The disgraces most commonly involved are the following:
- Heavy, drooping upper eyelids, with excess skin forming a more or less pronounced fold,
- Sagging, withered lower eyelids with small horizontal wrinkles caused by skin distension,
- Fat hernias, responsible for "bags under the eyes" on the lower eyelids or "puffy" upper eyelids.
The aim of the procedure is to correct these disfigurements permanently, by surgically removing excess skin and muscle as well as fatty protrusions, without, of course, altering the essential functions of the eyelids.
It should be noted that many other alterations may be present, but can only be treated using more complex techniques than a simple, classic blepharoplasty, or by resorting to complementary surgical procedures. These include sagging foreheads and drooping eyebrows, "frown lines" between the eyebrows, "crow's feet" at the corners of the eyes, "dark circles"We also treat minor skin surface imperfections (superficial wrinkles, scars, spots, etc.).
The procedure, which is performed on both men and women, is commonly performed in the forties. However, it is sometimes performed much earlier, when the disfigurements are constitutional (hereditary factors) and not age-related, such as certain "fat pockets".
The surgeon will ask questions and examine the eyes and eyelids, looking for any abnormalities that could complicate or even contraindicate the procedure.
A specialized ophthalmological examination will frequently be requested to detect any ocular pathology.
A pre-operative check-up is carried out as prescribed.
The anaesthetist will be consulted no later than 48 hours before the operation.
No aspirin-containing medication should be taken for 10 days prior to surgery.
Smoking cessation (or reduction to a minimum) is strongly recommended one month before and one month after surgery (smoking can delay healing).
Depending on the type of anesthesia, you may be asked to fast (eat and drink nothing) for 6 hours before the operation.
Type of anesthesia
There are three possible processes:
- Pure local anesthesia, where an analgesic product is injected locally to ensure eyelid insensitivity.
- In-depth local anesthesia with intravenous tranquilizers ("vigile" anesthesia).
- General anesthesia during which you sleep completely.
The choice between these different techniques will be the fruit of a discussion between you, the surgeon and the anaesthetist.
Hospitalization arrangements
The procedure can be performed on an "outpatient " basis, i.e. the patient is discharged the same day after a few hours of monitoring.
However, in some cases, a short hospital stay may be preferable. In these cases, patients are admitted in the morning and discharged the following day.
The intervention
Each surgeon adopts his or her own technique, adapting it to each individual case to achieve the best results. However, there are some common basic principles:
Skin incisions :
Upper eyelids: concealed in the furrow halfway up the eyelid, between the mobile and fixed parts of the eyelid.
Lower eyelids: located 1 to 2 mm below the eyelashes, they may extend slightly outwards.
Of course, the incisions correspond to the location of the future scars, which will be hidden in natural folds.
Note: For the lower eyelids, in the case of isolated "bags" (without excess skin to be removed), a transconjunctival blepharoplasty can be performed, i.e. using incisions placed inside the eyelids and thus leaving no visible scar on the skin.
Resections :
From these incisions, unsightly fatty hernias are removed, and the excess muscle and loose skin are eliminated. At this stage, a number of technical refinements can be made, to suit each individual case and the surgeon's habits.
Sutures :
They are performed with very fine, usually non-absorbable sutures (to be removed after a few days).
Depending on the surgeon, the number of eyelids to be operated on, the extent of the improvements to be made and the need for additional procedures, the procedure can last from half an hour to two hours.