Eye Puff Removal (Blepharoplasty - Before and After) - Dr Luísa M. Ramos on Você na TV
What is Blepharoplasty?
Blepharoplasty is a surgical procedure that allows you to remove excess skin and fat pockets from the eyelids, It can be carried out exclusively on the upper eyelid, the lower eyelid or both.
Blepharoplasty improves droopy eyelids (ptotic skin) and “eye bags”, It gives the eyes and face a more rejuvenated appearance and improves the field of vision of patients with very droopy upper eyelids.
However, blepharoplasty does not treat eyelid ptosis, remove crow's feet wrinkles from the corners of the eyes, eliminate dark circles and deep dark circles, or raise the eyebrows. To improve these points, additional treatments are needed.
Who it's for Blepharoplasty?
Blepharoplasty is indicated for people who fulfil the following criteria:
- Dissatisfied with the appearance of their eyelids;
- Excess skin on the upper and/or lower eyelids;
- Fat balls in the upper and/or lower eyelids;
- Healthy patients;
- Non-smokers;
- Patients who are emotionally stable and have realistic expectations about the results of the surgery;
- Patients without serious optical conditions.
Types of Blepharoplasty
There are different types and techniques of blepharoplasty. There is no standard method for all patients and each case must be treated individually. Blepharoplasty is a “tailor-made” procedure that allows the plastic surgeon to improve both the appearance and function of the eyes.
Upper Blepharoplasty
It removes excess skin from the upper eyelid and fat accumulated in the orbital region. Sometimes the drooping appearance of the upper eyelids can be due to weakened muscles in the forehead or eyebrow area, so it is extremely important to detect the anatomical reasons for the problem. The upper blepharoplasty scar is usually hidden in the natural fold of the upper eyelid, so it is only visible when the patient has their eyes closed.
Lower Blepharoplasty
It consists of removing excess skin and “eye bags”, which are nothing more than pockets of fat located on the lower eyelid. Lower blepharoplasty involves a small incision along the lash line. In the case of the subconjunctival incision, the approach is made “inside the eye”, through the conjunctiva. This approach allows fat pockets to be eliminated or redistributed, but does not allow excess skin to be removed. When there is excess skin to be removed, the scar must be along the lash line.
Surgery Procedure
Blepharoplasty
Blepharoplasty Consultation
Counselling
The first step in your blepharoplasty consultation is to share with the medical team your complaints, your expectations of the surgery and the result you want to achieve.
Treatment Plan
Depending on the initial state of the eyelids, a treatment plan will be devised to improve the appearance of the eyelids.
Detailed explanation
During the blepharoplasty consultation, the risks of surgery, pre- and post-operative care and the results you can expect will be explained.
Budget
After the medical diagnosis, you will be given an exact quote for your blepharoplasty according to the surgical plan that has been drawn up and you will be able to book your surgery date. The price of a blepharoplasty depends on whether it is upper, lower or complete.
Type of Incision - Scar
Lower blepharoplasty
If there are only pockets of fat without 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 be on the lower eyelid line, which over time will become thinner and more discreet.
Upper blepharoplasty
When the skin of the upper eyelid is removed, the scar is hidden along the natural fold of the upper eyelid, so it will only be visible when the patient closes their eyes.
Type of Anaesthesia
The anaesthetic administered depends on the type of blepharoplasty performed. Generally, upper blepharoplasty is performed under local anaesthesia and lower blepharoplasty is performed under sedation and local anaesthesia.
What results can I expect
After 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 doesn't stop the natural ageing process, so it doesn't guarantee a lifelong result. On the other hand, as we get older, the muscle strength of the eyebrow decreases, which can lead to the eyebrow drooping, exerting force on the upper eyelid, giving the appearance of a droopy eyelid. In these cases, a brow lift may be necessary, rather than a second blepharoplasty, as it is not excess skin.
Maintaining a close relationship with your plastic surgeon is of the utmost importance. Attend follow-up appointments and, whenever you have questions or concerns about the results of your surgery, contact the medical team.
Procedure
Blepharoplasty step-by-step
Eyelid marking
Before administering anaesthesia or sedation, the patient's eyelids are marked.
Sedation
In the event of sedation, this is administered intravenously by the anaesthetist who will be present throughout the surgery. The local anaesthetic is then injected into the area to be treated.
Disinfection and placement of surgical drapes
The entire area to be operated on is cleaned and disinfected to reduce the risk of infection. Operating drapes are placed to isolate the eyes from the external environment.
Incisions
Depending on the type of blepharoplasty, incisions are made so that the resulting scars are disguised in the natural folds of the eyelids.
Removal of excess fat and skin
Depending on the type of blepharoplasty, excess skin and fat is removed and muscles can also be strengthened.
Closing the incisions
The eyelid incisions are usually closed with sutures that are removed after 7 days.
Recovery
The patient is woken up by the anaesthetist and then transported to the recovery room where she remains under observation until she is discharged the same day.
Preparing for Blepharoplasty
Before Surgery
- Do not take aspirin or any anticoagulant medication two weeks before blepharoplasty. You should inform the medical team of any medication you take or any medical condition you suffer from;
- Do not smoke one month before surgery and while the healing process is in progress. Nicotine consumption compromises tissue oxygenation and negatively affects healing;
- If you catch a cold or suffer from a bad mood in the days before surgery, you should inform the medical team immediately.
- Read all the documentation you've been given carefully, as some questions may arise before the day of the surgery.
- Organise your routines in advance so that you can rest and recover calmly.
- Do you have any questions about blepharoplasty surgery, preparation or the post-operative period? Don't wait until the day of your surgery and ask all your questions first.
On Surgery Day
- The day before, eat light meals that do not cause indigestion. Fast absolutely for 8 hours - do not eat or drink liquids, including water;
- Bathe with the prescribed antiseptic gel the day before and the day of surgery;
- No jewellery or watches;
- Do not wear make-up or varnish/gel;
- Do not wear contact lenses;
- Bring comfortable clothes to wear when you are discharged - preferably with buttons or zips;
- After discharge, you cannot go home alone or drive. If you don't have someone to drive you home, you must inform us in advance;
- Bring sunglasses to wear when you are discharged.
Recovery and post-operative care
- Rest and avoid any kind of exertion for the first 8 days;
- You can return to work after 1 to 2 weeks;
- The eyes can be rinsed with sterile saline solution;
- Take the prescribed medication;
- Do not expose yourself to direct sunlight and wear sunglasses to protect your eyes;
- Apply ice, constantly renewing it during the first 72 hours after the operation. This is the most important measure to avoid excessive oedema;
- No smoking;
- Drink plenty of water and eat a balanced diet;
- Attend all review appointments.
Benefits Blepharoplasty
Some of the many benefits that eyelid surgery can provide are:
Improved vision
Significant drooping of the upper eyelid can be more than an aesthetic concern, as it can limit the field of vision. By removing excess skin, the field of vision is freer and expanded.
Rejuvenated appearance
Whether eyelid surgery is performed alone or in combination with other surgical procedures, you'll look more rejuvenated and rested.
No fat pockets or excess skin
Eye bags and excess skin on the eyelids give a tired, hard-to-disguise appearance. Removing fat pockets and excess skin will make the eyes look more open and rested. Many patients report the sensation of going back in time 5 to 10 years.
Medical Specialists
About
Dr Luísa Magalhães Ramos / Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 42810, specialising in Reconstructive and Aesthetic Plastic Surgery.
Graduated from the Faculty of Medicine of the University of Porto, specialising in Plastic, Reconstructive and Aesthetic Surgery, He specialised in University Hospital Centre Lisboa Central - St Joseph's Hospital.
Throughout his training, he sub-specialised in the area of Aesthetic Plastic Surgery, He has worked in world-renowned centres. At the same time, he also worked on breast reconstruction and the reconstruction of facial malformations.
He is currently working mainly on Aesthetic Plastic Surgery of the Face (eyelids, nose and cervical-facial lift), Breast Surgery and Female Genital Surgery.
About
Dr Alice Varanda Pereira / Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 47051, specialist in Reconstructive and Aesthetic Plastic Surgery and Subspecialist in Aesthetic and Cosmetic Medicine.
Licensed by Lisbon Medical School, It was at this institution that she took her Master's degree in Human Sexuality and is currently working on her PhD.
She has been a member of the faculty's teaching staff since 2008, as Assistant Professor at the Institute of Anatomy. It is in this unit that she produces most of her research projects, essentially in the area of surgical anatomy, and she is also the supervisor of master's theses.
About
Dr Mariana da Rocha Martins/ Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 55124, specialising in Reconstructive and Aesthetic Plastic Surgery.
He graduated from Abel Salazar Institute of Biomedical Sciences at the University of Porto and completed his speciality in Plastic, Reconstructive and Aesthetic Surgery at the University Hospital Centre Lisboa Central - St Joseph's Hospital.
During his specific training in Plastic Surgery, he worked at internationally renowned institutions such as the Kaplan Institute (Barcelona), in La Clinic (Montreux) and Great Ormond Street Hospital (London).
About
Dr Marta Gouveia Duarte/ Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 57817, specialising in Reconstructive and Aesthetic Plastic Surgery.
Graduated in Medicine from School of Health Sciences, University of Minho, where she completed her Master's thesis in Human Ageing.
He completed his speciality in Plastic, Reconstructive and Aesthetic Surgery at the Centro Hospitalar de Lisboa Central - Hospital de São José.
He collaborates in various research projects in NOVA Medical School.
About
Dr Filipa Oliveira/ Plastic Surgery
DOCTORS' ASSOCIATION: registration no. 59147, specialising in Reconstructive and Aesthetic Plastic Surgery.
Graduated in Medicine from Faculty of Medicine, University of Porto, where she completed her master's thesis on paediatric scars.
She holds a doctorate in medicine from the University of Münster in Germany.
After completing her speciality, she became a Senior Graduate Assistant (Oberärztin) at the Fachklinik Hornheide and the University of Münster. She is currently collaborating on 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.
Frequently Asked Questions about
Blepharoplasty
Is blepharoplasty a safe surgery?
Any surgery has associated risks and blepharoplasty is no exception. However, blepharoplasty is a surgery with a relatively low degree of complexity, a very low complication rate and a very high satisfaction rate. For blepharoplasty to be carried out safely, it is essential to choose a reconstructive and aesthetic plastic surgeon who is a member of the Portuguese Medical Association and has several years' experience in blepharoplasty and facial surgery.
How much does blepharoplasty cost in Lisbon or Porto?
The price of the surgery depends on the type of blepharoplasty (lower, upper or complete) and the combination of procedures. The exact cost of blepharoplasty, whether it is performed in Lisbon or Porto, will be confirmed on the day of the consultation after the medical diagnosis.
What anaesthetic is used?
The anaesthetic administered depends on the type of blepharoplasty (upper, lower or both). Generally, upper blepharoplasty is performed under local anaesthesia and lower blepharoplasty is performed under sedation and local anaesthesia.
What is the ideal age for blepharoplasty?
Patients who undergo blepharoplasty are usually at least 40 years old, but this is not a rule. Therefore, the ideal age to have blepharoplasty is when the changes to your eyelids start to interfere with your daily life (for both aesthetic and functional reasons).
Does blepharoplasty treat wrinkles around the eyes?
No. Blepharoplasty is a procedure to treat “eye bags” and excess skin on the eyelids. Wrinkles around the eyes, also known as “crow's feet”, can be improved with wrinkle treatments using other substances.
Does blepharoplasty also improve droopy eyebrows?
Neither. Drooping eyebrows are treated with a brow lift, which can be combined with blepharoplasty to achieve a better result and a more rejuvenated appearance.
What is the recovery time?
The recovery time for blepharoplasty depends on the patient, but it takes an average of one to two weeks to return to work.
Can I wear contact lenses after surgery?
Once the swelling has gone down, you can start wearing contact lenses again - on average 2 to 4 weeks after surgery. However, always talk to your plastic surgeon before you start wearing lenses again.
Can I have blepharoplasty in summer?
Blepharoplasty can be performed at any time of the year. The important thing is to choose a time when you can recover calmly. It's important to realise that you won't be able to expose yourself directly to the sun for a month.
Do the scars disappear?
Blepharoplasty scars are hidden in the natural crease of the upper eyelid and in the lash line of the lower eyelid. The scars are permanent, but over time they become thin, discreet and practically unnoticeable. During the first three months, they tend to become redder and more sensitive. After the first three months, the scar will improve in appearance and the final result should be achieved 12 to 18 months after surgery. The final appearance of the scar depends essentially on the patient's genetic characteristics and post-operative care.
Is the result definitive?
No surgery guarantees results for life, but blepharoplasty provides long-lasting, satisfactory results for many years. Many patients only have blepharoplasty once in their lives. However, blepharoplasty doesn't stop the natural ageing process, so as the years go by, the elasticity of the skin and the strength of the muscles continue to change, but they always start from a better level.
What are the risks of surgery and anaesthesia?
As with any surgery, blepharoplasty is not without its risks. Possible risks include: reaction to anaesthesia, infection, haemorrhage, changes in sensitivity, delayed or unsightly healing, allergic reactions, blurred vision, lack of lubrication, asymmetry and displacement of the lower eyelid. The risks and complications will be explained in detail at your blepharoplasty consultation.
