BLEPHAROPLASTY

A facial surgical procedure indicated for patients with excess skin and/or adipose tissue (fatty bags) in the upper and lower eyelids. My goal is to restore a more youthful eye appearance, which is lost as a consequence of aging, gravity, and the loss of tone of all supporting tissues — both external and internal — in the periorbital region.

During the initial interview and evaluation, it is important to precisely determine whether the patient presents the problems already described, or whether there is an associated eyebrow pathology (brow ptosis). It is common to find patients with an alteration in the anatomical position of the eyebrows — drooping — which manifests as skin folds on the upper eyelids, mainly in the outer part. In these cases, an endoscopic frontoplasty should be performed as a complement to improve the results of blepharoplasty.

We must be aware of any significant medical history, smoking history, and use of any medications or substances that could affect coagulation tests. These include corticosteroids, aspirin, anti-inflammatory drugs, vitamins, and natural products.

Surgical time is 1 to 2 hours.

Surgical Technique

Through perfectly camouflaged incision lines in the skin, the excess skin and fatty bags are removed.

For the upper eyelids, the folds are identified at approximately 8 to 10 mm from the free edge of the eyelid, and through that line the skin incision is designed.

For the lower eyelids, the procedure can be performed with skin incisions along the lash line, or retrograde through the conjunctiva with proper protection of the eyeball (Transconjunctival Technique). This transconjunctival technique reduces the risks of scleral exposure and ectropion complications.

In planning the surgical technique — particularly for the lower eyelid — the initial evaluation of the characteristics and flaccidity of the skin is very important, in order to plan the necessary technical adjustments to achieve a good aesthetic result and reduce complication risks.

This is an outpatient procedure (the patient is discharged the same day).

Pre-Surgical Examinations

Basic laboratory tests should be ordered: complete blood count, blood coagulation tests, kidney function tests, and urinalysis to rule out urinary infections.

Certain specialized tests will be ordered according to each patient's characteristics and medical history.

Post-Operative Care

Local ice for 24 hours, then local heat for 3 to 4 days.

Analgesics as needed.

Topical ocular medications to protect the eyes during the inflammatory period.

Recovery

The periorbital swelling and bruising (ecchymosis) cause the few days of incapacity associated with this surgery. On average, 5 to 10 days.

Complications

Eyelid surgery is a procedure that has been performed for many decades on thousands of men and women without major complications. Like any procedure, some risks exist:

1. Poor scarring.
2. Ocular and skin infections.
3. Asymmetries.
4. Ectropion or scleral exposure.

During our consultation I will be able to provide more details, with the goal of informing and guiding you — not alarming you.

Let us avoid the use of medications or substances that may increase the risk of complications. Smoking should be stopped in a timely manner.