Blepharoplasty / Eyelid Surgery

Eyelid Surgery / Blepharoplasty 

The eyes are commonly referred to as the window to the soul. They form one of the most important aspects of facial expression. The most fashionable eye shape is the classic almond shape, with longer curved lashes and thinned eyebrows.

Eyelid surgery, or Blepharoplasty, is a surgical procedure to improve the appearance of the eyelids. Bright, beautiful eyes make all the difference to a face. Having an upper eyelid crease is one way to achieve this result and look more youthful. In general, many Asians have no or partial eyelid creases. The fat inside the eyelid (orbital fat) often makes the crease look less visible, thereby reducing the brightness of the eyes. 

Kamol Cosmetic Hospital has several procedures for eyelid surgery to adjust the shape and size of your eyes to make them more attractive and proportionate. The procedures are as follows:    

1. Double Eyelid Surgery

         This is a popular surgical procedure for Asians due to smaller eyes, single eyelids, or double eyelids that are not visible. We offer two techniques for double eyelid surgery as follows:

         1.1 Double eyelid surgery by the open technique:  The surgeon makes an incision into the crease, removes fat and excess skin, and makes the desired aesthetics before stitching closed to create a new crease, as in Picture 1.

Picture 1. It shows the procedure for double eyelid surgery using the open technique.

         1.2 Double eyelid surgery by the Suturing technique: The surgeon marks 6 points on the new eyelid crease, then inserts the suture (thread) in and out of the muscle and passes it through the marked points from the anterior eyelid skin to the posterior. Finally, the suture is embedded under the skin to fixate the double eyelids, as in Picture 2

Picture 2. It shows the procedure for double eyelid surgery using the suturing technique.

2. Eye Ptosis Correction    

         Eye ptosis surgery is a surgical procedure to correct the drooping of the eyelid that often develops with age. There are many methods for eye ptosis correction and the technique used depends on the severity of eye ptosis. The surgeon can fixate on Levator application if the patient has only mild or moderate eye ptosis. If the patient has severe ptosis, the surgeon will use the frontalis muscle flap from the forehead to fix it with the tarsal plate, making the eye more open, as in Picture 3.

Picture 3. Shows the eye ptosis correction procedure.

3. Lower Eyelid Surgery

         A telltale sign of an aging face often includes dark rings, wrinkles, and sagging below the eyes. Lower eyelid surgery is a cosmetic procedure to correct loose skin, excess fat, and wrinkles of the lower eyelid, making the under-eye smoother and significantly more youthful. This procedure can take a decade or more off someone's perceived age. There are two methods for lower eyelid surgery as follows:

3.1 Transconjunctival lower eyelid surgery. This procedure is suitable for someone with eye bags but skin and tissue still have good elasticity. The surgeon will remove the excess fat through the incision in the conjunctiva and then close the incision with dissolvable stitches. The eyes will look entirely natural without any visible scars, as in Picture 4

Picture 4. Shows the transconjunctival lower eyelid surgery procedure.

3.2 Transcutaneous lower eyelid surgery. This procedure is used for those with sagging skin, bags, or wrinkles with less elasticity of the lower eyelid. The incision is made just below the lower eyelash, excess fat is removed, the muscle is fixated, excess skin is removed, and sutures (stitches) are made. See picture 5

Picture 5. Shows the transcutaneous lower eyelid procedure.

4. Epicanthoplasty

           A cosmetic procedure to reduce the “Mongolian fold” or Epicanthic fold of the eyes. The Mongolian fold is the skin of the upper eyelids, which covers the inner corner of the eyes. Epicanthoplasty involves making a tiny incision on the inner corner of the eyes to improve the shape, resulting in bigger and brighter eyes. People usually combine Epicanthoplasty with double eyelid surgery to create a more beautiful eye shape.

Kamol Cosmetic Hospital offers three techniques for Epicanthoplasty are as follows:

4.1 W-Epicanthoplasty. The surgeon makes a W-shape line at the inner corner of the eyes. This method is available for someone with a severe degree of Mongolian fold. The angle and extent of medial canthus dissection can be flexibly adjusted, as seen in Picture 6

Picture 6. Shows W- Epicanthoplasty procedure.

4.2  Z -Epicanthoplasty. This method changes the direction of the inner corner and does not require any skin resection (removal). The scar is less visible than the W-shape. It is suitable for someone who has a moderate Mongolian fold. See picture 7.

Picture 7. Shows Z- Epicantoplasty procedure.

4.3  V-Epicanthoplasty. This method is suitable for a mild Mongolian fold. It keeps the tip of the medial canthus pointed slightly downward. The surgeon must control the degree of the dissection to achieve natural results. See picture 8.

Picture 8. Shows V- Epicanthoplasty procedure.

5. Canthoplasty

      Canthoplasty is a surgical procedure that improves the lateral canthus so that it is balanced and has a natural appearance. There are numerous methods for lateral Canthoplasty, such as:

5.1  Lateral Canthoplasty. This is a cosmetic surgery that creates a change in the horizontal dimension of the eye. It can enlarge the outer edge of the eye by around 2-3 mm. It can be performed alongside a double eyelid surgery. Epicanthoplasty makes the eye significantly more prominent and brighter. See picture 9.

Picture 9. Shows Lateral Canthoplasty procedures.

5.2 Canthopexy (Cat eyes) This minor surgical procedure strengthens and stabilizes the lateral canthal tendon to tighten a drooping lower eyelid or ectropion. This method repositions the outside corner of the eye where the eyelids meet, restoring a youthful look. It can uplift the eye by around 5 mm. See picture 10.

Picture 10. Shows Canthopexy (Cat eye surgery) procedures.

5.3 Lowering Canthoplasty  In some East Asian people, the Lateral Canthus is too high and can look unnatural. Lower Canthoplasty can move the Canthus downward around  3-5 mm. Incisions are made in the upper and lower eyelids. The Canthal ligament is repositioned and adjusted to balance and shape the eye. See picture 11.

Picture 11. Shows Lowering Canthoplasty procedures.

Post-operative Care for Blepharoplasty

• For two to four hours after the surgery, a cold pack (or cold towel or gel pack) must be placed over the wound to reduce swelling.
• Sleep and rest with the head slightly elevated to reduce swelling for a week.
• The patient must take extra caution when coughing or sneezing to prevent bleeding after the surgery.
• Refrain from smoking, drinking alcoholic beverages, and eating salty, spicy, preserved/pickled food for 1-2 weeks.
• 24 hours after the surgery, the plaster may be removed, and the face can be cleaned with a moist cloth.

Risks and Complications for Blepharoplasty or Eyelid Surgery:

Risks and complications with blepharoplasty or eyelid surgery are rare but are as follows:

• Swelling and bruising
• Bleeding from the incision line
• Dryness to the eyes
• Sensitivity to the sun or other bright light
• Difficult to close your eyes
• Ectropion from lower eyelid surgery
• Infection
• Pain
• Scarring
• A temporary or permanent change in vision (extremely  rare)

Recovery from Blepharoplasty or eyelid surgery

      During the first week of recovery, you will feel discomfort from swelling, bruising, irritation, and dry eyes. This can be controlled with medication, cold compress, and ointment. Eyelid surgery will involve some pain, swelling, and bruising. Ten days after surgery, most patients can go back to work.

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