Ptosis Blepharoplasty Procedure

Ptosis is a medical term used to express the excess of skin over the upper eyelid which results in decreasing the vision of person. Some time if it in sever condition then person lift their eyelid by his finger to see something.

who should perform the Surgery

Usually Ptosis Blepharoplasty procedure is performed by an ophthalmologist who is expert in eyelid surgery. Ptosis Blepharoplasty requires a very much experience so look for a surgeon who is experienced in orbit, eyelid and tear drain system. Selected surgeon must have a membership in the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) showing he or she is not only a board certified ophthalmologist who knows the anatomy and structure of the eyelids and orbit, but also has had extensive experience in cosmetic surgery and ophthalmic plastic reconstructive.

Surgery Procedure

After selecting an experienced and suitable surgeon, main Ptosis blepharoplasty procedure will start. Normally the Ptosis Blepharoplasty can be completed the same day. In case of Ptosis blepharoplasty local anaesthesia is given in place of general anaesthesia so that patient is able to close or open the eyes to judge the position of eyelid because muscles is tightened or excess skin is removed from the upper eyelid. After giving anaesthesia, while it’s taking effect face is washed with an antiseptic normally Beta din (living person having iodine allergy) to come down the effect of infection. It must be taken care that no facial or eyelid makeup is worn on that day. In case of upper eyelid surgical incision is made in natural eyelid skin crease above the eyelashes. After healing time by time it will look like a natural crease. The incision is made by either CO₂ laser or radio frequency laser. This will help in minimal bleeding flow during Ptosis Blepharoplasty procedure.



After that again excess of skin is measured by opening or closing the eyelid. If required excess of skin is removed and incision will extend up to entire eyelid. After that wound is closed through fine sutures which will automatically dissolve in 7 to 10 days. Underlying skin is smooth in touch but outer surface is little rough in touch. Excessive rubbing of eyelid during this time period will harm and may be wound will reopen or may be result in skin puncturing, so care must be taken after Ptosis blepharoplasty procedure. After the wound is closed or dissolve it will look like a natural eyelid.

In lower eyelid blepharoplasty, some other factors must be taken in care. If excessive fat is present around the lower eyelid, it can be removed through inner surface without using skin incision. If excessive horizontal laxity of the eyelid present, the outer tendon is tightened to maintain or return the eyelid to its normal position. In the same way as in upper eyelid, wound will be given to lower eyelid to remove excessive fatty skin. This will give tighter, youthful and fine skin but some wrinkles still present in the skin which is not possible to completely remove with the help of Ptosis blepharoplasty.

Additional Testing and Medication of Ptosis Blepharoplasty

The Severity level of Ptosis is divided by determining the portion of upper limbus covered by the lid margin. Ptosis level is mild if its 2mm, moderate if its 3mm and severe if its 4+ mm. In second step we determine the peripheral vision affected by upper eyelid. An instrument known by Perimeter is used to measure the peripheral vision in upper half of eyelid vision. They check each eye independently. Lights are flashed on screen on different location for a short duration of time and person is instructed to see at a central target. If the person is able to see the light, he will push the buzzer. If no response is made by the person it means the droopy eyelid made him incapable to see the light. By following this procedure the extent of visual loss is determined. Photographs are also taken to determine the resting position of eyelid. Normally the photography session is instructed by Insurance company if surgery is insured to determine whether its medical reason or cosmetic reason of performing the Ptosis blepharoplasty.

                    Some of the patients take some type medicine which make the blood thinner ,this will increase the flow of blood during Ptosis surgery which may result in adverse effect .So some type of medicine must be avoided if you are thinking about performing surgery. Like Coumadin, Plavix, aspirin or any product containing anticoagulant (blood thinner) must be stopped 10 to 12 days  prior to surgery. Other things like Chinese black fungus or supplements containing vitamin E are must be discontinued one week prior the Ptosis blepharoplasty surgery. There may be other supplements which effect the blood clotting will be discussed at the time of consultation by the physician.

                 These are some of the testing which must be taken in care before performing the Ptosis blepharoplasty surgery.

An Overview of Ptosis Blepharoplasty

An excess of skin or fat in the upper or lower eyelid, is also known by Baggy eyes / Dermatochalasis, this type of condition may need surgical correction for their comfort, cosmetic and visual reason. This surgical treatment is known by blepharoplasty. The term Blepharoplasty is combined with a term ptosis when the edge of upper eyelid droops is closer to pupil in the combination or separation of baggy eyes then this combined known as Ptosis Blepharoplasty.

       The reasons of dermatochalasis are many but one and most important reason is increasing age. This comes into action when due to increasing age of a person the connecting tissues become weak and due to this weakness they start losing elasticity and which will create droops in upper/lower eyelid. Along with this the other reasons are tension, thyroid disorder, any type of medical injuries or fluid release and stretching of delicate skin of eyelid. When the cases of droops in upper eyelid, the actual margin of upper eyelid drop is nearly close or almost cover the pupil which create the condition of Ptosis Blepharoplasty. Due to fluid retention or a forward rupture in smooth muscle tissue will create puffiness in eyelid or a normal fat around the eyes. This fat around the eyes make the person helpless into raise the eyebrows due to which person experience tiredness mainly in forehead and muscular exhaustion. This overhanging skin in upper eyelid may cause intervention in vision either in side or above the eyebrows. More problem rise when we want to raise eyebrow to see more clearly or down to read something. The same factors are involved for the lower eyelid droops. The lower eyelid is hanging towards the nose and ear tendon, which looks like a hammock is hanging. If one or both the eyelid droops due to above mentioned reasons, this will create pulling of tears in eyes due to eyelid droops touching the cornea or sometime make the eyes dry due to exposure of delicate surface in air. The fat below or above the eyelids will create puffy and tired eyes. This puffiness or tiredness can be resolved by blepharoplasty or more specifically Ptosis Blepharoplasty.

Steps of Blepharoplasty Surgery

Step 1 – Anesthesia Medications are performed for your comfort during the bleharoplasty procedure. There are two choices one can select which include general anesthesia and intravenous sedation. After examin, your doctor will suggest you the best option.

Step 2 – The incision The incision lines for blepharoplasty surgery are marked in such a way that scars will concealed within the natural structures of your eyelid region. The upper eyelid’s droopy condition can be corrected through an incision in the natural crease of upper eyelid which allowing repositioning of fat deposits, tightening of tissue and muscles, and removal of excess skin if any.

The lower eyelid can be corrected through an incision just below the lower lash line. With this incision, excess skin of the lower eyelids can be removed.Transconjunctival incision is an alternate technique in which one hidden incision is made inside the lower eyelid to correct lower eyelid conditions and redistribute or remove excess fat.

Step 3 – Closing the incisions After Blepharoplasty, eyelid incisions typically closed with:
* Removable or absorbable sutures
* Skin adhesives
* Surgical tape
Laser chemical peel may be used by your surgeon to erase dark discoloration of the lower eyelids.

Step 4 – See the results The results of the Blepharoplasty surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and surrounding region, and an alert and rejuvenated appearance.

Get Rid of the Dark Circles Under the Eyes

Dark circles under the eyes make your appearance tired, stressed and aged. Some people have dark circles due to aging and others have from their young age. Dark circles in Caucasians can be seen more frequently as they have more dark pigments. Dark circles under eyes is not caused due to stress or tiredness, actually it is develop due to staining of thin eyelid skin from pigments that leaked through blood cells. Hemoglobin is the blood cell pigment that oxidizes close to the skin surface due to exposure to light and give a bluish red colour. When exposed to light hemoglobin change to hemosiderin, an iron-based pigment. Dark circles are become permanent as pigments deposit to the skin.

Some people prefer to have lower blepharoplasty to remove the dark circles. But this is not the solution. Lower blepharoplasty removes excess skin from lower eyelid and bulging fat. It is not meant for the pigment-staining problem under lower eyelid. Blepharoplasty may cause bruising and place blood products close to the skin surface, this may even look worse. But sometimes, lower blepharoplasty may help to fade-up dark circles under eyes. Lower eyelid is tightened in the surgery and removes the hollowness under eye for shadowing.

Chemical peel and laser resurfacing of lower eyelid skin does not help to remove dark circles. The peeling and exfoliation of the outer layer of skin does not treat the area where blood cell pigments lies. Laser skin resurfacing is performed to remove outer epithelium of lower eyelid skin. Resurfacing should not reach underside of the skin or the deeper dermis, it can cause lower eyelid scar. The process may cause the risk of hyperpigmentation which can make lower eyelid skin even darker.

Effective Approach to Dark Circles:
An approach of potential leaching of the skin with hydroquinone topical preparations is effectively safe and workable. But this approach is not specifically for pigment issue. Hydroquinone suppresses the melanin and colour production of lower eyelid skin, so it is effective over the hyperpigmentation or sun exposure brown spots. This process does not seem work well with hemosiderin pigment stains problem. Although bleaching chemical is an effective approach, it would be suggested otherwise.

There are many skin creams in the market that claim effective dark circles improvement. Some of them are even labelled as dark circle repair serums. These creams contain agents like arnica, haloxyl, and other enzymes that allegedly clear the pigments and help to get rid of the dark circles. This process is quite slow and may take months for noticeable change.

Another approach to the dark circles is the intense pulse therapy with vascular filters and topical dark circle serums. Light therapy is specifically target to the breakdown of pigments without injuring outer eyelid skin. This process does not even require any recovery for the patient.