Eyelid Aesthetics (Blepharoplasty)

Eyelid aesthetics, or Blepharoplasty in medical terminology, is the procedure of reshaping the eye area by surgically removing sagging skin, loosened muscle tissue, and herniated fat pads that occur in the lower and upper eyelids. While this operation permanently eliminates deformities that give the person a tired and aged expression, it is also an aesthetic and functional surgical treatment that removes the narrowing of the visual field caused by excessive skin accumulation on the upper eyelid. As one of the most effective methods among facial rejuvenation procedures, this process preserves the natural anatomical structure of the eye area and gives the gaze a more lively, refreshed, and healthy form.

Who Are Suitable Candidates for Eyelid Aesthetics Surgery?

In society, there is a mistaken belief that one generally needs to wait for older ages for aesthetic operations. However, eyelid problems may not always be related to aging. Our genetic inheritance plays a major role in shaping our eye structure. We have many young patients who, despite being in their twenties, have significant under-eye bags or structurally low eyelids.

Of course, the age limit of 18, when facial development is completed, is a basic criterion for us. However, if there is a condition that impairs the person’s quality of vision or affects their social life, it is necessary to produce a solution without focusing on age. An ideal patient profile consists of individuals who have realistic expectations from the operation and whose general health condition is suitable for surgery.

Generally, people with the following complaints are suitable candidates for this operation:

• Excess skin on the upper eyelid
• Narrowing of the visual field
• Under-eye bags
• A constantly tired expression
• Wrinkles around the eyes
• Difficulty applying makeup

What Is the Difference Between Eyelid Drooping (Ptosis) and Skin Sagging?

The two conditions our patients most frequently confuse are excess skin and true eyelid drooping. Skin sagging is the loosening of the skin as it loses elasticity and relaxes over the eyelashes. In this case, the muscles are intact; there is just excess fabric. However, the condition we call ptosis is quite different; here, there is weakness or loosening in the muscle that lifts the eyelid itself.

If the patient has ptosis, removing only the skin will not solve the problem. The patient will still continue to look “sleepy” after surgery because the mechanism that lifts the curtain is impaired. Therefore, during the examination, we measure muscle function in detail. If we detect weakness in the muscle, we apply techniques during the aesthetic surgery that will also strengthen this muscle. This distinction is the key to a successful outcome. It is necessary to repair not only the skin but the gaze.

Why Are Dry Eye Tests Performed Before Surgery Important?

One of the most important details overlooked before eyelid surgery is the health of the ocular surface. Blepharoplasty is a procedure that changes the position and tightness of the eyelids. If our patient has hidden dry eye, this condition may flare up after surgery and cause significant stinging and burning complaints. Therefore, when planning the operation, we focus not only on aesthetics but also on the moisture balance of the eye.

There are some basic tests we perform to determine risks. For example, we measure tear quantity with the Schirmer test and tear quality with the BUT test. If the results are borderline, we revise our surgical plan to be more protective.

The parameters we evaluate at this stage are as follows:

• Tear production volume
• Tear film quality
• Corneal surface health
• Blink reflex
• Eyelid closure strength

How Are Scars Hidden During Upper Eyelid Aesthetics?

Because the eyes are in the very center of the face, the concern “Will there be a scar?” is the question we hear most often from our patients. Fortunately, eyelid skin is one of the areas in the body where wounds heal best. In upper eyelid surgery, we do not determine the incision site randomly. The incision line is drawn millimetrically to coincide with the natural crease (fold) of the eyelid.

Thanks to this planning, when your eyes are open, the scar is hidden within the natural crease and is not visible. When the eyes are closed, over time it becomes a very thin, indistinct line that blends into the skin tone. Using very fine-tipped scissors and radiofrequency devices instead of coarse instruments during surgery prevents the tissue from being traumatized. The less the tissue is traumatized, the faster and more scarless the healing. What disrupts naturalness is not the scar, but removing more skin or fat tissue than necessary. Therefore, we proceed not with the logic of “more is better,” but by preserving the tissue.

What Are Modern Techniques in Lower Eyelid Aesthetics?

The biggest mistake made in lower eyelid aesthetics in the past was cutting out and discarding the fats that cause bulging. Over the years, this caused patients’ under-eye areas to become hollow and take on a skeletal, older appearance. In today’s modern surgery, we no longer give up volume.

Instead of removing the existing fat pads, we release them and spread them into the hollow areas just below, namely into the grooves between the cheek and the under-eye. With this technique, which we call “fat repositioning,” we both get rid of the bags and fill those fatigue-inducing hollows with the patient’s own tissue. If our patient is young and has no excess skin, we perform this procedure without making any external incision, entering only from inside the eyelid (transconjunctival). In this way, there is no suture scar on the skin and the recovery process becomes incredibly shorter.

Why Are Almond Eye Aesthetics and Combined Procedures Preferred?

The eye area must be handled as a whole. Sometimes correcting only the eyelids may not be enough to provide that desired attractive and energetic gaze. Especially in individuals whose eye corners structurally look downward and who have a sad expression, we include Canthopexy, or as it is popularly known, Almond Eye aesthetics, in the process.

In this procedure, the outer corner of the lower eyelid is suspended to the higher periosteum with a minimal intervention. This provides a more dynamic look aesthetically and also increases the tightness of the lower lid, creating a protective barrier against future sagging. In addition, we can also benefit from non-surgical methods to support surgical results.

The complementary procedures we frequently use are as follows:

• Botox injections
• Under-eye light filler
• Mesotherapy applications
• Plexr plasma energy
• Laser skin resurfacing

What Is the Recovery Process Like and When Can One Return to Social Life?

The postoperative process is not as difficult as our patients imagine. We do not expect severe pain after the procedure; there is usually a mild stinging sensation and tightness, which can be easily managed with simple painkillers. The first 24 hours are the most critical time for us. During this period, applying cold compresses regularly is the most effective way to keep swelling and bruising to a minimum.

It is quite natural to have edema around the eyes in the first few days. Keeping the head elevated accelerates healing. Stitches are usually removed within 5 to 7 days. After the stitches are removed, you can comfortably return to work or social life with the help of concealing makeup. For our patients who use contact lenses, we ask them to wear glasses for about two weeks. Although full recovery takes a few weeks, our patients get rid of that tired expression by the end of the first week.

The points to pay attention to during the recovery period are as follows:

• Cold compress application
• Sleeping with a high pillow
• Not rubbing the eyes
• Not lifting heavy objects
• Protection from the sun
• Limiting screen use

What Are the Possible Risks and How Is Ectropion Prevented?

For the sake of medical honesty, it must be said that every surgical procedure carries certain risks. General risks such as infection or bleeding are quite rare thanks to the rich blood circulation of the eyelids. However, the most important risk specific to this surgery is the condition we call “Ectropion.” This is the problem of the lower eyelid turning outward and the eye not being able to close completely.

It usually occurs as a result of removing more skin than necessary or not analyzing lid laxity well before surgery. To prevent this, we perform special examinations such as the “Snap-back” test before surgery. If we sense laxity in the lid, we support it by suspending the lid from the outer corner (canthopexy) during surgery. In experienced hands, with the right technique and a protective approach, these risks are minimized. As a result, when properly planned, blepharoplasty is a safe and satisfying process that positively changes not only a person’s appearance but also their outlook on life.