Eyelid correction

 

 

To the photo album Appointment

Lower and upper eyelid correction

A lower eyelid correction is usually performed to remove the so called eye bags or puffy bags under the eyes that are especially visible with light from above that casts a shadow and shows dark circles under the eyes. Another symptom is excessive skin under the eyes that forms skin folds, but this is far less common.

With age the skin of the eyelid starts to droop and the amount of underlying fatty tissue will decrease resulting in excess skin. In some cases there is a surplus of fatty tissue and thus a swollen eyelid. In both of these cases an upper eyelid correction offers the solution.

To the photoalbum

1. Lower eyelid correction

 

Eye bags or excessive skin

A lower eyelid correction is usually performed to remove the so called eye bags or puffy bags under the eyes that are especially visible with light from above that casts a shadow and shows dark circles under the eyes. Eye bags are caused by excessive fat in the sockets of the eyes. During the procedure some of this fat will be moved or taken away.

Another symptom is excessive skin under the eyes that forms skin folds, but this is far less common. In case of a pigmented skin the excessive skin can have a dark coloration. In this case only skin will be removed, there is no need to remove fat.

Lower eyelids can undergo an accelerated ageing process (both the eye bags and the excessive skin) caused by regular swelling. For instance due to an allergy, but also because of fluid retention. Fluid will first appear around the eyes. When this is the case I will refer you to the physician or to an internist in order to eliminate the cause of the fluid retention first, prior to the eyelid correction.

When you look at the photos, you will see examples of eyelid correction because of eye bags (fat) and because of excessive skin.

 

De ingreep

Fat removal
Just underneath the eye lashes of the lower eyelid an incision is made through the skin and the underlying muscle, after which some of the excess fat can be removed. Where necessary some skin can be removed. The scar just under the eyelashes is hardly visible. Because the removal of fat can be a bit painful, I prefer to perform this procedure under, short, general anesthetic, however, local anesthetic is also a possibility.

In case only fat (a small amount) needs to be removed than this can be done via an incision in the inside of the eyelid, the so called transconjunctival incision. This technique has two advantages:
a) There is no scar at all, not even the small scar under the eyelashes.,
b) The muscle around the eye is untouched which has long term advantages for the function of the lower eyelid.

Skin removal

If mainly excessive skin needs to be removed, than the procedure is as follows: The skin will be loosened from the underlying muscle through an incision just under the eyelashes of the lower eyelid. The skin will be partially removed and tightened. The muscle remains untouched.

The operating time for a lower eyelid correction is one hour.

2. Upper eyelid correction

 

Moderate procedure

An (upper) eyelid correction is a moderate procedure whereby a small strip of skin will be removed from the upper eyelid. This will result in an open look in the eyes and the weary feeling and the pressure on the eyes will diminish. Fatigue, but especially headaches can be caused by eyebrows that are low or drooping. See the treatment forehead lift

Drooping eyelids (Ptosis)

Ptosis or drooping of the upper eyelid, resulting in a sleepy look, is caused by a long eyelid muscle. The eyelid can be so long that it covers part of the pupil, partially blocking the sight. At a young age the condition is congenital in most cases, at a later age it can develop by, for example, wearing contact lenses. To correct this condition, the eyelid muscle will be shortened. 

See the 'before and after surgery' photos on the right.

Ptosis

The surgery

The procedure takes about 30 minutes. Local anesthetic can be easily applied to the eyelid and will be almost painless. The surgery will be performed on closed eyes. The excess skin will be marked with ink. Besides the skin often part of the underlying muscle is removed and sometimes some of the underlying fat. The skin will be sutured with one long continuous thread, leaving a scar in the crease of the eyelid. The suture will be removed after 5 days. The patients can go home the same day, but will not be able to drive themselves.

In case of ptosis the muscle that lifts the eyelid will be shortened or reconstructed. For this procedure I prefer general anesthetic.

3. After surgery

Take a rest at the day of the surgery and cool the eyes with cold, wet gauzes. It is important to avoid increased blood pressure. Therefore preferably avoid bending or force. The second day you can move around at home. 

Your eyes can get irritated because of the healing process and show a swelling and an increased or decreased amount of tear fluid. Typically the recovery period is 5 to 7 days. If your activities require you to be representable, it is saver to take a 10 days margin, by which time you can start to use make-up again. I advise you to wait for 14 days before wearing contact lenses. 

After 5 days the stitches can be removed. In case there is (slight) bruising that will disappear within a week. 

The healing process is only short, that counts for both treatments. Be aware though that within the first period, when the final result has not been reached yet, you might get well meant critical comments from family and friends. Click here to read more about this. 

Final effect with an upper eyelidcorrection

The scars can be a bit red at the beginning, but that will mostly disappear in a few weeks. Eventually a small line will remain visible, but it is nicely hidden in the crease of the eyelid. In case you have a sensitive skin, the redness of the scar can show for a few months.

4. Complications

When capillaries are not fully cauterized large bruises can be the result, especially in people with high blood pressure or in people who use blood thinners. An infection is rare. You do not have to worry about not being able to close your eyelids anymore after surgery. I have performed this surgery numerous times and this has never happened in my practice.

Another, irritating, possible complication of a lower eyelid correction is eye twitching. This can be prevented by careful surgery and restraint removal of skin. During the first few days after surgery a slightly twitching eye is normal and will disappear.

You do not have to worry about not being able to close your eyelids anymore after an upper eyelid correction. I have performed this surgery numerous times and this has never happened in my practice.

Dr. Erik J.F. Timmenga