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eyelid surgery
Eyelid reduction (Blepharoplasty)
A blepharoplasty removes excess eyelid bagginess creating
a more youthful appearance. As the brow descends, excess upper eyelid
tissue hides the pretarsal skin and lateral brow hooding may be
seen. Excision of this skin leaves a scar that is hidden in a natural
crease and leaves a face looking refreshed and more youthful. I
do most upper eyelid reductions under local anaesthetic as a daystay
procedure. This is done for a fixed price (includes theatre fees,
consumables and follow up). Please contact us by email or telephone
if you would like to know the current fixed price.
The anatomy of the lower eyelid is quite variable between individuals
and a precise anatomic diagnosis must be made. Surgery can distort
the lower eyelid if it is not adequately supported internally. Many
cases can be done under local anaesthetic but those requiring manipulation
of the retroseptal fat may need a general anaesthetic.
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Upper blepharoplasty
It is important to first ensure that a browlift is not
also required as this may not be able to be done afterwards. The
loose fold of skin that hangs over the upper eyelid is removed making
the eye appear wider and more youthful. The scar is placed where
there is a natural fold of skin and in most cases is difficult to
detect after a few weeks. There has been a vogue for removing the
fat that bulged around the eye. I avoid this as this may leave a
hollow eyed appearance.
Lower blepharoplasty
In a lower blepharoplasty I reposition the periorbital
fat rather than removing it. This augments the cheekbone region.
It important to reduce lower eyelid folds with a lateral vector
to avoid producing ectropian, a hanging over of the eyelid.
Asian eyelids
Some Asian eyelids are characterized by epicanthal folds
and absence of a pretarsal crease. Some people seek to have “westernization”
of their eyelids which leaves a dramatically different appearance.
I do not perform surgery to excise epicanthal folds as the scarring
is too unpredictable. In most cases these folds can be removed by
augmenting the nasal root region
Absent pretarsal creases are caused by an anatomical variation
of the levator palpebral muscle which does not insert into the deep
layers of the skin and instead allows herniation of pretarsal fat
above the eyelid. My technique for correcting this involves reattaching
this muscle to the dermis and the scars are usually excellent.
Cholesterol deposits. (Xanthelasma)
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Xanthelasma is a subcutaneous deposit of cholesterol
around the inner eye region. This does not occur without an
elevated serum cholesterol and correction of this is an important
aspect of management.
It is critical to carefully analyze just how much can be
safely removed as the deposits tend to occur in locations
away from where surgery for eyelid bags occur. Over zealous
excision may cause an ectropian (rolling over of the lower
eyelid).
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