneous tissue naturally sag in all areas of our face due to the decrease in collagen and structural changes in the skin. Eyelid is one of them. In parallel with this process, bagging on the eyelids, laxity in the skin, an increase in the amount of natural wrinkles on the eyelids, and discoloration may occur. Apart from aging, irregular life and irregular sleep patterns, exposure to cigarette smoke, polluted ambient air, excessive sun exposure, and alcohol use may also cause more frequent adverse changes in the eyelids. In fact, these factors are generally negative factors that accelerate the aging of the skin.

What are the signs of aging on the eyelids?

As a result of the sagging of the skin in the aging process, symptoms such as bagging on the skin on the eyelids, increased wrinkles and even overflow of the upper eyelid skin over the eyelashes when the eye is open may occur. The signs of aging on the eyelids can be listed as follows:

- Lower eyelid appearance, sagging (in some patients, this may even prevent patients from seeing as a result of skin sagging in the visual field, in this case it becomes a functional problem rather than just an aesthetic problem)

- Increased wrinkles on the eyelid skin

- Crow's feet lines around the eyes

- Tired facial expression

- More swelling in the eyelids after sleep

- It can be listed as bagging and discoloration under the eyes.

Although the above symptoms are not seen in some patients until the age of 60; It can occur in some patients after the age of 30.

After what age is eyelid eesthetics performed?

Eyelid aesthetics is planned for patients who have started the aging process or have congenital drooping eyelids. It is usually performed in people aged 35-40 years and above, where signs of aging begin on the eyelids.

Blepharoplasty surgery cannot stop the ongoing aging effects on the eyelids; however, it ensures that this area is tightened, wrinkles and bagging are reduced, and these effects continue for 7-8 years. After eyelid aesthetics, the tired facial expression of the patient leaves its place to a more vigorous and youthful appearance.

What to consider before eyelid aesthetics

At least 7-10 days before the operation, the use of products with blood thinners such as aspirin, plavix, ginkgo biloba should be terminated. Apart from these, it is appropriate not to consume various plants and runes that have blood thinning effects such as various fish oils, garlic and cherry. Smoking, which delays wound healing (carbon monoxide contact and nicotine's vasoconstrictor effect and circulatory-reducing effect), and tobacco should not be used. Cigarette smoke can also cause the incision line to darken.

How is upper eyelid aesthetics performed?

"Upper eyelid Blepharoplasty" or "droopy eyelid surgery" can be performed under local or general anesthesia. Generally, local anesthesia is more preferred as the procedure is simple. Before the procedure, local anesthetic injection is made with a dental needle just under the skin. The surgical excision area is marked with a line parallel to the upper eyelid line and a line on top of it to form a curved, ellipsoid shape (a skin pen is used). Before the operation, the patient is told to close his eyes, and during this, the skin area that is planned to be excised can be measured with a measuring tape. The incision is made in such a way that the incision area is in the fold line of the eyelid so that the surgical scar is not visible as much as possible. After removing the skin and partially subcutaneous tissue, an aesthetic skin suture is performed with prolene intracutaneously. As seen in the video, the ends of the stitches are not knotted and are fixed by repeatedly wrapping over the tape. Apart from this suture, a few intermittent external sutures can be placed as security sutures. At the end of the procedure, after re-application of disinfectant and opsite spray, tapes are placed parallel to the incision using brown, steri strips. The operation is terminated. The total operation time is usually around 10-15 minutes for one eyelid.

Video 1:

Upper left eyelid, marking the resection area with a skin pen, drawing. An incision area of approximately 5 mm in width was drawn.

Video 2:

Upper right eyelid, marking the resection area with a skin pen, drawing. An incision area of approximately 5 mm in width was drawn.

Video 3:

The view after the upper eyelid blepharoplasty operation, after the sutures are completed.

Video 4:

Taping technique after upper eyelid blepharoplasty operation and completion of the operation

One week after blepharoplasty

Upper eyelid aesthetic prices

Blepharoplasty cost vary between 1500-2500 US Dollars according to hospitals. The procedure is usually performed under local anesthesia. If general anesthesia is preferred, if the procedure is performed in luxury hospitals, the cost of the procedure may increase after 1 day of hospitalization. This procedure is usually done by planning a daily discharge.

Care after upper eyelid surgery

Since blepharoplasty is usually performed under local anesthesia, patients can eat and drink water immediately after the procedure. If general anesthesia is preferred, patients should wait 4 hours after the operation to eat and drink. Patients can be discharged a few hours after the procedure. After the procedure, the bands attached to the eyelid should not be removed for 7-10 days and these pads should not be touched. After this period, the bands are removed by your doctor, the stitches are removed and the control examination is completed by leaving the eyelid open. In the first week, depending on the tension in the upper eyelid, there may be a small amount of eye opening during sleep, eye pomade or artificial tear gel can be used to prevent dry eyes. It is ideal to avoid water contact for a few days after the sprockets and bands are removed. Applying ice on the eye for a few hours immediately after the procedure, resting at 45 degrees and then staying in an upright position can reduce the edema of the eyelid and its surroundings. Sometimes oral antibiotics and oral pain reliever tablets may also be prescribed to you by your doctor.

Complications in blepharoplasty - Eyelid hematoma

As with all surgical procedures, bleeding, infection, and suture reactions can also be seen after upper eyelid aesthetics. The photo above is of the patient who had upper eyelid aesthetics in a different clinic and then had blood leaking from the lid, swelling, and increased bruising. The patient's dressings were removed and it was found that he had a hematoma. The sutures were opened, the accumulated blood was drained, and cold application and pressure dressing were recommended to the patient.

Below you can find the photos of the patient above three days later.  It can be seen that the swelling due to the hematoma on the upper eyelid has decreased considerably.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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