Eyelids

It is often on the level of the eyelids that the first signs of fatigue appear in the form of wrinkles, of fadings and cutaneous distension.
Frequently also, of the lubricating “crucibles” exist on the level of the upper lids and lower, giving to the glance a “tired” aspect.

The esthetic attempts to correct these negotiable instruments and can be realized only, or in partnership with another esthetic intervention like a frontal face lift, a cervico-facial face lift, a temporal face lift or a face scrub.

The best indications for a are:

- “crucibles” at the level of the lower lids frequently existing at the young patient, because they are hereditary origins.

- A cutaneous depression on the level of the upper eyelid which appears in general between 35 and 40 years.

The association of these two signs leads to a surgery known as of the upper eyelids and lower eyelids

There is not for this intervention of specific age, because a certain number of mailmen intervene in the appearance of these signs, in particular of the hereditary and morphological mailmen, which explain why a can be practiced at young subjects.
This operation is practiced at the woman as well as at the man.

The first consultation is fundamental because it makes it possible to determine the motivations well and to lay down precise objectives.
The medical history and surgical is referred to (allergies and medicamentous capture…). A hereditary concept is specified.
The analysis of the face thus makes it possible to define the surgical possibilities and to specify the existence of lubricating crucibles, cutaneous excess, and a possible asymmetry.
The consultation contains the capture of photographs, useful for the operational evaluation.

A consultation with the doctor-anesthetist is programmed before the intervention to practice a complete physical exam and to prescribe the complementary examinations necessary.
This consultation makes it possible to refer to the various types of anesthesia and to take all the safety measures necessary.
The doctor-anesthetist then specifies you all the instructions to be followed before the intervention concerning the fuel supply, drinks, the tobacco, and the medicamentous captures.

Which type of anesthesia is practiced?
According to the cases, according to whether it is of the upper lids alone or the lower eyelids alone or the unit, it is possible to carry out various types of anesthesia.
The local anesthesia is frequently carried out for the surgery of the upper eyelids.
In the same way, the local anesthesia is realizable for the surgery of the lower eyelids.
Generally, for a surgery known as of the four eyelids, it is an neurolept-analgesia or thorough local anesthesia which is made, useful in the event of anxiety.
An ophthalmologic balance-sheet is made if necessary.

Which is the duration of the intervention?
A surgery of the upper eyelids and lower lids in general lasts 1 hour.

Will there be visible cicatrices?
On the level of the upper eyelids, the incision discrete, is hidden in a natural fold. Adapted consultings allow to make so that this cicatrice is extremely not very visible in the months which follow the operation.
On the level of the lower eyelids, the incision is carried out with the short-nap cloth of the eyebrows when there is an excess of skin to withdraw, that is to say, when it is not absolutely necessary to remove that the crucibles of grease, the incision is made by conjunctival channel, i.e. inside the eyelid and thus without cicatrice on the skin.

How is held the intervention?
The level of the upper eyelids, the incision makes it possible to withdraw the excess of skin as well as the “hernia “which, often, exists with the interior angle of the eye, close to the root of the nose.
The joining is carried out with a very fine yarn.
The level of the lower eyelid, when the incision is made on the level of the lower eyelid, it makes it possible to withdraw the crucibles and the skin is sutured using a very fine yarn.
When the conjunctival channel (interior of the eyelid) is chosen, the crucible is withdrawn, and it is not necessary to use specific yarn.
Obviously, the technique used is specific to each case and will be the explanation purpose personalized to obtain a natural result.
When there exist also lower eyelids and leg of goose, it is possible to use complementary techniques face scrub type, abrasion, or laser. This induced complementary therapy of rednesses which can last several weeks, and which require specific care. It is thus necessary, obviously, if such is the case, to inform particularly the patient of the later precautions to take to avoid any disadvantage.

Which type of bandage will be used?
There is no really bandage which is advised but only wet compresses which are posed on the eyelids and which the patient changes regularly.
The patient can thus see immediately after the operation and it will have only some drops of eye lotion to implement in the eyes.

Which is the duration of the hospitalization?
If the anesthesia is of local type, the patient can leave the very same day (ambulatory surgery).
If the patient wishes it, 24 hours of hospitalization can appear useful.

In the operational continuations, an edema and bruises appear on the level of the eyelids and attenuate gradually in a few days.
In general, 8 days after the operation, there are not practically more visible signs concerning the operation outwards, of the cicatrice of the upper lid which is discrete.
If there exist still some bruises, of the consultings hydration type of the skin and make-up foundation are given.
The wire are withdrawn between the sixth and the seventh day.
A light make-up is possible as from the eighth day.

Like any surgical operation, the can have some rare general complications such as: infection, hematoma, or an anesthetic complication.
On the esthetic level, it is rare that the cicatrices evolve/move on the hypertrophic mode, because the smoothness of the skin authorizes a good forecast.
However, if the development were done according to the hypertrophic mode, of the specific consultings and of the adapted care are prescribed.
The only disadvantage, which it is advisable to avoid is the amendment of the glance, in particular the round eye.
This complication occurs when too much skin was removed on the level of the lower lid.
This is why, the conjunctival channel constitutes a completely interesting alternative.
If there exist associated with the level with the upper lids, a light face scrub can be made making it possible to attenuate them.
When with the post-operative edema, it can sometimes persist a little longer (often for hormonal reasons) and justify an adapted processing.
If a were used or a laser treatment, the management of post-operative rednesses is particularly important, and it can sometimes on certain skins exist disorders of the pigmentation. An adapted processing will be advised to attenuate the aspect of it.

The activity is in general recovery rather quickly, at the end of one week. It will be necessary to avoid an exposure to sun in the four weeks which follow the operation and to take again activity of a sporting type only two to three weeks after the intervention.
Consultings of precaution (hydration, make-up foundation, total screen) are given

The lubricating hernias and crucibles which are withdrawn, disappear in general in a final way. When with the excess of skin of the upper lids, it does not reappear in the fifteen years which follow the operation.
It is thus about intervention of which the negotiable instrument is particularly durable.

This intervention simple and frequently carried out, makes it possible to effectively correct the excess of skin on the level them eyelids, durably even definitively to withdraw the lubricating “crucibles” and “hernias” and to attenuate the little wrinkles.
In certain cases, a light face scrub can be associated or come in complement with an esthetic and improve in a significant way quality of the skin.