Monday, March 21, 2016

Finer aspects of eyelid and eyebag rejuvenation

Eyelid rejuvenation for both upper and lower eyelids are commonly sought after aesthetic procedures by most people in their forties and older.
Done properly with accurate markings,the results of both procedures are very good and long lasting.

One of the most common complications is eyelid asymmetry. This can be prevented by an accurate pre op design. I have designed the cross incision for upper eyelid rejuvenation  to prevent and also correct asymmetry. The results have been consistent and patient satisfaction is generally high.


In the cross incision ,I use a line from the centre of the pupil and both limbal margins to the desired height  of about 7-8mm. The amount of skin to be resected is measured on both sides.If there is asymmetry, I adjust the  amount  by removing  less on one side.

Some tips:

1. Sometimes,in older people in their late forties onwards, one might have to plicate the loose orbital septum with 6 zero pds or vicryl and fix to the periosteum of the rim;care should be taken not to be too aggressive in your plication so as to prevent excessive scleral show. A moderate amount of plication is sufficient-test the septum laxity by pressing on the lower and upper eye during upper and lower procedures.

2. I like to re drape the fat to avoid the post operative hollow and cadaveric look years later, which is common when all the fat pads are excised.

3. The pinch test with fine forceps for lower eyelid rejuvenation is useful;only a small amount of skin is removed here.If septal plication is done,it my not be necessary to remove skin and muscle. The baggy eyes can be corrected  satisfactorily by rim fixation after plication .Fat re draping also gives a better and more youthful look post operatively.

4. In the oriental "double eyelid" procedure , I prefer to use a height of about 7-8mm so that the look is more natural. Too big a crease in Asians may look abnormal compared to the rest of the face structures. The septum is opened,and a few figure of 8 sutures with 6 0 pds or proline/nylon placed between the tarsal plate and levator aponeurosis-this everts the upper eyelids and increases the interpalbebral distance giving the eye a bigger and rejuvenated appearance.

5. If there is brow drooping in older patients.I also add a brow elevation procedure-brow lift ,sometimes or a mini lateral direct brow lift procedure.




3 comments:

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  2. I'm planning to undergo eye bag removal surgery in Singapore. I want to regain my confidence, I want to look beautiful again.

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  3. You can visit www.dryeapplasticsurgery.sg

    He is an excellent aesthetic plastic surgeon at Mt Elizabeth

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