Blepharoplasty (Lifting Eye)

blefaroplastica-incisioniGreek word for shaping the eyelid. This is an operation to remove excess skin and / or fat around the eyes in order to benefit from a more relaxed and youthful appearance. It can be performed on the upper or lower eyelid, or both.
Your eyes are the most important part of the face. They are what people notice first when we met.
With age the skin around the eyes loses its elasticity. You can develop skin wrinkles on the upper eyelids due to excess skin that can also come to cover the entire eyelid; or fat bags on the lower eyelids, due to ‘herniation spot fat to’ internal ‘s orbit. As well as loose skin, the muscles relax in this area so that the fat will find space giving the appearance of tired face with the features “bags under the eyes”.
The reduction of fat in some districts of the lower eyelid also associated with skin thinning, can cause the formation of dark complexion furrows also called “circles”.
Over time that the skin around the eyes increases, the muscles weaken, and develop wrinkles and bags.

These changes occur for a number of reasons:
• Inheritance
• Sunlight and ultraviolet light: they damage the skin, especially the delicate area around the eyes.
• Maturity: as already mentioned, the aging causes stretching of the skin of the eyelids and leads to excess wrinkles, sagging of the fat around the eyes, which will appear as bulges in both the upper and lower eyelids.
With the removal of excess skin and bags (ie redistribution of the latter), the eyelid surgery can improve many of these problems. It can not, however, totally eradicate all eyelid wrinkles. Can not, in other words, creating excess tension on the eyelids causing an overcorrection.
In the upper eyelid, the overzealous removal of an excess of adipose tissue has been shown to produce a blank appearance, which can make the patient’s eyes as the eyes of a doll.

LIMITS:

With blepharoplasty it will be removed only in the area wrinkles within the bony edge of your eye sockets. The “Crow’s feet” and other wrinkles around the orbital zone will not be removed from the procedure, but other treatments such as Botox. You will not get the effect of an eyebrow raising, nor the dark coloration under the eyes will also be resolved by blepharoplasty.

PREPARING TO ‘INTERVENTION.

At your consultation, Dr. Grassetti must be informed of:
Your overall medical history and the whole eyelid surgery to which you have previously submitted; dellatiroide possible disease or liver disease as these can cause swelling of the eyelids; a dry eyes past.
At least three weeks before the ‘intervention you will have to suspend the’ intake of medicines containing acetylsalicylic acid (aspirin, and c.). The day of ‘intervention should gently remove all traces of makeup from the face and nail polish from the nails of hands and feet.
Dr. Grassetti will specify the normal differences in facial symmetry that you might not have ever noticed, and will describe the results that you can expect from surgery and the placement of the scars. It ‘very important to tell your surgeon about your expectations and try to in a concerted manner to define a possible end result.

Surgery

Blepharoplasty can be performed under local anesthesia combined with sedation, or in particular cases under general anesthesia.
Upper eyelid
The incision in the natural crease of the eyelid falls about one centimeter above the eyelashes so as to make it less visible when the patient keeps his eyes open, and stretches a little ‘eye in the outer side area, so as to be confused with fine lines d ‘expression at this level. The ‘excess skin is trimmed and the lighter colored fat only in a side of the nose area is removed (bag medial fat only). In cases in which there is a bulge laterally to the eyelid, it may also be removed. Thereafter, the incision is completed with a continuous suture.

Lower eyelid

The incision is made just below the lashes and runs to the area where there are natural wrinkle around the eyes (crow’s feet). The fabrics are then relieved and the excess fat is partly removed and partly redistributed to fill the concave areas that otherwise would give a sunken appearance to the eye (dark circles). During the execution of this operation, a simultaneous lifting of the cheekbone could contribute to a more youthful appearance. Finally, the skin will be raised upwards and towards the outside, placing care that there is no voltage. It is then removed in its part the excess before the incision is sutured.
also often during the same procedure is performed a slight lateral angle suspension of the eyelid upwards (Cantopessi). This procedure helps to give a much more toned and youthful appearance to the eye.

After surgery

This may lead to excessive tearing or an abnormal pigmentation of the eyelid skin, but this will only be a temporary effect. Appropriate precautions are listed below:
• To prevent bleeding you do not have to bend down or perform vigorous activities for five days after surgery. Is should rest with the head raised on two pillows for the first 3 nights. It also a good idea to avoid lowering your head below the level of the heart, such as to pick something up or tie his shoes.
• The eyelids should be gently irrigated with water, but never rub in any way to remove any crusts until the removal of stitches
• The anti-inflammatory antibiotic eye ointment should be applied for four days and you will not have to apply any type of eye makeup for the first week
• ‘important to avoid aspirin after surgery. Any pain around the eyelids can be controlled by mild painkillers such as paracetamol. You can also try using artificial tears useful in the early days
• Local anesthesia may stop for a few hours the muscles of the eyeball, resulting in difficulty of complete closure of the eye and sometimes double vision for a few hours. All effects are fully reversible within 24 hours.
• Immediately after the ‘intervention are manifested in varying degree bruises and swelling on the eyelids. These resolve spontaneously within 5-10 days depending on the case. Dr. Grassetti may recommend some of lymphatic drainage massage sessions to accelerate recovery
• Because you will not be able to wear contact lenses for some time after surgery is helpful to have a few on hand glasses
• E ‘essential to wear sunglasses after surgery for proper healing.

Your stitches will be removed from 3 to 7 days after surgery. The students can begin to use hypoallergenic makeup or foundation. It can also resume normal work.
The sports activities may be resumed not earlier than two weeks, to avoid the magistrates swings resulting risk of bleeding or hematoma formation.
Your scars will be pink for a few weeks or months. Those in the area of ​​”crow’s feet” may become lumpy for a while, but should flatten out over time. This flattening can be helped by a gentle massage building to commence two weeks after surgery.
The lower eyelid may appear slightly stretched down with a tendency to tearing. This condition is generally due to the swelling and with it goes to disappear.
During the first few months some patients patients have an unpleasant appearance of the eyes, appearing tired and expressionless. It is due to transient stiffness of scar tissue which limits the expressiveness of the eyes .. After this time period, with the ‘settling of the fabrics and the’ softening of scars, it restores natural expression.

The risks

As with any surgery, there can be complications of a general nature such as bleeding, infection and wound dehiscence. Bleeding, should happen to retrobulbar level, it could rarely request a return to the operating room to prevent eye damage. The risk is present in the first 10 days, during which it is therefore recommended to avoid physical exertion, including sexual activity. The infection is quite rare because the eyelid is richly vascularized is usually easily cured with antibiotics and local medications, extending the course of treatment that you observed during surgery. When this can cause scarring of poor quality. Wound dehiscence, or an injury that tends to re-open, can determine an enlarged scar and therefore visible, most frequently in the lateral portion of the ‘eye. If appropriate can be corrected under local anesthesia after a few months.

You also can check specific complications of that intervention as:
Ectropion and lagophthalmos: An excessive removal of skin from the lower eyelid, sometimes difficult to evaluate, can determine a retraction of the same down, such as to expose a part of the eyeball resulting in tearing. In these cases it may want an exercise that gives hypertrophy of the orbicularis muscle and the patient can do at home alone. In severe cases may involve the use of a cantopessi to be made in the operating room
excess skin remaining. It ‘s normal if small entities because surgery is not an exact science. If too obvious to be corrected under local anesthesia after a few months from ‘intervention
Conjunctival hyperemia. red eye and swelling of the conjunctiva. It resolves in a few weeks with the ‘help of eye drops
Ptosis. The fall of the upper eyelid that does not resolve within 24 hours, ie where there is completely gone l ‘of the local anesthetic effect. Actually means that pre-existed the blepharoplasty, but it was masked by over-existing skin first.
corneal irritation. It may be due to prolonged eye opening during the intervention

RESULTS

The extent of the improvement is conditioned by the initial situation. And ‘less in patients with too thick or too thin fabrics and lassi, or in those with hypotonia of the lower lid, or with obvious lowering of the eyebrow. In addition, the amount of fat present locally, the biological age of the skin, the amount and quality of wrinkles, the underlying bone structure and hormonal influences are important factors that determine the success of intervention.
Blepharoplasty does not stop the normal aging process, so it is inevitable that with the age the skin relax, being able to make needed a touch-up every few years. However, even without subsequent retouching, the appearance of the eye will still be better than you would if the ‘intervention had not been executed!

SCARS

The scars will be very little visible because hidden in the natural folds of the eyelids and wrinkles on the sides of the eyes. In rare cases, in particular at the inner part of the upper eyelid, the scars may be flushed for a few weeks, detected or retracting.