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Eyelid surgery (Blepharoplasty)

Blepharoplasty is eyelid surgery that aims to remove excess skin and fat from the eyelids, which is usually above the age of 40, but in some cases prematurely before the age of 30. Each case must be analyzed individually because it might well need not a blepharoplasty, but the treatment of a kidney problem or heart to retain fluids causes the eyelids to remain swollen or “bloated”.

The problems of sagging and the formation of pockets of fat have a genetic factor that lead to their emergence at an early age. There are other predisposing factors such as: the habit of rubbing your eyes frequently, especially if it is linked to an allergic; the episodes of frequent crying especially in states of depression or chronic pain, fatigue and insomnia.

In some cases this is only the excess skin on the upper eyelid, which falls on the eyelashes and it will gradually limiting the amplitude of the visual field. In other cases it is only of palpebral bags in the lower eyelids, afeando the appearance of the face; but it usually occurs all at the same time, both the excess skin as the palpebral bags in the upper and lower eyelids. The goal of surgery is to rejuvenate the area around the eyes, giving a more youthful and fresh (not tired). This surgery can be performed alone or in conjunction with other procedures of the face such as the forehead, lifting the tail of the eyebrows, the lifting of the middle third or the surgery of complete facial rejuvenation (facelift, facelift, face lift).

Preoperative

Blepharoplasty, although it is a small surgery requires a preoperative consultation extensive to have an accurate diagnosis, to analyze the background as hypertension, diabetes, smoking, depression, drug abuse, and the use of medications that can affect blood clotting. You should explain to the patient the findings of the physical examination, laboratory, indications, type of anesthesia, type of surgery, the location of the cut lines, the behavior of the scar, edema and ecchymosis is present in the post-operative care must be taken, all in the presence of a close family member, to avoid the anguish or panic that may have patients usually within the first week, when not naturally look better but worse. The majority of complaints and lawsuits against plastic surgeons and ophthalmologists are related to the surgery of the eyelids, which resolve with time, once it passes the inflammation and retraction of tissues.

Surgery of the Upper Eyelid

The upper blepharoplasty aims to eliminate the excess skin that falls redundant and sagging on the same eyelid and eyelashes. The anesthesia is local under sedation. Previously, trace an ellipse that begins at the inner corner of the eye and running down the eyelid crease, by measuring the amplitude of the excess and prolongándola to the edge orbital external. Delete this ellipse of skin, treat eyelid bags, eliminating excess fat, especially in the inner corner, are cauterized to prevent bleeding and facilitate the retraction of the tissues, marking the eyelid crease and finally practiced the suture uniting the edges with a nylon thread is very fine and will be removed in between the 4 and 5 day. The line of healing will be virtually undetectable after 6 months.

Surgery of the Lower Eyelid

The lower blepharoplasty is proposing to remove the excess skin and fat from the lower eyelids that give the face look tired and aged. It is a small surgery, ambulatory, which is done with local anesthesia under sedation. The cut line goes through the eyelid margin next to the tabs and extends outward, oblique in the same direction of the grooves, to the edge orbital. It frees the skin of the lower eyelid and removes excess fat from the eyelid bags, were cauterized to prevent bleeding and then measured carefully as it is the fabric redundant to mark and remove the excess skin. Finally they are given the points of the approximation of the edges with nylon fine (6/0) that are removed between the 4 and 5 day post-operative. The scar is completely undetectable even for the same patient after the third month.

Post-operative Blepharoplasty

Once the surgery is complete, the patient can return home. It is important to use some dark glasses to not negatively impact, or create false alarms. In addition to a cap to protect you from the sun if necessary. In the first 24 hours it is advisable to rest in the house, putting the greater part of the time, a cool bag, not in contact with the skin, but on a gauze pad. The eyelids may dawn and closed with waste of blood the next day, it can be cleaned by placing drops of saline solution. The cool bag is to be used during the first 3 days to decrease the inflammation and avoid the bruising “purple”. The 4 or 5 day the stitches are removed and you can start using any cream anti-inflammatory, such as cream of arnica, or pasta of magnesium sulfate. In addition to taking the medicines that are prescribed for the swelling, pain, and the antibiotic. Avoid looking in the mirror for the first few days because this is not the end result, and can provide you with anguish unnecessary. Also is not the time to show it to no one, least of visits, as can also impressed you negatively.

After the first week because you can apply makeup and restart your normal social or working life, only to take into account to avoid exposure to the sun during the first 3 months to avoid the dark pigmentation of the eyelids, and always use a sunscreen to eyelids.
During the first month, it is likely that you need a daily massage with light pressure, with the pulp of the index finger, to soothe the inflammation of the edges of the scar.

Complications

Complications actual are not common, but may occur: hematomas need to be drained, dry eye which is used for drops of natural tears for a time, asymmetry, ptosis, and difficulty in closing the eyelids that in extreme cases require surgery retouching for later correction. The fall of the tail of the eyebrows is due to the sagging of the tissues in the lateral part of the forehead, due to the force of gravity and the passing of the years.

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Dr. Belman Galvis Maldonado, a plastic surgeon with more than 20 years of experience, director of D Corpus International, is a member of the Colombian Society of Plastic Surgery.

Dr. Belman Galvis, in Cali – Colombia, she has developed her own personal technique of abdominoplasty plus that includes the manoeuvre D Belman that consists of the rapprochement of the false ribs, and floating, which allows you to retrieve the waist and the waist of youth, impossible with the traditional technique and that today look hundreds of beautiful women in various parts of the world. 

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