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Eye Lid Surgery (Blepharoplasty)

Overview of Oculoplasty
Oculoplastic surgery is the cosmetic, corrective, and reconstructive surgery of the structures surrounding the eye, rather than the eyeball itself. The eyelids and surrounding areas are extremely complex and delicate structures that are vital to the preservation of sight and are important features of a normal facial appearance. Since surgery in this area can affect one’s ability to see, oculoplastic Surgeons are uniquely qualified to perform this delicate surgery and to provide care to the eye if needed.


You need to meet an Oculoplastic surgeon if you have any of the following conditions :

  • Droopy eyelids (Ptosis)
  • Droopy eye brows
  • Baggy eyelids
  • Eyelids turning in or out (Entropion / Ectropion)
  • Eyelid injuries/loss
  • Eyelid tumors
  • Excessive blinking or uncontrollable eye closure
  • Excessive wrinkles / skin folds around eyes
  • Paralysis affecting the face
  • Facial fractures around eye

Blepharoplasty

This procedure is done for cosmetic reasons. Over time, the eyelids become baggy or droopy because the skin stretches and fat pockets become more prominent. This is most commonly a result of aging, but sagging eyelids also run in families. When eyelids droop, it may give the impression of being tired or appearing older.


Eyelid surgery can treat :

  • Sagging or loose skin that obscure the natural fold of eyelids.
  • Loose hanging skin creating unnatural fold or impairing vision.
  • Excess fat deposits causing puffiness to the upper eyelids, giving impression of being tired.
  • Loose and wrinkled skin of lower eyelids
  • Droopiness of the lower eyelids showing excessive white below the colored portion of the eye.

The surgery can be performed on an outpatient basis and you can go home at the same day of your surgery. Eyelid plastic surgery is usually performed under local anesthesia or sedation. The surgeon makes incisions in the natural creases of the lid and using these incisions fat is mostly redistributed or sometimes small amount of fat is removed to correct the baggy eyelids in addition to removing excess loose skin. The incisions are closed with fine stitches, and scarring is often completely unnoticeable because the incisions are hidden in the creases. Blepharoplasty usually takes 1-2 hours, depending on the amount and location of tissue being removed. You can return back to the normal activities after 5-7 days of your surgery.
Aesthetic eyelid surgery gives you a more refreshed and alert look as this surgery alters the appearance of the upper eyelids, lower eyelids or both.
Blepharoplasty will not remove dark circles under the eyes & crow's feet around the eyes, which may require addition of other treatment modalities like laser resurfacing or Botox.
The results of blepharoplasty are usually long lasting, but may be affected by heredity and life style factors. You might require an additional procedure as ageing continues.


Ptosis

Ptosis is a drooping upper eyelid that is often treated with a corrective procedure. It refers only to the upper eyelid; it does not refer to lower eyelid sagging. In this condition, the border of the eyelid (part that contains the lashes) falls too low and may partially block vision. In severe cases, the lid may completely cover the pupil and the patient has to tilt his or her head back to see. Ptosis can affect children and adults at any stage of life. You may notice symptoms in one or both eyes. Individuals who are born with drooping eyelids have congenital ptosis. One of the signs of congenital ptosis is having uneven creases in the eyelids. Children who have ptosis may use certain gestures or body positions to improve visibility. Frequent eyebrow raising and head tilting can indicate that ptosis is interfering with normal sight. Mild ptosis does not always require treatment. However, it seldom improves over time and usually requires corrective surgery.
Ptosis can be caused by a number of factors that affect the muscles, nerves, or skin of the eyelids. The muscle that moves your eyelids up and down is called levator muscle. It can be week by birth or can become weakened from age or injury.
In adults, the underlying cause is determined and treated, if possible. Corrective surgery involves manually tightening the levator muscles in order to lift the eyelid. You may have trouble opening and closing your eye immediately after surgery, but as you recover, this function will return. An eyelid lift can restore normal vision in many cases. The procedure is usually performed under local anesthesia. It is preferable for the patient to be awake as it helps the surgeon to determine how high to lift the lid. Young children are given general anesthesia. If ptosis is not too severe, surgical correction is generally performed between the ages of 3 and 5. Severe ptosis that interferes with vision is corrected earlier to avoid vision problem.

Entropion is the turning inward of the upper or lower eyelid. It develops as a result of weakened structures that support the eyelid. It can occur in people of all age groups, but is most commonly in older people. It often occurs as a result of aging, infection, or scarring inside the eyelid.
When the eyelid turns inward, the eyelashes and skin rub against the cornea, causing severe irritation, redness, and pain. If untreated, it can cause eye infections, corneal abrasions, or an ulcer which can threaten vision. Surgical correction involves repositioning the lid margin to a normal position and tightening the muscles. It is performed under local anesthesia on outpatient basis.

Ectropion is the turning outward of the margin of the lower eyelid and the eyelashes. It occurs most frequently in older people, due to relaxation of the tissues. Other causes include skin cancer of the eyelid, trauma, eyelid scarring, and previous eyelid surgery.
This outward turning of the lower eyelid disrupts the normal tear drainage process. This can lead to excessive tearing, mucous discharge, eye irritation, and infection or inflammation of the inner membrane of the eyelid. Lubricating ointments or artificial tears can be used to relieve symptoms in mild cases, but surgery is necessary to correct the problem. The procedure is performed under local anesthesia in an outpatient setting. During the operation, the eyelid and underlying muscles are tightened.