Eyelid aesthetic

Eyelid aesthetic

Crow's feet treatment, tear spring treatment, eyelid surgery (blepharoplasty), eyelid eversion treatment (ectropion), light filling.

When considered within the entire aesthetic anatomy of the face, the eye area is perhaps the anatomical area that has the most important function in terms of reflecting character, describing beauty, indicating sincerity, in short, "reflecting the person to the outside". While it is an aesthetic problem on its own in my patients around the eyes, it can also manifest itself more often with changes such as sagging and line formation in other parts of the face.

Image note: The orbicularis muscle structure on the eyelid (left) and the scars that will remain after eyelid plastic surgery (right).

In every patient with sagging or bagging of the eyelids, treatment alone may not provide satisfactory results.

Frequently occurring changes around the eyes are sagging of the skin, eyelid bags becoming evident and contributing to sagging, the formation of lines called crow's feet radiating from the outer junction of the eyelids (canthus), and the formation of a depression line called the tear fountain in the area of ​​the lower eyelid close to the nose. .

Image note: Simple eye area problems can be solved with technologies such as botox, filler or laser.

Image note: Tear trough deformity.

It is not enough to evaluate every patient with just a frontal view. In patients, the position of the fullness created by the bone structure of the cheek relative to the eyeball should be evaluated. In these patients, if the eyeball border is more forward than the cheek, the cheek bones may need to be supported with solutions such as permanent implants or fillers or fat injection.

Non-surgical solutions can overcome problems such as crow's feet around the eyes, tear fountains and drooping eyebrows. While Botox is very effective in removing fine lines and raising the eyebrow, filler or fat injection is beneficial for deep folds and tear fountains. The effect of these injections is temporary and they must be repeated. Laser enables the rearrangement of skin and subcutaneous connective tissue and can produce a longer-term solution. However, the laser device tips must be suitable for the eyelid and the energy to be applied must be reducible to the eye area. Click here for detailed information about laser treatments.

Eye area rejuvenation surgeries can be performed with regional anesthesia, but short-term general anesthesia can also be applied to patients who wish.

Surgeries performed only on the eyelids (blepharoplasty) can be performed with local anesthesia using numbing drugs. In this way, it may be possible to make finer adjustments by telling the patient to open and close his eyes during the surgery. While the surgical scar on the upper eyelid will be hidden in the natural eyelid fold, the scar on the lower eyelid will be located just under the eyelashes. Usually, the scars become vague after a few months. Lower eyelid surgery can be performed on patients who only have bags but do not have excess skin (transconjunctival blepharoplasty) without creating a scar on the inner surface of the eyelid, called conjunctiva. 

During eyelid plastic surgery, pre-existing upper eyelid ptosis (ptosis) that blocks the visual field can also be treated.

Blepharoplasty surgery consists of three main components. First, the sagging skin on the eyelid is removed, in the second stage, stitches are placed to tighten the underlying muscle tissue. In the third stage, excess fat packets on the lid that cause bagging are removed and the skin is repaired. In cases where the outer junction of the eyelids is lower than the inner one, the outer junction can be hung higher to correct the sad appearance on the face. Although the three stages mentioned in the lower and upper lids are in principle, they have different details. In patients with drooping upper lids, procedures to correct the drooping can be performed by careful planning before surgery.

In patients with drooping eyebrows, eyelid problems may be caused by this. Therefore, when drooping eyebrows are corrected, intervention on the eyelids can be kept more limited. Therefore, it is necessary to examine the eyelid-eyebrow relationship in detail during the preoperative examination.

Eyelid plastic surgery can often cause bruising and swelling that lasts for several days.

The basic recovery period after eyelid surgery is 5-7 days. The stitches are not visible from the outside and are removed in 4-5 days. Edema, swelling and bruises around the eyes begin to become apparent during this period. Ice applications will help this process, provided that they do not exceed 10-15 minutes per hour. Some gels of plant origin can help dissolve bruises and swelling faster. Your doctor will have various suggestions regarding this. The scar is red at first and turns into skin color in about 2-3 months. Until this time, it can be hidden with foundation type concealers. It is recommended to go out with sunglasses after the surgery. If lenses are used, a break should be taken for about fifteen days. I do not recommend them, especially in transconjunctival surgeries, that is, through the valve. Various eye drops are effective in reducing pain and the possibility of infection after surgery.

Unwanted problems that may occur after eyelid plastic surgery are similar to those in face lift surgery, but they rarely occur with proper planning.

The most important and serious problem that may occur after surgery is the accumulation of blood under the eyelids (hematoma). Sometimes the amount may be large and the patient may need to be taken back to the operating room. In addition, infection, prolonged tearing of the eye or, on the contrary, dryness are among the problems that can be observed. In patients with these problems, it should be questioned whether they have problems such as hypertension, diabetes, and cardiovascular disease. Another problem that may arise from surgery is ectropion , which means turning the eyelid outwards. Excessive tension, especially in the lower lid, can lead to ectropion. If ectropion is observed in the first days after surgery, it is usually due to excessive stretching of the lower lid due to edema and is temporary. After the edema subsides, ongoing ectropion may require corrective surgeries. These problems can be easily overcome by communicating with your doctor.

Comments about hyaluronic acid fillers, which are called light fillers, lighten the color of dark eyelids are not very accurate.

Nowadays, with the increase in information pollution, our patients who are candidates for plastic surgery also come to us with various ideas. The presentation policies of practitioners who are not even physicians, aimed at supporting sales, cause our patients to undergo various interventions unnecessarily. For example, applications such as hemorrhoid creams, leech applications on the eyelid, and touching a frozen metal spoon are sometimes dangerous. Basically, the cause of eyelid darkness is insufficient blood supply in the area and the resulting color changes. We may have patients who benefit from laser applications.

Another product that is claimed to be good for dark eyelids is hyaluronic acid (HA) based filler materials called light fillers. Applying HA, the most commonly used filler type, to the moving parts of the eyelid can create a very visible appearance from the outside, no matter how thin the filler is. Another risk related to this is that when the filling is applied superficially, it may leak into the vein and become dangerous vascular-clogging formations called embolism. In these patients, it is planned to dissolve the filler in a short time with an enzyme called hyaluronidase. The filling material used is of the same quality and does not cause discolouration or scattering of light.