Clinic for plastic surgery, Belgrade, Serbia

EYELID SURGERY

BLEPHAROPLASTY

Eyelid surgery

According to our results, first sign of ageing of the orbital region is denting of medial canthus and appearance of lower orbital ridge.


Prof. Dr. Milan Jovanovic ‘s results of 10-year-long research on face and neck ageing and rejuvenation are presented in his doctoral dissertation. There he showed that dents and bulges, and then later skin flabbiness, represent first signs of ageing in orbital region.


By study of the upper orbital region (upper eyelids) he has determined that there are two types of ageing, and by study of the lower orbital region (lower eyelids) he has proved that there are 14 types of ageing. None of the categorizations of the orbital region age signs contain different types of ageing. Therefore we think that classification that made Prof. Dr. Milan Jovanovic's is very original and clear, both for understanding orbit ageing and for setting the indication and selecting surgical and nonsurgical treatments in orbital region rejuvenation.

 

By analyzing his results Prof. Dr. Milan Jovanovic favors his concept of rejuvenation of orbital region. This concept has to determine and includes the following:


  1. type of ageing
  2. it must not be based only on traditional excision blepharoplasty that can rather be called blepharectomy
  3. whole accent and plan should be set on augmentative blepharoplasty, and standard skin excision use secondary, as auxiliary method
  4. without orbital region augmentation it is impossible to achieve ideal results of youthful look of the orbit.

EYELID LIFT

The excess skin has to be removed in case when the patient has excess skin on eyelids (that appears after dents and bulges appear),


Eyelid lift (Blepharoplasty) is utilized as a standalone procedure or combined with facelift in order to rejuvenate the face.


Indications for this type of the procedure include: pouches on upper or lower eyelid (blepharochalasis) or there is a herniation of the orbital fat pouch, localized atrophy of the skin of the upper or lower eyelid that is thin and flabby and hangs over eyelid rim,.


COSMETIC EYELID SURGERY CANDIDATES

It is common to see a significant number of adult male and female patients between the ages 27 and 40 who are interested in mentioned surgical procedure.


INDICATIONS

Indications for blepharoplasty include: wrinkles around eyes, excess skin that hangs on eyelids, reduced field of view as a result of skin lowering on eyelids or skin pigmentation, clusters of fat pouches, reduced field of view as a result of skin lowering on eyelids or skin pigmentation.


PREOPERATIVE PREPARATION

There is no difference between preoperative preparation for eyelid correction and for the facelift. Preoperative preparation includes data of patient’s medical history, examination of the patient and his general condition.


Patient must undergo an anatomical evaluation of eyelids before eyelids surgery. Anatomical evaluation consist of evaluation of the skin, fatty tissue, muscles, orbital ridge, height of the supratarsal fold, eyebrow height, eye protrusion and preexisting eyelid ptosis (drooping).


EYELID SURGERY TECHNIQUE

Eyelid surgery is procedure performed in local anesthesia. It can also be done in combination with neuroleptanalgesia.


Surgery consists of removal of excess skin from upper and lower eyelid (or just from the upper or from the lower), removal and premodeling of fat pouches. Blepharoplasty must be planned carefully, it also requires very precise and meticulous measuring. One millimeter error in removal of the skin can lead to bad results or complications.


On the upper eyelid Incisions are located in height of palpebral sulcus, i.e. about 10 mm from the edge of eyelashes. On the lower eyelid incision is placed about 1 mm from the edge of eyelashes. On the insides of eyelids are located incisions created when transconjunctival blepharoplasty is performed.


Eyelid surgery duration is about one to two hours. After the procedure, swelling is reduced by placing bags or special eyeglasses with ice on the eyes. Sutures stay in place for 4 to 5 days after the surgery, and then they are removed.


COMPLICATIONS

Complications in blepharoplasty are rare, but they can appear. Most common complications are swellings with bruising (which usually disappear within couple of days), infections, visible scars or ectropion.


POSTOPERATIVE TREATMENT

A couple of days after the eyelid surgery, patients can fully return to their previous activities.  Utilization of anti-scar creams is necessary.



EYELID SURGERY COST

Upper eyelid surgery (blepharoplasty superior) - from 600€
Lower eyelid surgery (blepharoplasty inferior) - from 900€



RESULTS BEFORE AND AFTER EYELID SURGERY

Some of the patients that were operated on by Dr. Milan Jovanovic personally:

Note: All of the results are genuine, without any processing in Photoshop.



Before eyelid surgery After eyelid surgery
Before eyelid surgery | After eyelid surgery

Before eyelid surgery After eyelid surgery
Before eyelid surgery | After eyelid surgery

Before eyelid surgery After eyelid surgery
Before eyelid surgery | After eyelid surgery

Before eyelid surgery After eyelid surgery
Before eyelid surgery | After eyelid surgery