Second Part Of The History Of Pierre’s Blepharoplasty

The Blepharoplasty is cosmetic surgery most requested with rhinoplasty and liposuction . The facelift in men is more taboo, but the double chin is a frequent request. A cervical liposuction alone is sometimes possible, if the skin has sufficient retraction capacity (the tensor threads have a very ephemeral action). The Asian blepharoplasty is in growing demand.

In general, consultations in cosmetic surgery of the face are probably increasing because the techniques of aesthetic medicine find their limits, if we want to keep a natural face.

A cosmetic surgeon is, it should be noted, a doctor. But a cosmetic doctor is never a cosmetic surgeon .

Moreover, blepharoplasty without surgery gives very insufficient results, even if certain techniques are undoubtedly interesting avenues of research.

Pierre’s blepharoplasty operation in detail

At the end of July, Pierre entered the clinic . He is directed to the outpatient department and I made sure to make him wait as little as possible. He finds himself in the operating room 30 minutes after his arrival (the administrative formalities were done during the pre-anesthetic consultation).

Before entering the operating room, we did a final check-up. Installed and entrusted to the team, Pierre is asleep. Begin the operation by removing fat from the flanks (20 cc). This is centrifuged to keep only the pure part but I always keep some blood which contains platelets rich in stem cells.

Then an infiltration with xylocaine and naropein serum is carried out. The lower eyelid is everted by my assistant. I then cut the conjunctiva on 1 cm with a very fine point scalpel. By this way I access with the help of a blunt forceps the orbicularis muscle which lines the turn of the orbit. The fatty pockets are under the orbital rim. Either they came out of the orbit like fatty hernias, and reintegration in their place may be sufficient, or they are too large and fill the eyelid. In this case, it is better to remove the exteriorized part, this with great caution so as not to create an unsightly depression in place of fatty pockets.

For Pierre a resection of 3 pockets (internal, median and external) is necessary. There is no cutaneous resection in this technique. The conjunctival wound heals very quickly in 48 hours without stitches, there is no bleeding if you are meticulous, skilful and precise.

Secondly, using the prepared fat, I create a lipostructure of the valley of tears and the top of the cheekbones (about 4cc on each side). It is done in contact with the orbicularis muscle, above and below. You should be very moderate in the amount injected and avoid areas rich in lymphatic vessels to avoid roll edema. This is done with cannulas so fine that there is no point to put.

The 3rd step concerns the upper eyelids. Landmarks were marked before the operation in a seated position, then the drawing is made. The incision is masked in the eyelid crease. For Pierre, the ptosis is more marked externally. After the incision according to the drawing, I remove the skin, but also a small muscle band externally. Then I put a point in suspension of this outer part under the eyebrow, inside of course.

The effect will be a lifting of the eyelid externally, and the fatty mass (Charpy pad). Internally we do not resect the skin to avoid a bridle that would be troublesome.

Sometimes some fat (rolled and white) is removed internally, under the orbicularis muscle, if needed. This will not be the case here. Very careful hemostasis is performed. There will be no bleeding. The closure is done with a very fine thread which will be removed 8 days later.

At the end of the operation, an eye ointment is placed on the conjunctiva in order to protect it from any infection, and to protect the cornea. Finally, ice-cold serum compresses are placed on the eyes to prevent bruising and limit postoperative edema. In one hour the intervention is finished. Pierre is then taken to the recovery room where he will stay around 1 hour. Following this, Pierre will return to his room, where his wife is waiting for him, whom I completely reassure and explain to him the work carried out.