Blepharoplasty is the name given to the surgery of the eyelids. When performed on the upper eyelid of a patient with oriental characteristics, it involves creation of a new lid fold or redefinition of an existing one. Its purpose is to remove overhanging skin, which may interfere with vision, to correct the associated turning in of eye-lashes when present, and to reduce heaviness in the upper lids associated with excessive skin, and heavy accumulations and herniation of orbital fat.
In the process of eliminating excess skin, turning in of lashes, and general lid heaviness, it is possible to modify the lid fold in such a way as to enhance the natural oriental beauty and charm. In no way is the operation intended to “Caucasianize” the eyes. Many Oriental lids naturally possess a fold. In others the fold must be created surgically or modified surgically in such a fashion as to render the lid anatomy neat and precise.
Occasionally lid surgery alone is inadequate to solve the problems of the “heavy lidded” person, and it may be necessary to elevate the eyebrow to effect a complete correction. It is not uncommon among Orientals to find the necessity of continual eyebrow raising to have normal forward vision. Such a condition can cause continual headaches and fatigue, but can oftentimes be markedly improved by the “double eye” operation.
The surgery may be performed on anyone, age 11 or above, providing that the individual is fairly mature (In exceptional instances it may be done at an earlier age).
The surgery consists of removing small amounts of skin, a little muscle (usually), and appropriate fat from eyelids. The skin is then attached to the ligaments of the eye opening muscle, and oftentimes to the eyelid cartilage, creating a crease which is designed to remain permanent.
The “size of the fold” or the distance between the lashes and the crease, may be varied. In most cases, a “medium sized” fold is advisable. The size of the fold should be adjusted in relationship to the distance between eyelashes and the eyebrow with the eye open. Usually an attempt is made to begin the crease slightly above the canopy at the inner corner of the eye (the outside position). However, in some lids this is not possible without performing an additional procedure, Medial Epicanthoplasty, at the inside corner of the eye.
Dr. Ceydeli was trained with Dr. Flowers, who has been a leading teacher of East Asian eyelid surgery for over thirty years and has been widely honored in many East Asian countries for his expertise. Asian eyelid surgery at our Clinic is different because Dr. Ceydeli emphasizes beautification of the East Asian eye, rather than Westernization – which is rarely the desire of those requesting this surgery. We do however recognize that ethnic integrity can remain intact while still moving in the direction of international standards of beauty.
This procedure is best performed at the same time as the original lid operation. Its purpose is to soften the very heavy epicanthal fold (the canopy) at the inner corner of the eye. This medial epicanthoplasty may also be recommended to improve the shape of the eye, and to eliminate an illusion of the eyes being “too far apart”. The operation places a small zigzag scar just at the inside corner of the eye, which normally become inconspicuous with the passage of time.
In some lids the distance between the lashes and the lid crease is too generous due to eyebrow drooping from scalp, and forehead relaxation. In these instances it may be advisable to do a forehead lift to raise the position of the eyebrows. This is normally accomplished through a “coronal” incision across the top of the head. When this approach is used, it is often possible to reduce or eliminate troublesome frown lines. This coronal lift involves considerable additional time and increases the complexity of the surgery. It may, however, be necessary or advisable to achieve the desired effect on the eyelids especially in older patients.
Lateral Widening Of The Eye Aperture
Very small eyes, and especially those with a lateral epicanthus, or webbing at the outside corner, often benefit from a plastic repair of that area, increasing the distance between the inner and outer angles of the eye.
Lower Lid Blepharoplasty
Oftentimes the lid region can be significantly improved in appearance by operating on the lower eyelid. This may be directed towards correcting one of several conditions, the more common being bulging fat, excessive or droopy skin, and thickened muscle.
Too aggressive an attempt to tighten the lower lid may result in a lower lid droop, lowering the lid posture in an unattractive fashion and exposing more eye white than is desirable. This is an infrequent, but well known complication of the lower lid blepharoplasty. It is also possible for the lid to pull away from the eye globe. These complications generally result from the over aggressive removal of skin and/or muscle, and seem to have been eliminated by the cautious approach that Dr. Ceydeli uses.
Occasionally a “lazy eye” which fails to open completely may be present on one or both sides. If so, an attempt can be made to correct this condition at the same time. Such additional efforts will be discussed in advance of surgery.
Lateral Canthopexy (Canthoplasty)
Occasionally there may be intense sagging of the outer corner of the eyelid. This eliminates the normal attractive tilt from medial to lateral corners of the eye. There are several operations available to increase the tilt of the eye. These will be referred to as methods of lateral canthoplasty or canthopexy. It is possible to achieve spectacular results from this operation.
A new technique which is attracting much interest is the transplantation of eyelashes. A strip of skin is removed from the scalp, individual lashes are harvested, and transplanted to the eyelid margin. It should be appreciated that these “new lashes” have the characteristics of scalp hair, and must be occasionally trimmed, since they continue to grow.
Nasal Augmentation (Building Up The Nose)
A very flat bridge of the nose can contribute to heavy epicanthal folds. When appropriate, building up such a flat nose can improve the heavy “canopy” at the inside corner of the eye without requiring epicanthoplasty. Dr. Ceydeli may suggest this possible approach, or you may inquire if you are interested. It involves placing bone or other material (usually a solid piece of silicone which does not migrate to other places) on the bridge of the nose beneath the skin.
Our plastic surgery clinic is located in Panama City and Destin, on Northwest Florida's Emerald Coast.
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