Definition and objectives

Eyelid surgery is frequently requested within the context of facial rejuvenation. The aim of the operation is to correct excess skin, hernia of the fat pockets or loss of volume and projection of the eyelids which give the eyes a hollow appearance. In order to preserve a bright, youthful look, it is essential to remove only a moderate amount of skin and fat.

There are two types of eyelid surgery, one for the upper eyelid and one for the lower eyelid.

Prior to surgery

A preoperative examination is carried out in the course of which the patient informs the anaesthetist of his or her surgical history and any medication taken.

An ophthalmological examination, to diagnose potential eye disease, must be performed prior to eyelid surgery of any type.

During the consultation, the surgeon examines the patient in terms of skin ageing of the upper eyelid, excess skin and the presence of bags under the eyes.

The patient is only hospitalised for a few hours.

The operation

- Surgery of the upper eyelid: the operation is carried out with a fine incision hidden in the lower palpebral fold (beneath the eyebrow, at the top of the eyelid when it is closed).

- Surgery of the lower eyelid: the operation is carried out with a fine incision hidden the beneath the lashes. In some cases of isolated pockets of fat, the incision can be made inside the eyelid to avoid scarring.

These two operations last no more than 30 minutes.

After the operation

This type of operation is not very painful. An eye patch and ice compresses are applied for a few hours. Any eventual ecchymosis and swelling lasts about 10 days.

The patient can return to work 8 to 10 days after the operation. Substantial physical exertion must be avoided for at least 2 weeks and exposure to the sun should be avoided for 15 days after surgery.

Result

- After surgery to the upper eyelid and once the sutures are removed the scar should be practically invisible when the eye is open. Eyes look brighter and more open.

- After surgery of the lower eyelid, eyes look more « rested » as bags under the eyes which give the eyes a tired appearance are ‘pared down’.

Final results are achieved from the 3rd month. The effects of the operation last 10 years.

Combining Botox and hyaluronic acid injections to the upper face with eyelid surgery gives results that are as spectacular as that of the more complicated forehead-temple facelift.

Imperfections in the result and possible complications

Surgery of the lower eyelid is more complicated than upper eyelid surgery as healing of the incision hidden beneath the eyelashes can lead to changes in the shape of the eyelid, giving an unwanted ‘staring eyes’ appearance. This scarring can be avoided, for example by making the incision through the inner side of the eyelid to extract pockets of fat.

It should be pointed out that surgical correction of dark circles is not always possible as the problem of a blue hue requires medical techniques such as laser or peeling.