Blepharoplasty, eyelid surgery in Lyon and Geneva
Upper blepharoplasty, often associated with rejuvenation of the forehead, must be differentiated from lower blepharoplasty, which involves the cheekbones.
Indeed, the true purpose of the blepharoplasty is not to correct the eyelids per se, but to rejuvenate the eye area, which plays an essential role in non-verbal communication.
Excising some skin under local anaesthetic does not help to rejuvenate the eye area and might, moreover, lead to a poor surgical outcome. On the other hand, treating the whole fronto-orbital region to enable it to revert to its initial shape helps the eyes to regain a more youthful and attractive expression.
With age, the upper eyelids become hollow resulting in a sagging skin* aspect. This is accentuated by the eyebrows which naturally droop over the eyelids. All these changes contribute to a sad and tired look.
Lower eyelids :
Gradually, and often more visibly in the morning, bags appear under the eyes where the skin is thin and wrinkled. Underneath the bag, the emaciation slowly leads to the formation of dark circles. Concurrently, wasting of the upper cheekbone reinforces the drooping effect.
Considering the natural and constant pull from gravity, the treatment does not aim at lifting the skin but at restoring lost volume and natural contour to provide a smooth anatomic transition between the lower eyelidand the cheek. The skin itself is not the origin of the problem; it only mirrors underlying changes in the bone structure.
Thanks to this remodelling technique, the eye area will be rejuvenated and look natural, lively and expressive
- Procedure :
To treat the excess skin of the upper eyelid, which prevents the application of make-up and give you this tired and sad look, an incision is made a few millimetres from the eye lashes, in the natural crease of the upper eyelid (palpebral fold). As the eyelid skin heals very well, the incision is barely noticeable and the fine pinkish line that remains for a few of the weeks that follow can be easily concealed with some make-up.
Thanks to the incision, the excess skin is removed and the fatty deposits causing the puffiness next to the nose eliminated. This is a very meticulous procedure that is often required to be performed under the microscope.
Because the visible excess skin is also a result of the gradual loss of the youthful appearance (due to thinning fatty tissues), a lipofilling (fat micro-grafting) is frequently carried out in conjunction with this procedure in order to re-stretch the sagging eyelid from the inside. The eyelid external angle can also be lifted to emphasize the almond-shape of the eye.
For the rejuvenation of the lower eyelids, the incision is made along the lash line and becomes invisible very quickly. The fatty material is trimmed out and, if any, the excess skin will be eliminated using a re-draping technique: the skin is not lifted but rather repositioned in a pleasing way. Most of the time, the fatty tissues are extracted by gaining internal access with incisions placed inside the eyelids (transconjunctival approach), thus leaving no visible scar.
A light dressing is applied for a few hours and the patient can be discharged the same day, or the following one, depending on the extent of the procedure and the mode of anaesthesia used. A lipofilling is generally performed simultaneously to restore the regular natural curve between the eyelid and the cheekbone and to eliminate the dark shadow under the eye.
- Anaesthesia :
The surgery will be performed under local, or mild general, anaesthetic depending on the medical indications and the associated procedures.
- Recovery phase :
Moderate bruising is generally experienced and the affected area needs to be protected from sunlight. The associated conjunctival swelling (oedema) can sometimes feel as if the patient has a “bubble” in the eye, but this generally subsides after few days.
If laser was used during the procedure, the skin will remain pink for a little while. The surgeon is always available to meet and reassure his patient, who is expected to attend a follow-up appointment eight days after the procedure has taken place.
Generally very few, or no, stitches are removed because the surgeon uses either intradermal continuous sutures or absorbable sutures. It is possible to use make-up from the fourth day post-operation.
- Side-effects and complications :
As is the case for any surgical procedure, side-effects and complications can occur even with an experienced surgeon. These can include: severe haematoma, requiring draining to avoid vision disruption; ocular pain due to a light scratch and temporary eyelid retraction.
Although such cases are rare, we feel that it is necessary to mention them in order to provide honest and transparent information on a cosmetic surgery that has proven to have excellent results and lifetime benefits.