Treatments : Face and neck

Eyelid




Blepharoplasty

Blepharoplasty encompasses all eyelid cosmetic plastic surgeries that aim at removing excess skin, fat, or muscle from the upper and lower eyelids. It improves the appearance of the upper and/or lower eyelids and gives a rejuvenated appearance to the surroundings, making you look more rested and alert. Aging is the key factor in the change of the eyelids (most patients are over 40 years old) but genetic is another frequent factor that calls for treatment for younger patients. Blepharoplasty is often performed with another cosmetic surgery such as a brow-lift or facelift to improve droopy eyebrows, crow's feet, and facial sagging. The two surgeries can be done at the same time or separately.

The Perfect Candidate

If you are bothered by the way your eyelids look (for example puffiness, bags, dark and wrinkled skin under your eyes, “crows feet" lines around your eyes, “sleepy eyes”) then blepharoplasty is for you.

Eyelid surgery has greatly improved and allows us to use many different techniques adapted to each individual case.

Anaesthesia

The surgery is often performed under local anaesthesia (administered by me or an anaesthetist). In certain cases general anaesthesia will be necessary.

The surgery is normally performed on an outpatient basis, but you may have to stay overnight in the hospital (it will often be the case when blepharoplasty is combined with another surgery).

Improvements can be achieved via other surgical options:

  • Rings under the eyes: By moving the fat in the lower eyelid or by micro-fat grafting
  • Fine lines and wrinkles around the eyes: For a temporary solution (renewable every four to six months) Botox injections can be administered. For a more permanent solution a traditional blepharoplasty will take care of these wrinkles
  • Excess skin/bags and fine wrinkles of the lower eyelid: When moderate, the excess skin can be removed from inside the lower eyelid and an Erbium laser is used to restore the skin's volume and minimize the appearance of wrinkles, lines, and scars.

Other cosmetic surgeries that can be performed simultaneously:

  • Lifting the eyebrows
  • Smoothing the nasolabial lines (the first area that ages)
  • Smoothing rings under the eyes
  • Smoothing fine lines and wrinkles around the eyes

Pre-surgery

Pre-surgery lab tests will be required.

A visit to your eye-doctor will be required to determine the presence of any eye diseases (such as glaucoma,) dry eye or detached retina. In those cases specific care will be taken during the surgery.

Are the scars visible?

A cutaneous scar is always visible but in case of upper lid surgery, it is hidden in the crease. For the lower lids, the surgery can be done from inside or outside so the scar can be placed along the lash line, hidden in the lateral crease. The skin around the eye tends to heal nicely and the scars are invisible after only three to twelve weeks.

After surgery

There is no real pain, just some slight discomfort. You may feel some tension in the eyelids, irritation in your eyes and your eyesight may be unclear. You may also experience some swelling and bruising. It is highly recommended that you rest for the first three days following the surgery.

You might have difficulty closing your eyes for a few days or have the feeling the external angle of your eye is not attached to the eyeball but there is absolutely nothing to worry about – this will soon disappear. Stitches will be removed between the third and sixth day following the surgery.

You will be able to resume your social and professional activities after one to three weeks. The scar might be pinkish for the first few weeks but you will soon be able to use make-up (usually one week after the surgery.)

For the lower eyelids, I personally prefer using surgical methods performed from the inside of the eyelid, for two main reasons: To avoid visible scars and to reduce the after-surgery inconveniences. I also use all possible treatments pre- and post-surgery to allow you to be able to resume all activities one week after the surgery.  

The results

  • They are visible as soon as the day after your surgery for  procedures done on excess skin on the upper eyelid
  • For bags under the eyes, they are visible one to three weeks after your surgery
  • The final results are to be seen after a few months (usually three to six months).

Possible imperfections

They are usually the result of a misunderstanding between the patient (his/her expectations) and the surgeon. I will take all the necessary time during your consultation to discuss your options and the likely outcomes of eyelid surgery and recommend a course of treatment. I will also discuss any risks or potential complications.

There might be some unexpected reactions from tissues or healing problems.

These imperfections can usually be corrected by a second surgery with local anaesthesia about six months after the initial surgery. I always do my very best to avoid these imperfections and use techniques that limit them.

Possible complications

Severe complications are very rare. In most cases the surgery goes smoothly and the patient is very satisfied with the result.

However, the following problems may occur:

  • General surgery problems, such as symmetric or healing problems (very rare for eyelids)
  • Infection: Very rare, as eye drops are always prescribed post-surgery. Micro-cysts can appear but can easily be treated.
  • Problems related to the anaesthesia
  • Chemosis (oedema)
  • Eye-dryness
  • Lagophtalmos (difficulty being able to completely open the upper eyelid). This would only be temporarily and would not last more than a couple of weeks
  • Ectropion: The lower eyelid turns outwards. This is very rare and can be treated by repeated eyelid massages. I normally avoid the problem by anticipating it during your consultation.

Can these problems be avoided?

There are no guaranties that one or more problems may occur, as we cannot completely control the healing process. However, I guarantee that I do my very best to achieve the expected results. I am also qualified to take care of any of these problems, should they appear.

Why consult a plastic surgeon?

  • Plastic surgery in France is the only specialty that educates on every act and aspect of aesthetic surgery. It allows the surgeon to have a global picture, diagnostic and therapy.
  • As a surgeon, s/he knows the anatomy of the face and has a three-dimensional perception of it. S/he knows exactly where to inject products.
  • As a plastic surgeon, s/he can explain all the different therapy options, their advantages and disadvantages.