A lower blepharoplasty is a cosmetic surgery procedure indicated for the correction of imperfections of the lower eyelids. The eyelids are muscle-tendon structures that cover and protect the eye. They are covered externally by skin and internally by mucosa. The skin of the lower eyelids is very thin and delicate, thus it is often subject to early ageing and laxity compared to the rest of the face with tissue ptosis and increased periorbital wrinkles. Due to the typical laxity of the palpebral muscles, after some time it is possible to notice at lower eyelid level a subcutaneous swelling caused by the protrusion of the adipose tissue of the orbital cavity and the forming of the so-called “bag”.
Why undergo this surgery?
The eyes are a very expressive area of the face and our look is one of the main means of social communication. Lower blepharoplasty is the ideal surgery to rejuvenate and make one’s look and face seem brighter in case of drooping eyelids and adipose bags giving a lower orientation to the back of the eye with an entropion and an ectropion. Lower blepharoplasty makes the eyelids younger and relaxed, eliminates the bags, though it does not have a complete effect on wrinkles and on eyebrow ptosis. In these cases, even an upper blepharoplasty and/or temporal lift is required.
What needs to be done before surgery?
Speaking to the plastic surgeon before surgery helps eliminate doubts and perplexities and understand exactly how the surgery will be made and all options suitable for one’s case. In order to achieve the best result, all possible variables for the surgery procedure will be taken into account depending on the patient’s characteristics, namely the shape of the eye, the level of relaxation of the eyelid skin, the presence of wrinkles and/or bags, the shape of the eyebrows and the general condition of the face. The consultation is non-binding and gives one the possibility to have all data regarding the surgery and post-surgery programme, the drugs to take, analyses and check-ups to do and costs. There are two surgery options: - Transcutaneous blepharoplasty with incision of the skin along the natural fold of the lower eyelid and removal of the excess skin and adipose tissue. - Transconjunctival blepharoplasty with an internal incision at the level of the palpebral conjunctiva. This technique is advisable in case of excess adipose tissue or in younger patients.
How is the surgery performed?
A bilateral lower blepharoplasty surgery is made under local anaesthesia with sedation and lasts an average 60 minutes. The patient feels no pain during the surgery nor immediately after due to the prolonged analgesic effect of this kind of anaesthesiology technique. Once the surgery is over, small ice bags are placed over the eyelids to limit the formation of oedema, thus swelling. The patient can go back home after one or two hours from the end of the surgery.
What happens after the operation?
Temporary local swelling, light pain, lachrymation, itching, dry eyes and sensitivity to light are normal during the first days after the surgery. These symptoms can be solved using normal analgesic drugs and eye drops. All stitches are removed in the first follow-up visit, about 6 or 7 days after the surgery. Patients return to normal daily activities after 3 days from surgery, while it is better to wait around 30 days before returning to sport activities.
In case of transcutaneous blepharoplasty, residual scars follow the lines of minimal skin tension of the eyelids. They are almost invisible and just below the palpebral margin. In case of transconjunctival blepharoplasty, there are no scars.
The outcome of the surgery depends on many factors: the patient’s initial clinical condition, his/her healing capacity and compliance with the surgeon’s post-operative indications.
What are the possible risks?
Possible, though rare, complications after the surgery may be haematomas and bleeding, infections, late healing of the surgery wound, bad scarring, change in skin sensitivity.