Eyelid surgery, called blepharoplasty, is intended to rejuvenate the eyes. It aims to correct existing concerns, whether hereditary or age-related, which can make the face look sad and tired. This procedure can be performed in both women and men, giving a more rested and expressive look. To consider surgery, you will first need to meet Docteur Lionel SALLAZ for an initial consultation. After listening to your wishes and motivations, he will examine you carefully to confirm whether surgery is appropriate and will explain it to you in detail. He will assess for any lower eyelid fat pads, the amount of excess skin and the tone of the eyelid muscles. He will then be able to inform you as fully and honestly as possible about this procedure, explaining what it can genuinely achieve and what it cannot correct.
Anaesthesia-Hospitalisation The operation is usually performed under local anaesthesia with premedication (to help you relax) in the clinic’s operating theatre, a state-of-the-art environment authorised to carry out cosmetic surgery procedures by the Haute Autorité Sanitaire (HAS).
Principle The operation may involve only the upper eyelids or the lower eyelids, or all four eyelids. To correct excess skin of the upper eyelid, an incision is made in the eyelid crease (the natural fold a few millimetres above the eyelashes). Excess skin is removed and any small fat herniations, sometimes responsible for swelling at the inner corner of the eye near the nose, can be removed if needed. The orbicularis oculi muscle of the eyelid will be tightened and the wound then closed with a very fine suture hidden under the skin (= running intradermal suture). For rejuvenation of the lower eyelids, the incision is placed along the lash line, or sometimes only on the inside of the eyelid (transconjunctival approach). The under-eye fat pads are removed, the orbicularis oculi muscle is tightened and, if there is excess skin, it will be redraped evenly. Closure is performed with a very fine suture hidden under the skin. A light, cooling dressing (cooling mask) is then applied while you rest at the clinic for 1 or 2 hours after the operation.
Follow-up It will be carried out by Docteur Lionel Sallaz, first at the clinic during your hospital stay and then, after you leave the clinic, at his practice for postoperative consultations. Postoperative medical instructions will be explained to you and provided in writing for your home care. The sutures will be removed a few days after the procedure during your follow-up appointment with the surgeon at his practice. The postoperative course is most often straightforward and not painful. There is usually moderate local oedema (swelling) and sometimes ecchymoses (= bruising) for a few days. Their extent and duration vary greatly from one individual to another. Any discomfort is temporary, with a feeling of tightness of the eyelids and slight eye irritation. A period of 3 to 6 months is needed to assess the quality of the result. This is the time needed for the eyelids to regain full suppleness and for the scars to fade.
Risks and complications These are rare; nevertheless, although performed for essentially aesthetic reasons, a blepharoplasty remains a genuine surgical operation, which entails the risks associated with any medical procedure, however small. To minimise the risk of infection, patients should take preoperative showers at home using antiseptic washes. Bruising is usually present, but a haematoma can occur, slowing normal recovery; it will be prevented and treated if necessary. To limit this risk, no medicines containing aspirin or related compounds should be taken in the ten days before and after the operation. Smoking is a risk factor for poor wound healing. Tobacco use should therefore be stopped weeks before the operation to reduce risks. Temporary lower eyelid retraction (ectropion) can occur, requiring several massages a day and usually settling after a few weeks.
In summary, you should not overestimate the risks, but simply be aware that any surgical procedure, even one that appears simple, always carries an element of uncertainty. Choosing a qualified plastic surgeon ensures that he or she has the training and expertise required to avoid such complications, or to treat them effectively should they occur.
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