Eye Bag Removal (Blepharoplasty - Before and After) - Dra Luísa M. Ramos on “Você na TV” (TVI)
WHAT IS BLEPHAROPLASTY?
Blepharoplasty, or eyelid surgery, is a surgical procedure that allows the removal of excess skin fat bags from the eyelids, and can be performed exclusively on the upper eyelid, lower eyelid or both.
Blepharoplasty improves drooping eyelids (ptosis) and “puffy eyes”, and therefore provides a more rejuvenated appearance to the eyes and face, and improves the vision field of patients whose drooping upper eyelids are affecting it.
However, blepharoplasty does not treat eyelid ptosis, does not remove “crow’s feet” wrinkles from the corners of the eyes, does not eliminate deep dark circles, nor does it raise the eyebrows. To improve these, additional treatments are needed.
FOR WHOM IS EYELID SURGERY INDICATED?
This surgery is indicated for people who meet the following criteria:
- Dissatisfaction with the appearance of the eyelids;
- Excess skin on the upper and/or lower eyelids;
- Fat bags in the upper and / or lower eyelids;
- Healthy patients;
- Non-smokers
- Patients who are emotionally stable and with realistic expectations about the results of the surgery;
- Patients without serious optical conditions.
TYPES OF BLEPHAROPLASTY?
There are different types and techniques for an eyelid surgery. There is no standard method for every patient and each case must be treated individually. This is a personalized procedure that allows the plastic surgeon to improve both the appearance and the function of the eyes.
Upper Blepharoplasty
Upper eyelid surgery eliminates excess skin on the upper eyelid as well as accumulated fat in the orbital region. Sometimes the sagging skin of the upper eyelids may be due to muscle weakness in the forehead or eyebrow area, so it is extremely important to detect the anatomical reasons behind the problem. The scar from the upper blepharoplasty is usually hidden in the natural fold of the upper eyelid, making it visible only when the patient has her/his eyes closed.
Lower Blepharoplasty
Lower eyelid surgery consists in removing the excess skin, thus eliminating “puffy eyes”, which are nothing more than fat bags located on the lower eyelid. Lower blepharoplasty involves a small incision along the lash line. In the case of a subconjunctival incision, the procedure is performed “inside the eye”, through the conjunctiva. This approach enables the elimination or redistribution of fat bags, but it does not enable the removal of excess skin. When there is excess skin to be removed, the scar must be along the lash line.
BLEPHAROPLASTY
Procedure
BLEPHAROPLASTY MEDICAL APPOINTMENT
Consultation
The first step in your eyelid surgery medical appointment is to share your complaints, the expectations you have with the surgery and the result you want to achieve with the medical team.
Treatment Plan
According to the initial condition of the eyelids, a treatment plan will be devised to improve their appearance.
Detailed Explanation
During the medical appointment, the risks of surgery, pre and postoperative care and the results you can expect will be explained.
Quote
After the medical diagnosis, you will be presented with an exact price for your blepharoplasty according to the surgical plan that was drawn up, and you will be able to schedule your surgery. The price will depend on whether the surgery focuses on the upper eyelid, lower eyelid or both.
TYPE OF INCISION - SCAR
Lower blepharoplasty
If there are fat bags but no excess skin, a transconjunctival blepharoplasty can be performed, in which a small incision is made on the inside of the eyelid to extract the fat – the scar will not be visible at all. If there is excess skin to be removed, the scar will follow the lower line of the eyelids, becoming thinner and more discreet over time.
Upper blepharoplasty
When removing the skin from the upper eyelid, the scar is hidden along its natural fold, thus being visible only when the patient closes her/his eyes.
TYPE OF ANESTHESIA
The anesthesia to be used will depend on the type of blepharoplasty performed. Generally, upper blepharoplasty is performed with local anesthesia and lower blepharoplasty is performed with sedation and local anesthesia.
WHAT RESULTS CAN I EXPECT
AFTER PERFORMING A BLEPHAROPLASTY?
The results of blepharoplasty are long lasting and in most cases, the removal of fat and excess skin is performed only once in a lifetime. However, surgery does not stop the natural aging process, which makes it impossible to guarantee a lifetime result. Also, as we age, the eyebrow muscle loses strength, which leads to the eyebrow drooping and exerting force on the upper eyelid, causing a droopy eyelid. In these cases, an eyebrow lift may be necessary, instead of a second blepharoplasty, as the problem is not an excess of skin.
Keeping contact with your plastic surgeon is of the utmost importance. Attend all follow-up appointments and, whenever you have questions or concerns about the results of your surgery, contact our medical team.
BLEPHAROPLASTY
PROCEDURE STEP-BY-STEP
MARKING THE EYELIDS
Before administering anesthesia or sedation, the patient's eyelids are marked.
SEDATION
In case of sedation, it is administered intravenously by the Anesthesiologist who will be present throughout the whole surgery. Local anesthetics are then injected into the area to be treated. .
DISINFECTION AND DELIMITATION OF OPERATING FIELDS
The entire area to be treated is cleansed and disinfected to reduce the risk of infection. Operative fields are placed to isolate the eyes from the external environment.
INCISIONS
According to the type of blepharoplasty, the incisions are made so that the resulting scars are disguised in the natural folds of the eyelids.
EXCESS FAT AND SKIN REMOVAL
According to the type of blepharoplasty, the excess skin and fat is removed and muscles can be strengthened too.
INCISIONS CLOSING
The eyelid incisions are usually closed with sutures which are removed 7 days after.
POST-ANESTHESIA CARE
The patient is awakened by the anesthesiologist and is then transported to the recovery room where she/he remains under observation before being discharged on the same day.
PREPARATION FOR BLEPHAROPLASTY
Before Surgery
- Do not take aspirin, anti-inflammatories, or anticoagulant medication in the two weeks prior to the blepharoplasty. You must inform the medical team of any medication you are on and any medical condition you suffer from;
- Do not smoke the month before surgery and during the healing process. Nicotine compromises tissue oxygenation, negatively affecting healing;
- If you get a cold or feel ill in any way in the days prior to the surgery, the medical team should immediately be informed.
- Carefully read all the documentation that was given to you, as some questions may arise before the day of the surgery.
- Organize your routines in advance so you can rest and recover in a peaceful way.
- Do you have questions about the surgery preparation or postoperative care? Do not wait for the day of surgery and ask all your questions beforehand.
Surgery Day
- On the day before surgery, you should have light meals only, in order to avoid indigestion. You must be fasting for 8 hours before the surgery - do not eat or drink any liquids including water.
- Shower with the prescribed antiseptic shower gel the day before and the day of surgery.
- Do not wear jewelry or a watch.
- Do not wear makeup or nail varnish.
- Do not wear contact lenses.
- Bring comfortable clothes to wear when you are discharged - preferably with buttons or a zip.
- After discharge, you can neither drive nor go home unaccompanied. If you have no one to take you home, you must inform us in advance.
- Bring sunglasses to wear when you are discharged.
Recovery and postoperative care
- Rest and avoid any type of effort in the first 8 days;
- You can go back to work after 1 to 2 weeks;
- The eyes can be washed with sterile physiological saline solution;
- Take the prescribed medication;
- Do not get direct sun exposure and wear sunglasses to protect your eyesight;
- Continuously use ice in the treated areas for the first 72 hours after surgery to avoid excessive edema;
- Do not smoke;
- Drink plenty of water and follow a balanced diet;
- Attend all follow-up appointments.
BENEFITS OF BLEPHAROPLASTY
Some of the many benefits that eyelid surgery can provide are:
Vision improvement
A significant drop in the upper eyelid may be more than an aesthetic concern, as it can limit the visual field. Removing excess skin will free and expand the visual field.
Rejuvenated appearance
Whether the eyelid surgery is performed alone or in combination with other surgical procedures, you will have a more rejuvenated appearance and a more relaxed look.
No fat bags and excess skin
“Puffy eyes” and excess skin on the eyelids convey a tired look that is difficult to disguise. Removing fat bags and excess skin will make your eyes wider and more relaxed. Many patients state they feel 5 to 10 years younger.
Specialist Doctors
About
Dr. Luísa Magalhães Ramos / Plastic Surgery
PORTUGUESE MEDICAL ASSOCIATION, Nr. 42810
Graduated by the Faculty of Medicine of the University of Porto, she specialized in plastic, reconstructive and aesthetic surgery, at Hospital de São José, in Lisbon.
Throughout her training, she subspecialized in aesthetic plastic surgery, having worked in world-renowned clinics.
Currently, she is mainly dedicated to face and breast aesthetic plastic surgery and to intimate female surgery.
About
Dr. Alice Varanda Pereira / Plastic Surgery
Member of The Portuguese Medical Association, Nr. 47051
Graduated by the Faculty of Medicine of the University of Lisbon, she completed her master’s degree in human sexuality and is currently developing her PhD at this same institution.
She joined the University faculty academic staff in 2008 as a lecturer of the Institute of Anatomy. It is in this unit that she produces most of her research projects, mainly in the area of surgical anatomy, whilst also supervising master’s thesis for undergraduate students.
About
Dr. Mariana da Rocha Martins / Plastic Surgery
Member of The Portuguese Medical Association – Nr. 55124
Graduated by the Abel Salazar Institute of Biomedical Sciences at the University of Porto and specialized in reconstructive and aesthetic plastic surgery at Hospital de São José, in Lisbon.
Throughout her specific training in plastic surgery, she worked in internationally renowned institutions such as Institut Kaplan (Barcelona), La Clinic (Montreux) and Great Ormond Street Hospital (London).
About
Dr. Marta Gouveia Duarte / Plastic Surgery
Member of The Portuguese Medical Association, Nº 57817
Graduated in Medicine from the School of Health Sciences of the University of Minho, where she completed her Master’s thesis in Human Aging.
She concluded her specialty in Plastic, Reconstructive, and Aesthetic Surgery at the Centro Hospitalar de Lisboa Central – Hospital de São José.
Collaborates in several research projects at NOVA Medical School.
About
Dr. Filipa Oliveira/ Plastic Surgery
PORTUGUESE MEDICAL ASSOCIATION: registration Nº. 59147, specialist in Reconstructive and Aesthetic Plastic Surgery.
Graduated in Medicine from the Faculty of Medicine of the University of Porto, where she completed her Master’s thesis on pediatric scars.
PhD in Medicine from the University of Münster in Germany.
After completing her specialty, she became a Senior Graduate Assistant (Oberärztin) at the Fachklinik Hornheide and the University of Münster. She is currently involved in various research projects at the University of Münster, where she is supervising doctoral students. She is also a regular correspondent for scientific and leisure magazines in Germany.
FAQ about
Blepharoplasty
IS BLEPHAROPLASTY A SAFE SURGERY?
Any surgery has associated risks and eyelid surgery is no exception. However, this is a surgery with a relatively low degree of complexity, with a very low rate of complications and with a very high level of satisfaction. However, for a blepharoplasty to be performed safely, it is essential to choose a reconstructive and aesthetic plastic surgeon enrolled with the Portuguese Medical Association and with several years of experience with blepharoplasty and facial surgery.
HOW MUCH DOES A BLEPHAROPLASTY COST IN LISBON - PORTUGAL?
The price of the surgery will depend on the type of blepharoplasty (lower, upper or complete) and the combination of procedures. The exact price will be shared with you during your medical appointment, after diagnosis.
WHAT TYPE OF ANESTHESIA IS USED?
The type of anesthesia will depend on the type of blepharoplasty (upper, lower or complete). Usually, upper blepharoplasty is performed with local anesthesia whereas lower blepharoplasty is performed with sedation and local anesthesia.
WHAT IS THE IDEAL AGE TO PERFORM A BLEPHAROPLASTY?
Patients who resort to blepharoplasty are usually older than 40, but this is not always the case. The ideal moment to perform a blepharoplasty comes when changes in your eyelids start to interfere with your day to day life (both for aesthetic and functional reasons).
DOES BLEPHAROPLASTY TREAT WRINKLES AROUND THE EYES?
No. Blepharoplasty treats “puffy eyes” and excess skin on the eyelids. The wrinkles around the eyes, also known as “crow’s feet”, can be treated by different methodologies.
DOES BLEPHAROPLASTY ALSO IMPROVE DROOPING EYEBROWS?
No. Drooping eyebrows are treated with a brow lift, possibly combined with blepharoplasty to achieve a better result and a more rejuvenated appearance.
HOW LONG DOES RECOVERY TAKE?
The recovery time from a blepharoplasty depends on the patient, but patients take on average one to two weeks to get back to work.
CAN I USE CONTACT LENSES AFTER SURGERY?
Once the swelling has subsided, you will be able to use contact lenses again – on average, 2 to 4 weeks after surgery. However, always consult your plastic surgeon before starting to use lenses again.
CAN I PERFORM A BLEPHAROPLASTY IN THE SUMMER?
Blepharoplasty can be performed at any time of the year. What matters the most is to schedule it for when you can recover peacefully. You must be aware though that you cannot get direct sun exposure for a month.
DO SCARS DISAPPEAR?
The blepharoplasty scars are hidden in the natural fold of the upper eyelid and in the lash line in the lower area. The scars are permanent, but, over time, they become thin, discreet and practically imperceptible. During the first three months, they will become redder and more sensitive, but will improve in appearance after this period, and should reach a definitive result 12 to 18 months after the surgery. The final appearance of the scar depends essentially on the patient’s genetic characteristics and postoperative care.
O resultado é definitivo?
Nenhuma cirurgia garante resultados vitalícios, mas a blefaroplastia proporciona resultados duradouros e satisfatórios por muitos anos. Muitos pacientes realizam uma blefaroplastia apenas uma vez na vida. No entanto, a blefaroplastia não trava o processo natural de envelhecimento pelo que, com o passar dos anos, a elasticidade da pele e a força dos músculos continuam a sofrer alterações, mas partindo sempre de um patamar melhor.
WHAT ARE THE RISKS OF SURGERY AND ANESTHESIA?
As with any other surgery, blepharoplasty is not without risks. Amongst the possible risks, the following stand out: bad reaction to anesthesia, infection, hemorrhage, changes in sensitivity, prolonged or unsightly scarring, allergic reactions, blurred vision, lack of lubrication, asymmetry and dislocation of the lower eyelid. The risks and complications will be explained in detail in your blepharoplasty medical appointment.
