1.What kind of people can do double eyelid?
First, the eyes are not long enough. The eye length of Westerners is generally more than 32 mm, while Easterners only have 22 to 26 mm. This is because most oriental people have an inner canthus, making the distance between the inner canthus of both eyes too wide. Aesthetically speaking, there is an eye distance between the two inner canthus is beautiful, but the vast majority of oriental people have an inner canthus distance of one and a half eyes, plus the general flatness of the root of the nose in oriental people, making the face lack a sense of three-dimensionality.
Second, the eye height is not high enough. Westerners’ eye height is generally around 12 mm, while oriental people are generally in the range of 6 to 7 mm. This is because the rate of double eyelid occurrence is almost 100% in the West, but less than 50% in the East, and the presence of double eyelid can increase the height of the eyes. Insufficient eyelid height can cause the cornea (black eye) to be exposed in small proportions, making the eyes look lackluster.
Third, bloated eye muscles and/or fat and sagging skin give the impression of sleepy eyes and lack of energy.
Fourth, the eyebrows and eyes are too far apart. Most Westerners have large, parallel, multi-layered eyelids, and the eyelids are located between the eyebrows and the eyes, while most Easterners have single eyelids or broad-tailed small or hidden pairs, and the eyebrows are too high and not very three-dimensional.
Fifth, oriental people have relatively low eyebrow arches, cheek arches and nose bridges, making it difficult to achieve deep eyes.
These are conditions that exist to a greater or lesser extent on every oriental eye. Different adjustments can be made to the blepharoplasty for different problems in order to create a pair of large, expressive eyes.
2. Why do I need blepharoplasty?
Blepharoplasty is commonly referred to as double eyelid, or in ophthalmology terms, upper eyelid crease. Aesthetically, the shape of the upper eyelid with heavy lids makes the eyes more emotionally expressive and revealing. Single eyelids often give the impression of being monotonous, bloated and lacking in vitality, so in order to change this lack, surgery to form heavy eyelids was born.
3. Who can have blepharoplasty?
Blepharoplasty is the most common cosmetic surgery today, and can be performed on people with single eyelids or those with overly sagging eyelids or ingrown eyelashes. However, the surgery must be individualized and cannot be forced to be consistent. The surgery should be decided based on the individual’s face and eye shape (length and size of the eye socket, relative position of the eye socket to the eye ball, width of the upper eyelid, height of the eyebrow, direction of the eyelashes, whether the inner canthus is redundant, thickness and texture of the skin, amount of muscle and fat) as well as the individual’s temperament, aesthetic situation, and length of recovery time. Therefore, you should discuss and consult with your surgeon before having double eyelid surgery to have a proper judgment of the post-operative appearance.
Although blepharoplasty adds a lot of charm, some people, such as those with a saddle nose (low flat nose) and canthus, should have a comprehensive correction to achieve the desired effect. Some people, such as those with very narrow eye fissures, excessively protruding eyeballs, and a narrow distance between the upper edge of the eyelid and the eyebrow, should not undergo this surgery. In addition, congenital amblyopia, acute and chronic eye inflammation are not suitable for surgery, and surgery is strictly prohibited for people with blepharoplasty and scarring.
4. What are the common methods of blepharoplasty and their advantages and disadvantages?
I. Incisional blepharoplasty involves cutting open the upper lid skin to create anatomically similar fiber adhesions to the natural blepharoplasty. This method is suitable for any type of single eyelid, especially for older patients with lax and hypertrophic upper eyelids and those who have high aesthetic requirements and require the heavy lids to remain in place for a longer period of time after surgery.
This method is clearly exposed, easy to perform, facilitates tissue removal and hemostasis, and creates a very stable double eyelid crease with upturned eyelashes; for patients with lax skin, orbicularis oculi hypertrophy, or bulging orbital fat (bulbous eyes) a small amount of skin, muscle, and some orbital fat can be removed to reduce the symptoms of laxity and bloating of the upper eyelid. The disadvantages are that the stitches need to be removed after surgery, the swelling is long in some patients, the eyelid is unnatural in the near future, and the scar of the incision line is visible and takes 3-6 weeks to fade.
The basic steps of the procedure include: spot scribing, local anesthesia, surgical incision, removal of excess tissue, hemostasis, suturing and bandaging.
Common complications include high pain, significant swelling, lid ectropion, infection, localized depression of the upper lid, asymmetry in the length or width of the eyelid on both sides, significant scarring, unnatural curvature of the eyelid line, and very few upper lid folds that are not visible or disappear.
This method uses a thread to fix the dermis to the lid plate so that the eyelid appears when the eyes are open. It is also divided into interrupted and continuous. It is suitable for young people who have a large eyelid, thin eyelids, no muscle or fat hypertrophy, and normal eyelid skin tension without laxity.
The procedure is simple, easy to master, and minimally invasive. The ligatures persist in the upper eyelid, so the wall of the eyelid is stable; the swelling after surgery is light, there is no obvious incision scar, and the appearance is natural; if the surgical result is not good, it can be corrected with an incision; for those who are not satisfied with the shape of the eyelid, the ligatures can be cut within a few days after surgery to return the original single-lid face.
The disadvantage is that the upper lid crease becomes shallow or even disappears after the adhesions between the eyelid and the lid plate are loosened; the nodes can be buried too shallowly to form nodal cysts or inflammatory reactions, resulting in localized bulging of the upper lid when the eyes are closed; and the surgery cannot remove loose upper lid skin and excess muscle and fat at the same time.
The basic steps of the procedure include: sizing, local anesthesia, eye protection, suturing at each spot and leaving a node and adjustments as appropriate.
Common complications include loss of the upper lid wall due to suture relaxation and small cysts in the knot.
Auxiliary procedures commonly used when performing blepharoplasty.
Because each person is different, sometimes one or more of the following procedures may be required for comprehensive correction during or after blepharoplasty to achieve better results.
1. Adjustment of the upper lid skin, orbicularis muscle and orbital fat: In order to make the blepharoplasty more natural and aesthetically pleasing, the right amount of skin, muscle or fat needs to be removed during the blepharoplasty for those with lax upper lid skin, orbicularis muscle hypertrophy and orbital fat hypertrophy or sagging.
2. Inner and/or outer canthoplasty: Inner canthoplasty not only lengthens the eye but also improves the shape of the eyelid in patients with inner canthus; if the eye length is too short, the outer canthus can be opened to increase the length of the eye.
3.Brow cut or temporal lift: For those with sagging eyebrows and/or crow’s feet, brow cut or temporal lift can be used to lift the eyebrows and eliminate crow’s feet.
4. Tear gland repositioning: In a very small number of patients, the upper lid bloating is due to the prolapse of the tear gland, which can be improved by repositioning the tear gland during blepharoplasty.
5. Shortening of the levator muscle: For mild ptosis, the levator muscle can be shortened at the same time as the blepharoplasty to correct the ptosis.
5. What kind of preparation must be done before surgery?
Patients should avoid menstruation, preferably in the middle of two periods; no allergies or inflammation in the eyes or face; if you are taking aspirin or other medications that affect blood clotting, it is best to stop taking them a week in advance if they do not affect the effectiveness of the original disease; no smoking or alcohol before or after surgery; good facial cleanliness and no cosmetics before surgery; and it is best to schedule one to two weeks of rest in advance.
6. Is the procedure painful?
Blepharoplasty is performed under local anesthesia and the pain during surgery is mainly when the eyelid anesthetic is injected, but not during surgery.
7. What is the post-operative care?
Oral antibiotics can be taken for 3-5 days to prevent infection. Although the incision and tissue wound are closed after surgery, small blood vessels that have been closed during surgery may open again, and there may still be a small amount of blood leakage, so appropriate pressure bandages and cold compresses are usually applied after surgery. In principle, ice can be applied for 24 hours, and oral painkillers can be given to patients with low pain domain. The dressing can be removed on the second day after surgery to clean the wound and eye secretions for the best healing of the wound.
8.How to deal with postoperative swelling and when will the swelling go down?
Due to intraoperative or postoperative bleeding, some patients may also experience local bruising, which is normal and usually subsides on its own in one to two weeks. The swelling of the eyelid may be noticeable in the first three days after surgery due to the impact on the blood and lymphatic flow to the eyelid, and may cause stinging and tearing when using the eye. We recommend that patients reduce eye use and sleep with their head elevated to reduce eyelid swelling, but review the swelling promptly if it becomes severe and worsens. The time for swelling and bruising to subside depends on the individual’s body type and condition, and generally ranges from 2 weeks to 2 months, although it may take longer for patients over 30 years of age.
9.When will the stitches be removed? Is it painful?
The stitches are removed 5-7 days after surgery. The removal of the stitches is not as scary as some patients may think. Generally, the removal of the nodes on the outside and middle of the eyelid is not particularly painful, but the pain is slightly stronger on the inside of the eyelid. As long as the patient is cooperative and relaxed with the doctor, the removal of the stitches will go smoothly. After the stitches are removed, the eyelid swelling will go down more quickly and will basically return to natural in about 2-3 weeks.
10.What are the possible unsatisfactory situations after eyelid surgery? How do I choose the time to repair again?
The following are possible dissatisfactions after eyelid surgery: ① asymmetry of the eyelid; ② the eyelid line is too wide or too narrow; ③ subcutaneous nodules; ④ the eyelid line is short, forming half double eyelids; ⑤ triple eyelids; ⑥ triangular eyes, etc.
If you are not satisfied with the results after eyelid surgery and want to have surgery again, you should do it 3 months or 6 months after surgery. It is best to do it after three months or longer because it is in the tissue repair period, when the tissue is brittle, adhesions are heavy, and anatomical relationships are unclear, so the skin is easily torn by the sutures, bleeding is high during surgery, and scar growth is heavy.
11. Why do some people who have undergone blepharoplasty recover quickly and some recover slowly?
Some patients with blepharoplasty look natural very quickly, while others take a long time to be accepted. This is because in addition to the patient’s own condition, the details of post-operative care are also critical to a patient’s recovery. Each patient should follow the Post-Operative Precautions to achieve the best results and add to your beauty.