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Aesthetic Eyelid Alterations

3346_paginaEyelid surgery (blepharoplasty) treats skin excess and bags which form around the eyes and which give a tired and sick look. This 53-year-old patient presents skin excess both in the upper and lower eyelids although he only wanted us to treat the severe bags in the lower eyelids. We proceed to solve his problem by direct resection of excess skin, leaving a minimally visible scar in the lower palpebral crease.

Eyelids suffer varied aesthetic problems: wrinkles and skin sagging, lower eyelid fat, muscle alterations and displacement of lower palpebral edge or external edge of the eyelid.

  • Crow’s feet are wrinkles around the eye that usually appear any time after the age of 30 and begin at the outside corners of the eyes. Later and resulting from skin laxity augmentation, wrinkles are more visible in the lower eyelids, while skin accumulates in the upper lids. The result is an overall aged appearance of the eyes, and of the face as an overall.
  • Bags: under the eyeball there is fat tissue that serves as a shock absorber, as if it were a pillow. A fibrotic membrane exists in the eyelids that keeps the fat in place, preventing its protrusion, that is, that it pushes and bulges out. When the fat bags fill with liquid, they make pressure on this fibrotic layer, causing puffy bags in both upper eyelids and under the eyes, instead of the typical grayish rings under the eyes. Just lightly press the globe inwards and you will see how they appear. Although they’re typical in signs of aging, these bags can also appear in young people either due to genetic characteristics or other pathologies.
  • Eye muscle alterations are less frequent and complement the treatment of other structures. External Eyelid Edge: as time goes by the palpebral muscle weakens, due to globe pressure and effects of gravity, and droops down. This causes a narrowing of the eye width, a curvature increase in the lower eyelid edge and drooping, which gives the eye a sad look. 

bibliografia

  • Krastinova D. Blepharophimosis: a new approach to surgical correction. In: Hinderer UT, ed. Plastic Surgery. Madrid: Elsevier Science Publishers 1992; 489-490.
  • Mustardé JC. Cirugía Reparadora y reconstructora de la región orbital. Ed Toray, Barcelona. 1982.
  • Toth BA, Keating RF, Stewart W. An atlas of orbitocranial surgery. Martin Dunitz Ltd, 1999.