Lower eyelid surgery- blepharoplasty

Over the years, the lower eyelids become flaccid. Below the eyelid, fat hernias appear. Part of the adipose tissue decreases, which causes the tear valley to grow. These processes can be slowed down and partially undone during lower eyelid plastic surgery.

Benefits of lower eyelid surgery
• increasing the tension of the lower eyelid,
• reduction of hernia in the area of the lower eyelids,
• filling the valley of tears (in the lower eyelid surgery there are many modifications, in some clinics the filling of the valley of tears can take place during the lifting of the middle part of the face),
• rejuvenating the appearance of the area around the eyes and the entire face,
• reduction of excess skin on the lower eyelids,
• after lower eyelid plastics the face gives the impression of being rested (it is a subjective feeling, difficult to measure unequivocally).
Indications for lower eyelid plastic surgery
The basic indication is the thinness of the lower eyelid. Sometimes the eyelid is so flaccid that it sticks out from the eyeball. In less severe cases, you can use laxity tests of the lower eyelids.
One of them is to catch the lower eyelid in the fingers and pull it away from the eyeball. The space between the eyeball and the eyelid should not be larger than 6 mm.
Another test is to pull the eyelid (as above) and release it. The eyelid should immediately return to its original position, the "click" sound should be heard. If the "click" does not occur, the patient must blink so that the eyelid returns to the original position or the duration is above 1 second - this indicates the laxity of the lower eyelid.
In the next test, the patient is asked to look up, the lower eyelid should go up. If the eyelid is still, it may indicate its laxity.
In another test the eyelid is caught in the medial part and pulled in the lateral direction. If the tear point moves to the hem of the cornea - this indicates the laxity of the lower eyelid.
These tests are helpful, they are not necessary to qualify for surgery. This involves a large variety of operational techniques. Interpretation of tests varies.
Fatal hernias are visible as highlight of the lower eyelid. They can appear on the entire eyelid (medial, medial and lateral hernia). After light pressure on the eyeball (through the eyelid) the hernia increases.
Deepening the amount of tears is not a typical indication for lower eyelid plasticine, but it can be corrected during surgery.
Contraindications for lower eyelid plastic surgery
Contraindications are active phases of autoimmune and endocrine diseases resulting in eyelid dysfunction and accumulation of connective tissue around the eyeball.
Please inform your doctor about aesthetic medicine procedures, especially botulinum toxin injections into the lateral angle of the eye (crow's feet), and fillers (e.g. hyaluronic acid injection).
Patients with allergic diseases, especially those that manifest with conjunctivitis and tearing, should be operated during the period in which they are not exposed to allergens.
Tell your doctor about eye diseases, some of their stages may be a contraindication to surgery. Eye specialist consultation may be needed.
Contraindications are local infections of the face and conjunctiva.
A patient reporting for surgery should not be during or shortly after respiratory infection or herpes infection.
Lower eyelid surgery is not a life-saving procedure and should not be performed at any price. If the patient has a large number of other diseases and low physical capacity then the risk of surgery is too high.
Patients with chronic diseases that increase the risk of surgery may be disqualified or asked to perform additional consultations and preparation with a specialist in a given field.
Before the lower eyelid plastic surgery
Before the operation, you should report to a doctor who will operate. It is good to prepare for consultations. It is worth to write down on a sheet of paper:
• other diseases - current and past
• operations carried out
• cosmetic and aesthetic medicine treatments performed in a given region of the body
list of medicines (including those without a prescription) including dosing. e.g., Piramil 2.5mg 1-0-1 (morning and evening after one tablet). You can also deliver packaging from the medicines you are taking. You should also replace eye drops here.
During this consultation, the patient is examined and qualified for surgery. The plan and scope of lower eyelid plasticine is presented. Often the patient in front of the mirror together with the doctor assess the laxity of the eyelids and the possible scope of correction. If necessary, the doctor will commission additional tests and consultations if necessary. This is a very good time to ask questions and raise concerns.
Consultation with a physician performing an operation should take place several days to a few weeks before surgery. The interval between consultation and surgery is beneficial, because at that time the patient "calmly" can rethink everything, talk to family or friends.
Reporting to the operation:
• the patient should provide the results of tests commissioned during the consultation. In some clinics, tests carried out on the spot, after the patient has applied to the clinic, however, it extends the time from coming to the surgery.
• 6 hours or more should pass between the last meal and surgery. Most often you can eat a light meal before leaving the house. The surgery is usually performed under local anaesthesia, so this time does not have to be strictly adhered to.
• in the morning you should take medications taken permanently (unless the doctor recommends otherwise during consultations)
• apply without applying a cream or make-up on the face or wash it after reporting to the clinic
• it is good to report without glued eyelashes or you should expect to be partially removed during surgery.
• Avoid sunbathing and tanning for 2 weeks before surgery
After coming to the clinic:
• it is good to take a shower,
• remove the jewellery,
• it is good to use the toilet just before surgery.
The next medical consultation takes place on the day of the surgery. During the consultation, the patient is examined, the treatment is discussed in detail. Eyelid asymmetries are marked (asymmetry can be corrected during surgery). Photographic documentation is made. This is a very good time to ask questions. During this consultation, the patient should sign consent to the operation.
Type of anaesthesia for lower eyelid plastic surgery
The surgery is usually performed under local anaesthesia or in sedation with local anaes