What does blepharoplasty consist of, doctor?
It’s the surgical procedure that we use to remove excess fat and skin from the upper and lower eyelids. It works for both fallen eyelids and “bags under the eyes.

”How do the eyelids age?
The eyelids are the first zone of the face that suffers ageing. It’s here that we have the finest skin of all of the face, with little muscular support of the fat of the eye, and it’s also a zone that’s very sensitive to external factors (such as tiredness, lack of sleep, smoke, stress, etc.). The ageing of the eyes manifests itself differently in each person. It can appear as fallen eyebrows, appearance of excess skin in the upper eyelids, wrinkles, crow’s feet, sunken eyes and the well-known ‘bags’ in the lower eyelids.

Can this operation improve the dreaded crow’s feet and wrinkles?
No. What it does improve is the expression of the eyes, giving them a younger and more relaxed look. But to make wrinkles and fallen eyebrows disappear, other operations or treatments will be necessary. In general, for wrinkles, laser resurfacing and botox injections are very effective. As for bags under the eyes, which are caused by a lack of fatty tissue, producing the falling and even a darkening of the eyelids, a very effective treatment is filling the eyelids by means of injecting the patient’s own fatty tissue (lipofilling) or raising the fatty tissue of the cheek, which falls with the passing of time; the technique for palliating this effect is called blepharoplasty with malar lifting. As for fallen eyebrows, the solution is frontal stretching (or lifting).

What is the current state of eyelid surgery?
In the last five years there has been a revolution in palpebral surgery, thanks to the development of multiple specific techniques for particular problems such as bags or rings under the eyes, crow’s feet or the sagging of the skin of the eyelids. There are also new techniques for ‘westernising’ oriental eyes or achieving almond-shaped eyes. To all this we have to add the introduction of laser surgery, which is essential for achieving the best possible result in these operations and also to minimise the post-operative haematoma of this surgery, even achieving in many cases an absence of haematomas and allowing patients a quicker return to their normal activities.

Is the operation performed with local anaesthesia?
Yes. Generally it’s a simple operation that can be carried out with local anaesthesia and sedation. Only in cases where other operations are performed at the same time is it necessary to use general anaesthesia and admit the patient into the clinic if he or she prefers this.

Does it leave scars?
This is one of the zones of the body with the best scarring characteristics. The scars on the upper eyelid are in the crease, and those on the lower eyelid are just below the eyelashes. After three months they are practically imperceptible.

When can the patient lead a normal life again?
After twenty-four hours. For people who work with the public, five to eight days’ sick leave may be required for the bruising to disappear. In addition, we make the following recommendations for the post-operative phase: in the first twenty-four hours after the operation it is advisable for the patients to apply cold to the treated zones to reduce the inflammation (packs of frozen foods, like peas, are very good for this). No activities must be performed in water until the stitches are removed. The first days after the operation it is advisable to wear dark glasses to conceal the bruising and swelling (although this recommendation is in fact unnecessary, because everyone does it). On the other hand, the patient can read, watch television and travel the day after the operation.

At what age is this operation recommendable?
Whenever the problem exists, although generally it tends to be performed after the age of thirty-five or forty. But in some cases, where there is a hereditary tendency to have bags under the eyes, the patients are younger.

Do men also ask for this operation, or is it exclusive to women?
Men are opting more and more for this kind of operation, precisely because bags under the eyes are anti-aesthetic.
In men the technique of transconjuntival blepharoplasty is more frequent, because the bags are eliminated through the connective tissue of the eye and it is not necessary to make an incision in the skin.

Does blepharoplasty achieve lasting results?
The elimination of the bags tends to be long-lasting and definitive, except in hereditary cases like congenital blepharochalasis, which consists in a flaccidity of the upper eyelids that can extend so far as to cover all of the eye. Here it’s necessary to cut the skin every five or ten years.