Upper Blepharoplasty and Sagging Eye Surgery - March 2017

Upper Blepharoplasty and Sagging Eye Surgery - March 2017

This content was presented at the Spring Symposium of the Korean Society of Craniofacial Plastic Surgeons.

In elderly eye plastic surgery, natural results are usually emphasized the most. This is because patients are often dissatisfied if the impression looks too harsh after upper blepharoplasty or if the sagging remains, making the surgery feel ineffective.

Since the skin is much more saggy compared to younger patients, an incision must be made to remove the excess skin.

I would like to summarize the details presented in March 2017.

The presentation title is as follows.

Most patient requests are quite similar:

• 1. Resolve the sagging appearance
• 2. Improve skin irritation on the outer corners of the eyes
• 3. Look as natural as possible
• 4. Minimize the procedure (due to economic factors, etc.)

However, for those with a narrow distance between the eyebrows and eyes, a forehead lift may be necessary. In cases where only the outer skin is irritated, a sub-brow incision alone can yield good results.

The patient above achieved excellent results through a sub-brow incision alone, without redo double eyelid surgery.

The core of this presentation is to perform the surgery with appropriate fixation so that the eyes do not look too deep or ‘pinched’. While methods like non-incisional fixation combined with skin excision have been devised, the key point was to induce a more natural look by using septal fixation or fixing at the junction of the levator and septum, rather than direct fixation to the tarsal plate.

The schedule was as shown above.

Min-su hyung even took a video for me.

Frequently Asked Questions

What is the most important consideration for elderly eye surgery?

Yes, the most important thing is naturalness. If the impression looks fierce after upper blepharoplasty or if the sagging eyelids remain, satisfaction will decrease, so the key is to properly incise the stretched skin while maintaining the original impression.

What surgery is suitable if only the outer skin of the eye is irritated?

Sub-brow incision surgery may be suitable. By incising below the eyebrow and pulling up the sagging skin without performing double eyelid surgery again, irritation of the outer skin can be improved, and natural results can be obtained.

Is upper blepharoplasty alone sufficient if the distance between the eyebrows and eyes is close?

No, a forehead lift may be additionally necessary. If only the sagging eyelid skin is cut when the distance between the eyebrows and eyes is narrow, the eyes and eyebrows may become even closer, making the impression look stuffy, so the overall structure must be considered.

How can I prevent the eyes from looking pinched during upper blepharoplasty?

It is necessary to utilize septal fixation instead of direct fixation to the tarsal plate. By fixing appropriately at the connection point between the levator palpebrae superioris and the septum, it is possible to prevent the eyelids from looking deep or unnaturally pinched, and to create a more natural eye shape.