It is said that the eyes are the mirror of the soul, but they are also that of age! And for good reason: “As you age, the eyelids become heavy, wrinkle, the tail of the eyebrow sags, the eyes grow hollow, bags form, which gives the look a tired look”, analyzes Dr Marc Divaris , specialist in plastic, reconstructive and aesthetic surgery.
It is therefore not surprising that eyelid surgery is the one that women – and men – ask for first, from the age of 40 for some. The eye area is indeed the one that catches the eye the most. “Not considering droopy eyelids make makeup difficult“, emphasizes Dr. Divaris.
When to have eyelid surgery?
“Women ask us to give them back their look of before, the same in fresher, more rested, says Dr. Bernard Hayot, oculoplastician. This is also our objective: to make them gain five to ten years, keeping the overall harmony so that those around them notice their good looks without guessing that there is surgery behind it.”
“The goal of upper blepharoplasty is to correct drooping eyelids in order to open up the gaze, confirms Dr. Cécile Winter, specialist in cosmetic and reconstructive surgery. For lower blepharoplastywe seek to remove the identified and tired aspect”.
The intervention will therefore modify the signs of aging, without modifying the person’s expressions.
What age for blepharoplasty? What contraindications?
- For an operation of the upper eyelid (upper blepharoplasty), there is no age limit.
- For an operation of the lower eyelid (lower blepharoplasty), the skin must still be toned, and Dr. Cécile Winter sets her limit at around 75 years old.
In fact, the contraindications are not related to age. “An eye disease, allergies, scars on the eyelids or a malformation, for example, can prevent the intervention“, specifies Dr. Jacques Saboye. Hence the importance of carrying out a ophthalmological check-up before going to consult a plastic surgeon in order to eliminate a possible contraindication.
The intervention takes place in the operating room, under local anesthesiawhich allows you to go home a few hours after the operation.
- If only the upper eyelid droopsjust remove the excess skin and hide the scar in the eyelid crease down to a small crow’s feet wrinkle.
- When the tail of the eyebrow also sagged, surgeons each have their own little technique. Some offer a temporal lift: “We raise the eyebrow endoscopically through a small incision hidden in the hair”, explains Dr. Claude Aharoni, plastic and aesthetic surgeon. Others remove the small end of the orbicularis muscle responsible for crow’s feet wrinkles and eyebrow droop. Or, prefer to use fat injections at the tail of the eyebrow and the top of the cheekbone: “The result seems more natural to me,” says Dr. Hayot.
- When pockets of fat have formed under the eyes, there is no choice but to withdraw them. “If there is no excess skin, just the right amount of fat is sucked in, ideally passing through the inside of the conjunctiva”, explains Dr. Divaris.
- If the skin is wrinkled, two possible solutions depending on the case: cut the excess by making the incision flush with the eyelashes, smooth it with a CO2 laser. Fat injections along the orbital rim can finally be proposed if, in addition, the eyes have widened over time.
Injections are sometimes necessary in addition
Surgery does not correct hollow and colored dark circles or hollowed-out inner corners. In these cases, the surgeon may suggest a injection of hyaluronic acid “in depth, which will erase the shaded appearance of dark circles”, specifies Dr. Jacques Saboye, general secretary of the French Society of Reconstructive and Aesthetic Plastic Surgery, or a fat injection. “It is fat that is taken from the patient and reinjected into her, specifies Dr. Cécile Winter. In addition to filling a hollow eye, this technique (lipofilling) realigns the curve of the eyelashes and eyebrows. “
You need at least a week off
Count a social eviction of seven days after the operation upper eyelids, and ten days if the rejuvenation concerns the four eyelids.
No dressing is necessary, the threads are removed after a week during the control visit.
Blepharoplasty: the scars are invisible
- The skin incisions on the upper eyelids are hidden in the crease located halfway up the eyelid, between the mobile part and the fixed part.
- For the lower eyelids, the scar is hidden in the mucous membrane, under the eyelashes.
The scars disappear completely within a few months.
Complications, risks of side effects… this surgery is not trivial
Blepharoplasty is not a trivial intervention. “It requires meticulousness, dexterity and subtlety from the practitioner”, insists Dr. Aharoni.
The slightest error in assessment can indeed have very penalizing consequences: “Removing too much skin from the upper eyelids can give an unnatural look of surprise, emphasizes Dr. Hayot. The same error in the lower eyelids can create a ’round eye’ that makes even the smartest woman look fishy! And Dr Divaris added: “If we remove too much fat from a pocket, we also risk gouge the eye and strain the gaze even more“. In this case we can consider a new surgery, with graft.
Finally, there may be a transient dry eye phenomenon.
The side effects are sometimes impressive
Three days after the operation, the eyes are extremely swollen because of the edema inherent in this procedure. Better to hide them behind sunglasses!
After ten to fifteen days, they are still a little red and swollen. After two months, the swelling has subsided and a good make-up can camouflage the remains of redness.
The final results are observed after an average of six months after the operation.
Are the results really effective in the long term?
- “That of eyelid surgery lasts a long timeand it’s rare to have to do it again,” says Dr. Saboye.
- Lipofilling is also sustainable, only the injection of hyaluronic acid for dark circles must be renewed every year on average. “With regular maintenance, by means of injections of hyaluronic acid at the corner of the eyes to smooth out crow’s feet, or botulinum toxin to relax the muscles which tense the contour of the eyes like frown lines, we can maintain the effect for up to twenty years,” concludes Dr Winter.
Who operates on droopy eyelids?
Blepharoplasty must imperatively be performed by a surgeon, in the operating room.
To find out who to contact, consult the website of the French Society of Plastic, Reconstructive and Aesthetic Surgery: sofcpre.fr.
How much does blepharoplasty cost?
- For a simple blepharoplasty of the upper eyelid: count 1,500 to 3,000 €.
- For the removal of pockets of fat under the eyes: count 2,200 to 2,500 €.
- For the four eyelids at the same time (top and bottom): count 4,000 to 5,000 €. Count around €500 more if there are fat injections, €1,000 to surgically lift the tail of the eyebrow.
Most of the time, it is cosmetic surgery. The costs are therefore not covered by health insurance. But blepharoplasty can be supported in rare cases, when the eyelid droops so much that it interferes with the patient’s sight (usually in the elderly).
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