Blepharoplasty: Understanding the procedure in the eye area

The procedure is indicated for aesthetic and functional purposes, since excessive flaccidity can hinder vision.

Communication is not just oral: expressions also inform a lot. And in this context, for better or for worse, the eyes communicate a lot without needing to say a word. They help us develop meaningful relationships by revealing our true emotions and feelings.

On the other hand, however, they can also reveal our stress level and how well (or poorly) we slept the night before. This may be why blepharoplasty, also known as an eyelid lift, is the most commonly performed surgical procedure in Brazil and the United States, according to the International Society of Aesthetic Plastic Surgery (ISAPS).

In 2022, 201,396 operations were performed in Brazil, 104,214 in the United States and a total of 1,409,103 worldwide, surpassing, for example, abdominoplasty and rhinoplasty.

“Recommended for aesthetic and functional purposes, since excessive sagging of the eyelids can hinder the vision of some people, blepharoplasty surgery aims to rejuvenate the periorbital area by removing excess skin and fat pockets present in the upper and lower eyelids , with the possibility of repositioning these structures or filling grooves in the region when the doctor deems it necessary”, explains Paolo Rubez, plastic surgeon trained by Unifesp, member of the BAPS (Brazilian Association of Plastic Surgery), of the Brazilian Society of Plastic Surgery and of the Society International Aesthetic Plastic Surgery (ISAPS).

According to plastic surgeon Felipe de Bacco, member of BAPS, surgical and non-invasive techniques are performed to alleviate the signs of aging that occur in this region and improve the aesthetics of the eyelids.

“The procedure typically involves treatment of excess eyelid skin, eyelid sagging, ptosis, orbital septum and orbital fat. Blepharoplasties involve a combination of techniques, applied according to each patient’s needs: skin and fat removal, reshaping (transposition) of periorbital fat, tissue repositioning and fat grafting,” says plastic surgeon Felipe.

In turn, plastic surgeon Beatriz Lassance, member of the Brazilian Society of Plastic Surgery, points out that many patients say that their eyes make them look tired or aged.

“With age, the composition of the skin changes. Collagen and elastic fibers change in quality and quantity, the skin becomes thinner and less elastic, like an elastic band that stretches, but does not return to its initial state. This happens with skin in general. The skin of the eyelids is extremely thin and, losing thickness and elasticity, looks like residual skin. Under the skin there are other structures, very thin muscles and a fat deposit that serves to accommodate the eyeball. This fat is contained by a membrane which also loses its quality and ends up herniating, leaving some of its place, these are the eyelid bags. The upper eyelid, in addition to the change in the skin and the protrusion of the bags, can be aggravated by the loss of the eyebrow. A very common mistake in blepharoplasty is to remove excess skin without taking into account the position of the eyebrows. The sad and tired appearance that excess skin generates does not improve if the cause is the loss of eyebrows,” explains the plastic surgeon.

Therefore, a quality blepharoplasty can accomplish much more than simply lifting the eyes. It can also remove excess skin, reduce the appearance of puffiness under the eyes, and in some cases even improve previously impaired vision.

Beatriz explains that blepharoplasty has changed a lot in recent years. “It has been proven over the years that simply removing skin and fat is responsible for sunken, rounded eyes. Today we have a more conservative approach, instead of removing volume we reposition the tissues. Diagnosis is very important. The tired and sad appearance may be due to the loss of eyebrows associated with the protrusion of the eyelid bags and excess skin. If all these structures are not treated together, it will not look good. In young patients, simple removal of the skin may be sufficient. In the lower eyelids, flaccidity of the ligaments and muscles may occur as well as protrusion of the bags. Even in this case all the structures must be treated together”, explains the doctor.

Like all surgical procedures, it must be performed in a well-equipped surgical environment that is safe for the patient.

«Performed under local or general anesthesia with sedation, the operation, which lasts from one to two hours, can also be performed in conjunction with the lifting of the upper third of the face, when the excess tissue in the eyelids is also caused by the loss of the eyebrows,” explains Paolo Rubez.

Typically, the patient leaves the hospital the same day. According to Paolo, recovery from surgery is smooth and painless, and in the first few days after surgery the patient may experience swelling and bruising at the site, symptoms which resolve within a few weeks and can be alleviated with the help of rest and Freddo. compresses on the eyes.

According to Paolo, in some patients, fat grafting can also be performed to fill local tissue loss, as the results of the surgery become more natural when there is a certain volume of tissue around the eyes.

For Felipe, lasers and injectables can also complete the result. According to the doctor, the goal of laser treatment is to ensure the contraction of the skin, which can be smoother and more toned.

“This complementary treatment should be carried out under the advice of your doctor to achieve a better aesthetic result, as the laser can improve the quality of the skin and help stimulate supporting proteins, such as collagen,” says Felipe.

Filling with hyaluronic acid, for example, is an injectable that can be recommended for rejuvenation of the periorbital area – but also for deep dark circles. “There has been a paradigm shift in the last two decades in this field of aesthetic medicine, considering that volume loss has been recognized as one of the main causes of facial and periorbital aging, resulting in symmetrical or asymmetric emptying, a excessive visibility of the upper eyelid and sagging skin of the eyelids. As a result, volume restoration has become the preferred approach to achieve natural rejuvenation results,” he points out.

Watch the video with Pamela Daniela Silva Massuia Graciano, plastic surgeon member of the Brazilian Association of Plastic Surgery.

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Ben

Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.