There has been a significant change in our approach to eyelids in recent years. It has been noticed that the surgical techniques that have been performed for the last 30 years as a standard have many inadequacies and problems. It is now argued that attempts to “take the fat bags” are unnecessary. Our expectations have gone beyond just creating “bagless” eyelids and we prefer to evaluate the face as a whole.
AGE FINDINGS AFFECTING THE EYES:
Eyelids are where aging manifests itself the most and attracts the most attention. Wrinkling of the skin is almost inevitable in the advancing age in the eyelids, which are both very mobile and very thin skinned by their nature. All the sagging and loosening that starts around them also affect the eyelids.
1. As the forehead gets older, the truth goes down. Along with the forehead, the eyebrows are starting to fall over the upper eyelids. Eyelids, which do not have the power to carry such a load, slide down.
2. There is a membrane that surrounds the eyeball and separates the fat bags that support it from the lower eyelids. It acts as an elastic membrane and a barrier. With advancing age, this membrane loosens and becomes unable to carry the weight of the fat bags. In this way, the oils carry out without mistake, and we see them as “eye bags”.
3. The skin of the eyelids is the thinnest in the body. It is also adhered to the very mobile muscles underneath. Therefore, with every eye movement, the skin of the eye becomes a little more wrinkled and sagging. Side wrinkles called “crowbars” around the eyes are an example of this.
4. A deep hollow appears on the upper border of the cheeks during detention. This is due to the drooping of the cheeks.
In standard eyelid surgeries, the eyelid skin, thin muscle layer under the skin and fat filling the eye bags are removed. Although this is a very common operation, it often causes disappointment in patients. The reason for this is that some of the main problems I mentioned above are not related to the operated tissues, but to other neighboring structures such as the cheeks and forehead. For example, the bulk of the upper eyelids comes from drooping eyebrows.
WHAT IS THE IDEAL TREATMENT?
The ideal is to approach the eyelids as a part of the face. Step-by-step fixes:
1. First of all, if there is a deep pit under your eye that goes down to your cheek, this pit should definitely be filled. Standard lower eyelid surgeries do not solve this problem, it may even deepen it. This pit should be removed by spreading the fats that make up the under-eye bags and lifting the cheeks up. In this way, an uninterrupted flat surface should be formed that extends from the cheekbones to the lower eyelids. This is a must-have rule to look young and lively.
2. If there is a significant sagging on your cheeks, this should definitely be corrected. For this, it is possible to use endoscopic techniques and to lift the cheeks or to bring the middle face up during lower eyelid surgery.
3. For the upper eyelid, the forehead should definitely be evaluated. If your forehead and eyebrows are piled up on your eyes, they should be corrected first, and the eyebrows should be placed in the correct position with temporal lifting. Then, if there is still sagging in the upper eyelid, this should be treated. Crow’s feet also appear from sagging in the temple area and are largely eliminated by temple stretching.
After the problems I have mentioned above are eliminated in both eyelids, it will be sufficient to remove only muscle and skin excesses.
FREQUENTLY ASKED QUESTIONS:
Why should eyelid surgery and other surgeries be performed together?
Because aging should always be approached as a whole. Eyelids often carry the problems of other regions on them. If we do not see and correct these problems differently, the eyelids alone will only give a slight light to the face. For example, if the forehead and brows are drooping, trimming only the upper eyelids will quickly make almost no difference.
Does the fat filling the eye bags increase with aging?
These fats do not actually increase. The problem is in the weakening of the barrier tissues in front of them.
Is the ideal eye shape round or slanting?
I think today, slightly slanted, almond eyes are much more attractive. In the 1950s it was fashionable to have big eyes. It should be preferred that the eyebrows be straight. Old-fashioned eyebrows were curved.
- This surgery will be much more successful if the hollow that extends to the cheeks can be filled under the eyes. Receiving your bags
- Removal of eye bags is very common, but rarely necessary. You stay very happy for the first six months, but then your eyes start to sag and make you look old. Definitely talk to your doctor about this before surgery.
- Excessive removal of the lower eyelid skin can cause the eyelid to be pulled down, and this is an important complication.
- The reason for eye bags is not the excess of fat filling the bags, but the weakening of the barrier in front of them. The treatment should be the correction of this barrier.
WHAT TO EXPECT YOU AFTER THE SURGERY?
Although this is a minor operation, the eyelids swell very easily. So organize yourself in a way that you won’t be in public for about a week. This is not a painful surgery. You don’t need to stay in the hospital. Your eyes will also be open after the surgery. There will only be thin bands on the eyelids.
Infection of the eyelids is very rare. But bleeding can be a feared complication. It is normal to have some bleeding under the skin of the eye. This appears as a popular bruise and is quickly encountered in almost all eyelid surgeries. However, in cases where eye bags are removed, a bleeding that will occur in the vessels feeding these fats can press on the visual border behind the eyes and may even lead to visual defects and blindness. Although this is a very rare complication, such cases have been reported in the literature.
The most feared and relatively common complication is a true downward pull of the lower eyelid. This possibility increases in patients who have undergone surgery for the second time. The problem is that the skin of the eyes is taken more than necessary, and the treatment is to replace the missing skin. For this, it may be necessary to take skin from the upper eyelid.
There is also the possibility of damaging the transparent layer of the eye during this surgery. Even though this sounds like something that would not be human, it is useful to consider that the surgery is performed very close to the eye with pointed and sharp instruments and that there is always a small risk.