Eyelid Surgery- Blepharoplasty-
Lid-Bag-Cosmetic

probably the time you need some upper and lower eyelid correction or blepharoplasty. This is what you need to rejuvenate your face in the upper region.

Blepharoplasty is eyelid surgery removing skin and fat around your upper eyelids, your lower eyelids (the "bags"), or both. The procedure is done on thousands of people each year, for cosmetic reasons or because the excess skin impair your vision.

A blepharoplasty or eyelid surgery is usually performed under local anesthesia, means you get a injection into the upper and lower eyelid, this injections hurt terribly but must you must go through, there is no pain after.

The plastic surgeon will make incisions in your eyelids. Then, excess skin will be removed and your incision will be closed up. If you are having the bags underneath your eyes removed, the fat pad beneath your eye will be removed.

After eyelid surgery you will experience some swelling and bruising for a week or so. Applying cold compresses to your eyes can help reduce these post-operative conditions. You will notice most of your cosmetic changes in the first week or two after your surgery. But keep in mind that it might up to a year to see the final outcome, it depends how your body responds to the procedure. Although the incisions will be made in the folds of your eyelids to conceal any potential scarring, there is always a possibility of visible and permanent scarring. Refrain from rubbing the treated area for at least 2 month in order to avoid damaging your new sensitive tissue. Aloe vera or vitamin E can help reduce noticeable scar tissue. Makeup also help to conceal any visible scarring. -Often a discussion is on double eyelid surgery. Many people seem to want double eyelid surgery, and just as many think it's not a good idea. The question here is why people would undergo surgery just to change something that isn't really wrong in the first place. There are many people who seem to hate their single lids, wanting all kinds of eyelid surgeries to make them feel better about themselves. Many Asian pop stars become "Americanized", one of the procedures is double eyelid surgery. The first question here is why to do the whole, have pain and risks since most people wont notice a double lid anyway In the US, Europe etc. almost every eye makeup product is marketed towards women with double eye lids since most women have them. Actually all those products also work the same way with singe eyelids. Here are photos on eyelid eurgery before and after done in a Bangkok plastic surgery hospital from a Thai plastic surgeon. This was part of a larger facelift surgery and also included some nose surgery, neck lift surgery and the usual procedure for a facelift. Plastic surgery costs for the whole operation was around US$ 7000,-, that included everything also a post operation correction 3 month later on the nose and the upper eyelids. Now 2 years later it looks quite ok. The overall outcome of the plastic surgery was not 100% as expected but around 90% which is a excellent average.

Eyelid surgery before Eyelid surgery after 7 month

-Recommended procedure

Dr. Lee generally discourages medial epicanthoplasty out of concern for hypertrophic scarring. But for doctors who choose this, he recommends the following procedure be done this first because it alters medial anatomy:

Total height of a V-W plasty should be about 5mm by 3 mm, with each arm of the V and W measuring approximately 2 mm.

After anesthetic takes effect, cut each arm of the flap with a No. 11 blade and remove the muscle along with the skin before closing the incision. Next, make a 1-cm incision along the lateral aspect of the upper lid marking. Ignoring retroorbicularis fat, remove a sliver of orbicularis, then septum, to enter the prelevator space. Once inside, remove 1 cc to 2 cc of fat.

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-Assessing need

Extra folds of loose skin indicate a need for upper eyelid repair. Palpating the skin and pushing upward against the globe can suggest whether skin alone or skin plus underlying muscle or fat should be addressed. When assessing a full lateral upper eyelid, it's important to rule out a ptotic lacrimal gland, which would require suture pexy to be repositioned within the bony orbit, according to Dr. Fincher.

"Many patients come in asking for upper lid eyelid surgery blepharoplasty when what they really need is a brow lift," Dr. Fincher tells Cosmetic Surgery Times. "With age, the brow often drops down from its elevation high above the bony orbit, causing the appearance of redundant skin on the upper lid."

-Electrocautery Eyelid Surgery using the Colorado needle appears to be at least as effective

as the UltraPulse C laser for blepharoplasty, Cameron K. Rokhsar, M.D., reported at the annual meeting of the American Academy of Cosmetic Surgery.

The techniques resulted in equivalent amounts of ecchymosis, edema, and erythema, as assessed by both physician and patient during the 30-day postoperative period. In addition, there were no significant differences in the width of the scar left by each method, said Dr. Rokhsar, a dermatologist in private practice in San Diego.

A study involved 12 patients compared lower blepharoplasty methods, 11 of whom had an upper-eyelid blepharoplasty and 2 of whom had a lower-eyelid conjunctival blepharoplasty. After an initial incision with a 15C blade, they were randomly assigned to have the skin, orbicularis, and fat of one eye excised by the C laser and those of the other eye excised using the Colorado needle and electrocautery.

The C laser was operated with a coherent 0.2-mm beam at 150 mJ, 3.5 W, and 25 Hz. The Colorado needle has an ultrasharp, 5-[micro]m tungsten tip; it was operated in this study at a cutting setting of 2 and a coagulation setting of 2.

Patients were assessed at days 1, 3, 7, 14, and 30 following surgery. At day 30, eyes treated with the C  laser had scars 1.03 mm in width, and eyes treated with the Colorado needle had scars 1.08 mm in width. These did not differ significantly.

In recent years, the transconjunctival approach to lower blepharoplasty has become a popular alternative to the traditional transcutaneous approach, but which technique is best?

The answer "is not entirely clear," Hayes B. Gladstone, M.D., said at the joint annual meeting of the American Society for Dermatologic Surgery and the American College of Mohs Micrographic Surgery and Cutaneous Oncology.

"The transconjunctival approach to lower eyelid surgery or blepharoplasty is safe, but edema and wrinkled skin are the two most common complications," said Dr. Gladstone, director of the division of dermatologic surgery in the department of dermatology at Stanford (Calif.) University.

"It also seems that with the transconjunctival approach, an adjunct procedure such as laser resurfacing or chemical peels is an important consideration," he said. Reported advantages of the transcutaneous approach are that it provides easy access to the skin, the fat pads are usually well visualized, and it removes excess skin, he said. The reported disadvantages of this approach include risk for eyelid malposition, risk for ectropion, and the fact that it leaves a visible scar.

Other reported advantages of the transconjunctival approach are that it leaves no scar and it poses a decreased risk for eyelid mal-position as well as ectropion. Reported disadvantages include difficult access to the skin, less visualization of all fat pads, potential for inferior oblique injury, and the fact that "it doesn't address excess infraorbital skin," he said.

Dr. Gladstone conducted a metaanalysis of the transcutaneous and transconjunctival approaches to lower blepharoplasty based on relevant studies published in the medical literature from 1970 to the present. He evaluated components of the studies that concerned complications, patient satisfaction, and physician assessment.

The studies he reviewed included 4,460 patients who underwent transcutaneous lower blepharoplasty and 3,438 patients who underwent transconjunctival lower blepharoplasty.

Edema occurred in 18% of patients who underwent the transconjunctival approach, compared with 0.2% of those who underwent the transcutaneous approach. In addition, 11% of patients in the transconjunctival group experienced wrinkling, compared with 2.4% of patients in the transcutaneous group.

Dr. Gladstone also observed that 32% of patients who underwent the transconjunctival approach required an adjunctive procedure such as laser resurfacing or chemical peels, compared with 1.5% of patients who underwent the transcutaneous approach. surgery, plastic surgery face lift, plastic surgery for eyes, under eye bag removal, upper eye lift, upper eyelid, upper eyelid blepharoplasty, upper eyelid lift, upper eyelid surgery, upper lid blepharoplasty

The patient assessment of lower blepharoplasty "was not clear" in studies of the transcutaneous approach, he said.

Among patients who underwent the transconjunctival approach, more than half (52%) described being satisfied by the procedure, while only 29% described their results as excellent. "They wouldn't even consider that they had excellent results, which I think is a problem when you're doing a cosmetic procedure," Dr. Gladstone commented.

He was not able to quantify physician assessment of the two approaches from the studies he reviewed.

COPYRIGHT 2005 International Medical News Group, & 2008 Gale, Cengage Learning