| Freshen
up your eyes
By
Dr Vickie Lee, Oculoplastic Surgeon |
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| We’re all young at heart,
but often our bodies insist on suggesting otherwise. With age our
skin loses its lift
and elasticity and our muscles slacken. The result around our eyes
is a baggy and droopy look that wasn’t there before. What
can be done to correct this and restore
our youthful confidence? |
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| Appearances can be deceptive. You may be well rested
and in good spirits, yet appear to be tired and sad, all because of
the way the skin looks around your eyes. Your eyes are a powerful
communication tool and one of the most noticeable features in your
face. If the eyelids or frames of these windows of facial expression
have loose skin folds that hang down and slightly obstruct your vision;
or ‘bags’ that sag downwards, they can seriously detract
from the expression of your eyes. Many women also find that in these
circumstances the use of eye makeup, instead of enhancing their appearance,
often has a counterproductive effect instead. |
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| Many of these problems can be corrected with surgery
on the eyelids (blepharoplasty). An oculoplastic surgeon performs
a relatively straightforward operation to remove the surplus skin
and re-contour the protruding fat pockets. This is a popular procedure
that ‘freshens up’ the eyes and gives a new look to an
ageing face. As the thin skin around the eye area tend to age about
10 years ahead of the rest of the face, in many cases, people choose
to have eyelid surgery first and then may consider a full face-lift
many years later. |
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| What to expect from a blepharoplasty? |
| Properly proportioned upper and lower eyelids
rejuvenate the face and create a more alert appearance. If
you have suffered from excessive skin on your upper eyelids, the procedure
should also improve your peripheral vision. For many ladies, removing
the loose excess upper eyelid skin allows a more ‘stable platform’
for the application of eye make up. However a blepharoplasty procedure
cannot remove crow's feet or other wrinkles, eliminate dark circles
under your eyes, or lift sagging eyebrows. Blepharoplasty, however
can be combined with other treatments such as Botox and fillers, which
may be more effective in treating these other problems. |
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| Who is a good candidate for such surgery? You should
be physically healthy, psychologically stable, and probably have passed
your 35th birthday (although younger people with a family history
of baggy eyelids also have the operation). |
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| The preparation stages |
| Before your surgery, you need to inform your
surgeon about your complete medical history and say whether you smoke. Your
health record should specify if you have any allergies and are taking
any vitamins, medications (prescription or over-the-counter), or other
drugs. During the consultation, your surgeon or a nurse will test
your vision and assess your eyes. If you wear glasses or contact lenses,
be sure to bring them with you. |
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| An important step during the preoperative consultation
with your surgeon is to discuss your expectations frankly and in detail.
The surgeon will then discuss the scope
of the procedure - which eyelids you wish to alter (all four, just
upper or just lower), whether skin as well as fat will be removed,
and whether any additional procedures are appropriate. Other topics
will cover the place where the surgery will be performed and the risks
and costs involved. Note that most insurance policies will not cover
eyelid surgery unless you can prove that it is necessary for medical
reasons (such as drooping upper lids that interfere with your vision).
Remember to plan for someone to drive you home after your operation
and help you out for a few days if necessary. |
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| How is blepharoplasty carried out? |
| The upper eyelid surgery is carried out through a thin
incision in the skin of the upper lid, which is later closed with
fine sutures. In the lower eyelid, the incision is made in two possible
places: either hidden just underneath the eyelashes where excess fat
and skin has to be removed; or from the inside of the eyelid so no
scar is visible on the skin (where only excess fat has to be removed). |
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| The surgery is usually performed on a day patient basis
and the procedure usually takes one to three hours. After a short
rest you can be taken home. You are given local anesthesia and light
intravenous sedation to relax you. This means that you will be awake
during the surgery, but relaxed and insensitive to pain (however,
you may feel some tugging or occasional discomfort). Some surgeons
prefer to use general anesthesia; in that case, you'll sleep through
the operation. In any case, this is a point to discuss. |
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| After your surgery |
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| Bear in mind that any kind of surgery will cause some trauma
from which your body has to recover. After the operation,
your surgeon will probably lubricate your eyes with ointment and may
apply bandages over both eyes for some hours to minimize the bruising.
They will be removed so you could see your way home. It is normal
to experience bruising and swelling, and your eyelids may feel quite
tight. You can control any discomfort with the pain medication prescribed
to you. Keeping your head elevated and using cold compresses to reduce
the swelling and bruising will help. By the end of the second week
you should feel much better. |
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| Getting back to normal |
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| You can expect the maximum bruising and swelling to settle
after two weeks, but it often will take up to six weeks for the tissues
around your eyes to settle down completely. You don’t have such an operation
every day and therefore it is important to plan a significant amount of time
(a couple of weeks) away from your regular activities. As the incisions in
blepharoplasty are made in the normal creases in the eyelids, it will be very
difficult to see any visible scars once healing is complete. |
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| Three to four weeks after your operation, when you
look in the mirror, you should see a younger person looking back. |
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