The age-marked changes of the surrounding parts of the eye are characteristic. The upper eyelid might become lax in the old age - sometimes so much that it may even cause eyesight problems. Extreme lax lower lids might result in difficult closing of the eye and may be the source of other problems as well. Aesthetic complaints, of course, arise much earlier. The ageing face may be rejuvenated by plastic surgery on the eyelid, in many cases combined with face lifting surgery.
In the case of the upper eyelid the troubling extra skin is just part of the a complex problem, since laxity of the eyebrow-line and the accumulation of fat tissue also contribute to the matter. For a good result it is not adequate to merely remove the extra skin, but fat tissue removal is also necessary by plastic surgery.
The operation is under local anesthetic; we close the wound with thin, subcutaneous thread, which we remove after 5-6 days. During a few hours after the operation we recommend chilling the operated territory. ( People generally have a false picture of what chilling actually means. What we mean by chilling is cooling the territory through a cloth with ice in plastic bags / or simply a frozen pack of milk for about 20 minutes each hour. Frozen pea pack is also excellent, for peas take up the shape of the coolable region and, therefore, have a wonderful effect. Chilling for hours without a pause may be very detrimental. Chilling - time might be prolonged by putting the cooler - gel bag in to the fridge instead of the freezer.) After 1-2 weeks the scar will become virtually invisible to the eye.
Operating the lower lids is not quite as simple, the chances of complications are higher. We lift the skin up from the lower muscles round the eye by an obtuse - angle downward section driven under the structure of the eye-lash in the corner of the eye. By opening the muscle and the interstitial tissue lamina, we remove the extra fat tissue from the three chambers lying beneath. Judging the amount of extra skin is a difficult task, since too much skin removal may result in a turned - out eyelid which cannot close and may be the cause of serious problems, even sclerotic ulcer. Too little skin removal might leave the operation without a result at all.
Nowadays more and more emphasis is laid on fat-retaining operations. In the course of this operation the excess fat causing the "bags" is not removed, but spread, or as in the case of hernia the bulging part is replaced to its original place and the interstitial tissues are closed above it.
Bags often occur on the lower eyelid without wrinkling or sagging of the skin. This deformation is due to excess fat tissue that surrounds and pads the eye - ball. In cases like this there is no extra skin on the lid, the surgeon cannot cut out any skin, therefore only removes the excess fat tissue. In order to reach that excess fat tissue he needs to perform the same section beneath the eye - lash contour along the lower lid as in regular eyelid operations, notwithstanding the fact that he does not wish to remove skin. A relatively new method offers a proper solution. We approach the target area from the bottom of the inside - conjunctiva covered - part of the eyelid facing the eye - ball. We open this 'conjunctival bag' and remove the excess fat. After the operation there will be no scar left, and the recovery is also very quick: 2-3 days.