As you age, the elasticity of your skin is reduced. As a result, the skin on the upper eyelids stretch and can cause sagging, known as Dermatochalasis. This may be accompanied by the protrusion of fatty tissue under the muscle layer of the eyelid (fat prolapse). The drooping eyelids make your eyes look tired. Heavy upper eyelids press the lashes and rub the cornea, or even cause skin ulcers.
Heavy eyelids (dermatochalasis) may often cause a narrow visual field. When the upper eyelid descends near the level of the pupil, a disturbing shadow appears in the field of vision. You may need to turn your head or raise your eyebrows in order to be able to look upwards. Raising your eyebrows is tiring for your facial muscles and often causes headaches. The limited field of vision can lead to dangerous situations in traffic or everyday tasks.
Gravity lowers the forehead and eyebrows, further aggravating the disadvantages of dermatochalasis. The correct place for the eyebrow is notably situated at the orbital bone or just above it. If the eyebrow is located lower than that, the diagnosis may be eyebrow ptosis. Eyebrows which are too low, press the excess skin on top of the eyelids- making it look like dermatochalasis.
Surgical procedures around the eyelid (blepharoplasty) and brow (internal/ external browpexy) areas
Eyelid surgery corrects functional discomfort and refreshes the facial expressions. Most patients undergo eyelid surgery between the ages of 40 and 60, but elderly patients are also common. The surgery is performed under local anaesthetic. In addition, the surface of the eye is anesthetized with eye drops. The surgery itself is pain free, but pressure and stretching can be sensed. The procedure takes about 45 to 60 minutes.
Before the operation the doctor marks the areas as to where and how to perform the operation, at this point the drawings are made with the patient being in a sitting position. This allows the wounds to be well placed on their own facial lines so that the scars become as discreet as possible. During the surgery some skin, muscle and if necessary also excess fat is removed. Usually both eyelids are operated at the same time.
If the eyebrows are heavily descended, operating them both during the same surgery may be considered. The easiest option is to attach the eyebrows through the same cut as the eyelid surgery with a few stitches to the surface of the bone (internal browpexy). Eyebrows can also be raised by a procedure in the forehead area (sector lift). Sector lifting involves local anesthetic with 4-5 cm long cuts by the hairline, removing some excess skin from the forehead. The cut can also be made directly above the eyebrows, where the skin is removed and the eyebrows raised (exterior browpexy). Brow lifting surgery should be carefully and individually considered. The eyebrow’s tendency to fall back down is quite common.
Cold gel packs are kept on the wounds for approximately 1 hour post surgery, before the patient is allowed to be sent home. Cold reduces bruising and swelling. It is recommended not to drive a vehicle for 24h after being operated on.
To minimize swelling, we recommend regular use of ice or cold compresses during the first 1-2 days after surgery. Nevertheless, bruising may occur in the operated areas. Gravity can also bring bruising to the lower eyelids. The eyes may be bruised and swollen for a couple of weeks. Once the forehead is lifted, a support bandage is applied to the area, which should be kept there for 24h.
Sweating and exercise exacerbate swelling and slow down the process of healing the wound. Excessive bending down should be avoided. If necessary, wound pain can be treated with non-prescription painkillers. During your second week after surgery, you are allowed to move a bit more. For example eye bruises can then be covered with sunglasses. Stitches will be removed 6-7 days after eyelid surgery, and 9-11 days after the brow lift operation. Make up can be used 24 hours after having the stitches removed.
Scars may appear red and firm for several weeks or even months. It is recommended to keep the fresh scars well moisturized at all times, and gently stretch the skin while applying the lotion to the skin. Eventually the scars become lighter and softer. The scars are quite undetectable and may not even be noticed by others. Always protect the new scars with sunglasses or a strong UV proof sun lotion to prevent them from getting dark pigmentation. Sometimes eyes may dry out after eyelid surgery and moisturizing drops are needed. However, this is temporary.