The eyes, this massive means of seduction, are windows to a person’s soul.
All human relationships start with the eyes. In the blink of an eye, a shared glance can indicate emotion, happiness, sadness, desire, an unbreakable decision…and can be far more implicit than words.
Sometimes this essential element of human communication can go wrong. Drooping eyelids, unsightly pockets, etc.
We shall do everything we can to help you maintain these windows to the world open in a natural manner!
What you might not know
Eyelids are really secondary elements.
The elements to take into consideration are: eyebrows (shape and position), temple, cheekbone and the area’s volumes. In truth, one of the major signs of eye ageing is the progressive appearance of dark circles as well as a gradual decrease, to extinction, of the eye’s brightness.
– Loss of volume to the forehead and temple slackens the corner of the eye, which tends to droop and shrink resulting in the eye being less open.
– Eyebrows always sag, particularly at their tail (outer part) so causing crow’s feet and an excess of skin on the lids (commonly called “the cap”).
To counteract this inevitable sagging, the forehead contracts to lift the lids which results in raising the central part of the eyebrows; it is this that causes more and more forehead wrinkles.
Only the middle and inner parts of eyebrows may lift, sometimes in an exaggerated manner, creating a large hollow triangle in the angle of the eye on its nose side. The shape of the brows is inverted, eyelids hollow out especially near the nose because the eyebrows have sagged and there is loss of volume.
Dark circles, a large number of wrinkles, an unsightly demarcation between lids and cheeks are caused by loss of volume around the cheekbones and eye sockets.
You understand now why it is important to analyse all the elements concerning the eyes and why blepharoplasty is used less and less.
Surgery should only be used for large, congenital pockets, important amounts of surplus skin or to reposition the cheeks where necessary (malar lift), which will spread the volumes and enable surplus skin on the lower lid to be removed “without risk”.
This eye related intervention concerns one’s visible identity; it requires a well-developed sense of artistry to obtain an emotionally positive result.
Eyelids are very delicate and fragile and, as such, must be infinitely respected.
It is often better to avoid surgery and find more adapted solutions for the area.
It must always be remembered that all surgical acts are irreversible; here we are encroaching on a person’s visible identity, the window to that person’s soul.
The “soft” technique
All that is possible must be done to avoid surgery altogether, or very little, on the eyelids; action should mostly be taken on the temples (hyaluronic acids), the forehead (hyaluronic acids and Botox) and dark circles (replenishing cheek volumes).
Even surplus skin on the upper eyelids may be due to loss of volume and require just a simple orbital lipostructure or a hyaluronic acid injection to the eyelid hollows. The youthful look gained will be amazing.
Surgical technique
Large, congenital pockets, important amounts of surplus skin or the necessary repositioning of the cheeks (malar lift) which spread the volumes and allow the surplus skin of the lower lids to be removed “without risk” all clearly indicate aesthetic surgical interventions.
There are numerous techniques which especially concern the environment around the eye; it might be necessary to combine several procedures to arrive at a natural-looking look. The following are just a few:
- Lower blepharoplasty could be the answer, but it is a delicate operation, used less and less often by itself and only when there are important amounts of fatty tissues, which can be removed by incising the inside of the eye (conjunctival scarring). But, to want to smoothen the eyelid completely by removing excess skin is practically impossible because of the risk of eyelid ectropion (pulling the eyelid downwards). To avoid this phenomenon and to remove the real amount of surplus skin, without much risk, a blepharoplasty is associated with a malar lift. After care takes longer, any scars are invisible, but glasses are essential for the first few days.
- Upper blepharoplasty is used too frequently. To remove skin with or without any fat means removing volume and so quickens ageing. Only surplus skin on the upper lid must be removed, notably on its exterior and very little on its inside, which would make the eye look hollower. The technique is wrongly trivialised for each millimetre counts! A pre-intervention drawing is fundamental. Very often, when there is surplus skin, the eyebrows sit too high, consequently they will automatically descend, which is good for a youthful look even if surplus skin reappears. Well thought-out, this simple operation, under local anaesthetic, is very satisfying. After care is simple and easily hidden behind glasses. Scarring, if well-placed are virtually invisible.
- Temporal lifts: a lateral incision, hidden in the hairline, aims essentially at lifting the outer part of the eyebrow thus allowing more space for the outer part of the upper eyelid. Following the patient’s request regarding its repositioning, it allows the palpebral fissure to become almond-shaped and the crow’s feet to be smoothed out. It is an ideal procedure for heavy upper eyelids, the resulting look being most satisfying.
- Forehead lift: since botulinic toxin, the procedure has become ever rarer. It allows the eyebrow to be lifted particularly when the middle section has dropped giving a mean look. Beware, the operation could lead to a “horrified look” if not well-planned and well-balanced. It is without a doubt a wonderful procedure with scars hidden within the hairline. In a few cases, too small and simian foreheads may be “enlarged” (a rare occurrence in blonde-haired women).
- Eyebrow lifts: the aim is to raise the outer edge of the brow by making an incision at its upper edge. After care is simple and the result almost immediate. The procedure may be done under local anaesthetic as an out-patient.
- Very recently, permanent suspension threads allow us to open the look, raise the brow tail or remodel the shape of the eye (“cat eyes”). The procedure is performed under local anaesthetic, with no surgery involved and no scarring.
- Malar lifts, if necessary, combined with procedures on the lower eyelids: With a resulting scar on the lash border of the lower lid, the whole cheek is raised. The big hollow circle at the junction between cheek and eyelid disappears since the weight of the cheek has been lightened. The eye regains its youthful shape as the corner has been lifted. Lifting the cheek leads to a surplus of skin which can be removed risk-free, since it is not tugged downwards. This intervention is wonderful for giving a youthful look, but the social downside lasts between two and three weeks (much swelling).
- Lipostructure is a surgical procedure to reset “natural” volumes by injecting the patient’s own fat to where it has decreased with age. The fat may be injected to any part, forehead, eyelids, temples, dark circles, malar palpebral junction, cheeks, etc. The intervention may be done by itself or be combined with another surgical procedure. The complementary volume effect is very satisfying, more so since the fat with its own stem-cells, regenerates skin quality. There is one small worry: there must be sufficient fat available in other parts of the body! If inevitable, intervention on the eyelids may be performed out under local anaesthetic or potentialized local anaesthetic and the patient must wait between one and three weeks to be totally presentable socially.