Lower eyelid blepharoplasty
Patients with only mild eyebags or mild lower lid skin laxity, fine lines and discolouration may not require a blepharoplasty. Instead, they may be able to get a noticeable improvement from either laser resurfacing treatment or a chemical peel with trichloroacetic acid.
If there are deep tear trough hollows (orbito-malar groove) or hollowing at the orbital rim and upper cheek (orbital rim and zygomatic hollow), we may use an injection of hyaluronic acid filler such as Restylane® or Juvéderm® in the periocular region to increase the soft tissue volume. Once the hyaluronic acid has reabsorbed after several months, we can offer a further injection. Some patients can proceed with an autologous fat transfer(also known as a Coleman fat transfer).
If a blepharoplasty is required, we make the incision from the inside of the lower eyelid, which causes little swelling and leaves no scar visible on the outside. This is known as a transconjunctival blepharoplasty. The transconjunctival route is used if we remove a small amount of fat, and reposition it into the tear trough.
If we are removing skin from the lower eyelids themselves during blepharoplasty, we’ll make a fine incision (known as an infra-lash incision) close to the eyelashes. At the same time, we can tighten the eyelid, and stabilise it using an orbicularis muscle flap. We often do a lateral canthal canthopexy at the lateral corner of the eye to strengthen and sharpen the lateral angle of the eyelids. We use discreet absorbable sutures to close the skin incision, which heals well usually leaving no visible scar.
A pinch blepharoplasty of thelower eyelid is an excision of just a small pinch of skin from either below the eyelashes or a little lower down the eyelid, without touching the orbicularis muscle.
We may insert punctal plugs at the same time as a blepharoplasty surgery with patients with dry eye, to reduce dry eye symptoms after surgery.
Eyes and eyelids look younger, with tighter and softer skin. They are more open, with better eyelid position, fewer wrinkles and fewer visual problems.
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