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Lower eyelid correction

Lower eyelid correction

As a result of aging, your skin becomes wrinkled and the muscles weaken. This causes wrinkles under your eyes. It is also possible that there is too much fat under your eyes at a young age. This makes you look tired and old. A lower eyelid correction can remedy your bags. This will aesthetically make a big difference. Often a lower eyelid correction is combined with an upper eyelid correction. Correction of the lower eyelids can occur at the same time as the operation for the upper eyelid. This will happen under full anesthesia. After the surgery you can go home the same day.

During the first consultation the skin, the muscles, the amount of fat and the tension of the eyelid are assessed. Based on your wishes and the surgical possibilities, we will put together an operation plan and discuss this with you. It is important that you have a good idea of the operation and that your expectations are realistic.

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Baggy lower eyelids are the result of the aging process whereby the skin and muscle become less tight and the orbital fat start to protrude forward. The skin becomes wrinkled and the muscles can become so stretched that it forms large folds below the orbits (festoons). The tension on the lower eyelids can in elderly people become so weak that the eyelid drops down, turns outward and loses contact with the eye (ectropion) or turns inward, causing the eyelashes to touch the eye (entropion). In these situations, there is a medical necessity for a lower eyelid correction. Often at a younger age there may be too much fat bulging in the lower eyelids, making the person look tired and old. The correction of the lower eyelid with plastic surgery is called a lower blepharoplasty. Sometimes the swelling is due to fluid retention but this cannot be corrected with surgery. A lower eyelid correction is often performed simultaneously with an upper eyelid correction.

During your first consultation the skin, muscle, amount of fat and the tension of your lower eyelid is assessed. Also, the relationship of the eye to the orbit is noted because different situations can occur in the lower eyelids. The operation needs to be adjusted to the specific needs of each person. This will be discussed in detail during the first consultation.

Often because of a combination of skin, muscle, fat and the tension of the lower eyelid, it needs to be addressed that the lower eyelid correction is more complicated than the upper eyelid. The correction can be performed under local anesthetic, with or without sedation, or under general anesthetic. The incision will be just below the eyelashes to continue laterally into the crowfeet area. Excess fat is removed or redistributed by transposing it downward and excess skin is excised. Often the lower eyelid is tightened to prevent descent after the procedure. Shortly after the procedure you can go home, once you are fully awake.

After a lower eyelid correction, the eyelids will become bruised and swollen. This will eventually diminish. A cold compress using iced water or ice glasses can be applied to the eyes for 30 minutes, 3 times a day in the first 3 to 5 days. This will contain and reduce the swelling and bruising. Paracetamol is normally sufficient for pain relief. At night the head should be elevated higher than the heart by using an extra pillow. The stitches will be removed after 5 to 7 days and your appearance will be very acceptable after 2 weeks. Any residual bruising can be camouflaged with make-up and the remaining swelling will continue to subside in the coming weeks. During the healing process you may feel some pulling and the scar may be slightly sensitive, especially on the sides where the eyelids have been tightened. You may experience some numbness of the eyelids for some time but this will all settle down in the weeks and months thereafter.

A lower eyelid correction will have no effect on your peripheral vision as is often the case in an upper eyelid correction, but esthetically it can make a great difference. A fresher appearance can replace a tired and older look. The scars are well hidden under the eyelashes and on the sides, and, are usually hardly visible after the healing is complete. The results are sustainable, but the aging process will continue.

Sometimes after the correction, the eyelids will be more bruised and swollen than normal. This will eventually completely resolve itself, but it may take a little longer than normal. After the correction the eyes may be dry for a while. Eye drops may be used until the tear production has normalized. Sometimes a swelling on the white of the eye can develop (chemosis) for which eye drops need to be taken. This swelling may take weeks to settle. When too much skin has been excised or the tension of weak lower eyelids has not been corrected, an ectropion can develop. The eyelid loses contact with the eye and this will cause irritation and tearing and to correct this another operation is necessary. The eyelids may not always be completely symmetric, but, if the difference is significant and if eye fat has not been removed sufficiently another correction may be necessary. In rare instances, an inclusion cyst can develop in the scar which needs to be removed surgically. An extremely rare complication is a large bleeding behind the eye (retro bulbar hematoma), which can lead to blindness if not immediately treated aggressively.   

Before
Before
After (Dr Karel Taams)
After (Dr Karel Taams)