Blepharoplasty is also commonly referred as cosmetic eyelid surgery. It is one of the most frequently performed face cosmetic procedure. Blepharoplasty surgery is either done alone or in combination with face lift surgery. To achieve the best blepharoplasty result, the procedure should be done with great skills and finesse, with technical details and margin for error calculated in millimetres.
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The procedure is generally done under local anesthesia. Adequate premedication is essential. Local anesthesia used is a combination of lignicaine and epinephrine administered in the operative site with fine needle. Excess eyelid skin is excised according to the preoperative assessment and marking. If necessary, a strip of muscle and fat is also removed to get a good pretarsal skin show.
Patient preparation is similar to upper eyelid surgery. The incision is placed just below the lash line so as to minimise the visibility of scar. The steps involves removal of adequate width of skin, fat and if needed a strip of muscle. The fat is present in three compartments and its meticulous removal is of utmost importance to achieve the best lower eyelid blepharoplasty result. Canthopexy or fixation of the canthal ligament is important in the older group of patients to avoid complications. In few cases with prominent infraorbital hollow, eyebag fat can be used to augment it.Post operative period is relatively simple. Pain relief and antibiotics medication is given. Postoperative ice pack application reduces the swelling. Stitches are removed after 7days.
A small group of patient can have excessive tearing and prolonged discolouration after the procedure. Both the conditions improve with time. Ectropion or schleral show is an uncommon side effect of the lower eyelid blepharoplasty.