Upper eyelid lift in Turkey is a minimally invasive surgical procedure that improves the appearance of sagging or overworked eyelids. It is possible to perform the operation on either the upper or lower eyelids, or both. The operation also gives a more glamorous cosmetic appearance to these delicate areas around the eye and can restore a more vibrant and youthful appearance. The aim of an upper eyelid lift is to remove excess skin folds that accumulate between the eyebrow and eyelashes, thus obscuring the appearance of the natural eyelid and the septum between the eyelid and the eyebrow. In this case, the eye appears swollen, and this appearance may affect the efficiency of vision if these growths become heavy on the eye. As for lower eyelid lift surgery, it aims to remove excess fatty cysts resulting from swelling of the fatty tissue under the skin. It is possible to perform the upper or lower eyelids surgery alone or in one operation.
Might interest you: Under Eye Fillers: Price Of Injections And How To Perform The Procedure
Surgical evaluation of the patient before an upper eyelid lift
Before performing eyelid lift surgery, the doctor performs a comprehensive visual examination. This examination includes evaluating the state of vision and all abnormal aspects that may hinder the doctor from performing the operation. A successful eyelid lift begins with a skilled surgeon who is highly professional and has a deep understanding of the cosmetic relationship between the eyelid, forehead, and eyebrows. The shape of the eyelid is evaluated for the patient while speaking, smiling, and in the natural relaxed position, and the doctor observes all these changes in the corners of the eyelid in all available positions. These observations help to reveal the range of movement of the eyebrow and eyelid longitudinally and transversely during the contraction and relaxation of the forehead. A good patient who is suitable for this type of plastic surgery must meet some basic conditions, such as:
- Swollen upper eyelids: It is possible for the operation to flatten these bulges and make them smooth, parallel to the eyebrow.
- Exhausted eyes: Eyelid lift is one of the procedures that reduce the causes of aging factors in and around the eye area.
- Skin growths in the upper eyelid: The doctor can tighten the skin and remove all growths from the eyelid area.
- The patient must be at least 18 years old, despite this, the majority of patients are over 35 years old, but if these skin growths or swellings around the eyes are common in the patient’s family, it is possible to perform the operation at a younger age.
- The patient must be in good health and psychological condition. Although this procedure is a very simple surgical procedure, there are some medical precautions for some patients that must be taken into account.
- Also, the patient’s expectations must be reasonable regarding the results of the operation, so as not to clash with the reality and limits of its implementation.
Some patients who look good for eyelid surgery in Turkey may not be able to undergo the operation due to some health or visual problems, which may worsen the patient’s condition. Among these visual considerations are glaucoma and dry eyes. It is expected that the risk of these visual problems will increase in the event of any eyelid surgery. Also, hyperthyroidism is considered one of the health problems that hinder the patient from performing eyelid surgery, as well as cardiovascular diseases, diabetes, and high blood pressure. The patient must be well and appropriately prepared several weeks before the operation so that he can have a successful, safe and satisfactory operation in terms of results. In order to obtain these results, it is necessary to consult the doctor and visit him before the operation to find out all the ways to perform the eyelid lift operation properly.
Surgical evaluation of the upper eyelid
The upper eyelid is tested before an eyelid lift is performed. The patient should bear in mind that the doctor will achieve cosmetic results by means of a surgical method, including removal of excess skin from the upper eyelid, including parts of the circular muscle of the eyelid if required, and perhaps also some Herniated fat, which causes protrusion in the eyelid. In addition, the doctor takes care to palpate the lacrimal and lateral glands and locate the eyelid crease and fold at the edge of the tarsal bones, which are the bones at the top of the eyelid.
The quality and density of the skin is one of the most important factors in the upper eyelid lift procedure. The patient who has thin skin in these areas is usually advanced in age and requires careful removal of excess fat in the middle of the upper eyelid in order to avoid any wrinkling or excessive wrinkling of the skin after the operation. Also, one of the most important factors for the doctor’s care is that in the case of elderly patients, the circular muscle of the eyelid is very sensitive, so it must be avoided as much as possible, or part of it must be removed so as not to harm the movement of the eyelid in the future.
In patients with thick skin, especially those who are younger, the upper eyelid crease is usually not clear, and it is the area that the doctor must explore to determine the location of the eyelid bulge. To get a tight eyelid, the doctor removes a large amount of fat, part of the circular muscle of the eyelid, and any loose skin in the outer eyelid area. It is very important for the patient to look at the expected shape of the eye and the eyelid area after completing the operation, as they want to be assured of their visual image after the surgical procedure. The patient who has thick skin, especially in the outer area of the eyelid, may have a fear of performing the operation because of his concern about the effect of the surgery on the efficiency of vision.
Preparing for an upper eyelid lift
The decision to perform an eyelid lift operation depends on some psychological and medical tests and examinations, as well as vision examinations, which must be done before the operation mainly so that the patient does not face any health or psychological problems after the operation. The patient is prepared for the operation during a lengthy discussion with the doctor, in which the patient’s and doctor’s expectations for post-operative results, instructions to be followed before the operation, how to implement the steps of the operation itself, and any problems or consequences that may occur as a natural reaction to the surgical procedure are presented.
It is important for the doctor to discuss with the patient about the medications and medications he is taking, as taking some drugs leads to instability of the patient’s health during and after the operation. Among the most important drugs that the patient should avoid before the operation for a period of two weeks are aspirin, vitamin E, ibuprofen, and non-steroidal anti-inflammatory drugs. All of these medicines lead to increased blood flow, increased bleeding during the operation, and possibly delaying the body’s ability to heal and heal wounds, and also lead to bruising and increased swelling. Drinking alcohol before the procedure is supposed to increase swelling and inflammation. Also, the patient should be careful about practicing strenuous sports activities or planned travel plans, because it may exacerbate the problems of the operation.
How to perform an upper eyelid lift
Figure 1: The doctor infers the eyelid crease to determine the lower part of the eyelid before the operation. This line is determined in each eye separately, so consistency and symmetry must be made between them. It is normal for the eyelid crease to be 8-10 mm above the edge of the eyelid. If the line is above or below this level, the wound will be visible after the operation. In this image, the defining line of the crease extends to the side of the eye, and the upper points mark the bones of the eye socket.
Figure 2: Patient in the flaccid position on the left, the brow position gently raised along the available area of the scalp. This lift works to reveal the excess amount of skin in the upper eyelid. In the picture on the right, the doctor applies light pressure on the eyebrow down, which is the natural position in which the wrinkle line is drawn
Figure 3: The doctor grasps the skin with surgical forceps to determine the amount of excess skin to remove. The lower end of the forceps is on the crease line and the upper end is on the end line of the eye socket bones.
Figure 4: The amount of skin to be removed from the eyelid is evident through the zigzag drawing between the crease and the end line of the eye socket bones, while the patient is closing his eyes.
Figure 5: The patient opens his eye and then notices the amount of excess skin at the outer edge of the eye. Thus, the operation aims to remove these amounts of skin and fat below it.
Figure 6: The doctor fully stretches the skin to prepare for the eyelid opening. The drawn line is very precise so that the surgeon can open in a manner that does not tolerate error or swing between the drawn marks. Because any thick drawing of these lines may lead to the removal of large parts of the skin that are not targeted.
Figure 7: In this case, there is no increase in the circular muscle of the eye. Therefore, once the excess skin is removed, the edge of the eye socket bones will be exposed.
Figure 8: The skin in this case is of the thickened type which necessitates, and is followed by, a slight increase in the thickness of the circular muscle of the eye.
Figure 9: In this case, there is a large increase in the circular muscle of the eye, which requires significant removal of the eyelid skin until the upper eyelid incision is clearly exposed.
Figure 10: Fat removal in this young woman with thin skin is limited to the removal of the middle layer of skin and beyond the medial fat. Removing any central fat will result in excessive eyelid retraction after the operation.
Figure 11: In this case of thicker skin, it is expected that parts of the central fat will be removed in addition to the middle fat so that the eyelid appears more clearly and is taut and flat.
Figure 12: The patient in this case has very thick skin and a large space for the circular eyelid muscle. The percentage of fat accumulated in the form of bags in the middle area of the eyelid, which requires its complete removal.
Figure 13: The lateral incision is first closed with small sutures ranging from 0-6, so that the most tense Small surgical suturesarea is between the skin of the eyelid and the skin of the face.
Figure 14: Closure of the medial wound with small surgical sutures. It shows the removal of any accumulated skin in the central region. In this case, surgical tape can be used.
Detailed explanation of the process steps
The process begins with defining the shape of the eyelid and drawing an outline with a pencil on the areas from which the doctor will remove fat. The doctor cleans the skin of oils and fatty secretions until it becomes completely dry, as this step reduces bleeding and makes the doctor able to reveal the basic wrinkle line in the eyelid. Cosmetics are removed and not used two days before the operation, so that the skin is not mixed with any harmful chemicals when opening the incision and using a surgical scalpel. The doctor cleans the eyelid with alcohol or acetone before drawing the borders of the eyebrow.
Define the medial crease of the upper eyelid
The upper eyelid crease is at the upper edge of the eye socket bones . The eyelid crease is often found at the same level for each eye, but if there is a difference of 1 mm between each eyelid, the doctor makes some adjustments in the different eyelid crease line so that the surgical incision is above the edge of the eyelid at a distance of 8-10 mm. In other words, the doctor uses the upper eyelid edge as a measure to determine the position of the eyelid incision. The upper eyelid edge is just below the eyebrow and is the area of the edge of the eye socket bone below the eyebrow. The doctor measures a distance of 8-10 mm from this edge, and this is the crease or medial eyelid line at which the doctor will open to lift the eyelid.
The percentage of excess skin in the upper eyelid can be determined when the skin is pulled down completely, as the skin of the scalp and forehead works in a resting position to raise the eyebrow above the edge of the eye socket. Thus, the position of the eyebrow in this case is unnatural and cannot be used to measure the area of excess skin in the eyelid area. In order to determine the area of skin to be reduced, the eyebrow should be gently pulled down towards the eye socket.
The doctor holds the eyelid with surgical forceps so that one end of the forceps is on the eyelid crease, which is the midline of the eyelid skin, and the other end is on the end of the loose skin below the eyebrow. If the skin area between the two ends of the tweezers is large, the excess space should be removed in the relaxed position of the eyebrow and eyelid. The presumed surgical incision is located between the lateral tip of the eye (the anus) and the lateral tip of the eyebrow. At the end of this stage, the doctor defines this line with a surgical marker.
Local anesthesia of the upper eyelid
After the doctor finishes drawing the specific lines for the eyelid crease and the location of the surgical incision, the local anesthesia stage begins. The patient does not need partial or full anesthesia in such simple surgical procedures, because it is considered one of the operations that do not expose the patient’s internal organs.
Simple local anesthesia is very sufficient to perform the operation safely and safely by means of xylocaine 2% with 1: 1000,000 epinephrine diluted in sodium bicarbonate at a rate of 8.4%. The proportion of anesthesia is 10 ml xylocaine to 1 ml bicarbonate. For the average patient, about 1 ml of the anesthetic solution is injected with a 1.5-inch needle. The doctor waits at least 10 minutes for the anesthetic to take full effect.
Surgical incision of the upper eyelid skin
The initial surgical opening is by stretching the skin of the eyelid, which has been previously determined, until it is in a taut and straight position. Then the doctor uses a small surgical scalpel, usually the scale of the scalpel according to the size of the eyelid, but it is common to use the Beaver 67 scalpel, as it is small and sharp. The doctor makes an incision in the skin in the predetermined position, and uses surgical forceps to lift the skin up to expose the inner eyelid and tissues. After exposing the tissue, the doctor makes a decision about the circular muscle of the eyelid. Doctors usually remove some parts of this muscle so that they can remove excess fat and tissue freely. For elderly patients who have thin skin, a large part of this muscle is not removed, but for young patients, removal is required to obtain a clearer aesthetic appearance. The surgical incision is usually the width of the eyelid, but it can be reduced in width and depth, depending on the patient’s condition.
Call now and get a free consultation provided by the medical team of Turkiyaholidays Beauty and Health Center in Turkey.. Call and start your journey towards performing an upper eyelid lift operation with the latest safe technologies and with all medical guarantees.
Removal of fat from the upper eyelid tissue
If there is an abundance of fat in the eyelid tissues, it is best to remove the fat in the central area of the eyelid before dealing with the midsection fat. Fat in the eyelid can be removed by making an incision in the skin along the eyelid or by making a small incision so that the fat is pulled through. If the eyelid tissue contains a small piece of fat, it is pulled out with small surgical forceps.
In the case of a large amount of fat, the central space of the eyebrow must be separated into two parts so that one of these sections is completely removed. Before removing these amounts of fat, the doctor injects them with local anesthesia, so that the patient does not feel pain if they are pulled. In the event that there is a lot of fat in the eyelid area, the doctor uses a hemostatic or bleeding cutter forceps, which is a tool that helps to withdraw any fat or tissue in cosmetic operations without bleeding afterwards.
It is important that the doctor does not remove any fat that does not enter the wound space by pulling or forcefully pulling, because this may lead to relaxation of the outer skin of the eyelid. This process, if done in an unorganized manner, may cause the eyelid and the outer skin to sag, and in this case, the shape and structure of the eyebrow may be deformed. Therefore, it is preferable to deal with the upper eyelid and its excess fat by removing the visible fat in the incision area without exposure to the unclear or visible fat by pulling or pulling. The majority of plastic surgeons believe that pulling fat from these areas leads to shrinkage of the eyelid and moving the position of the eyebrow from its original position on the edge of the eye socket bones. These practices result in an increase in the appearance of aging factors.
The process of removing the middle fat from the incision area may be invasive, so it is important to analyze the angles and amount of fat before the operation, and based on this, fat is removed according to prior planning. Sometimes, this fat in the middle of the eyebrow comes back because of how the operation was handled. If this fat is formed in the form of follicles or cysts in the middle of the eyebrow, it must be completely withdrawn without leaving any roots for these cysts.
One of the most common surgical errors is that the doctor makes an inaccurate estimation of the midsection. The fat in the central region is white in color and is also more dense in contrast to the central fat scattered in the rest of the eyebrow, which tends to be yellow in color. The circular muscle of the eyelid is the barrier separating the fat from the central region of the eyelid and the middle fat. This muscle is very visible in the upper eyelid, unlike the lower eyelid muscle, which is not visible among the accumulated fat. Therefore, the doctor must determine the position of the circular muscle of the upper eyelid before any surgical treatment of the fat accumulated around it, and it is also supposed to determine the type of treatment of the muscle, whether by complete or partial excision, according to the patient’s age and the shape of the outer eyelid.
This fat can be removed through small incisions behind the mucous membrane of the eyeball and eyelid. Where the doctor takes out the inner part of the upper eyelid with surgical pliers, and the digital pressure device is installed in the middle fat. This fat will be seen as a cyst behind the mucous membrane. It must be realized that the membrane of the eyelid-stopping muscle is not located between the mucosa and the medial fat, as is the case in the central fat. Finally, the mucous membrane is opened and fat is safely extracted from the bottom.
The stage of cauterization of the wound in the upper eyelid
After completing the process of completely removing fat from the surgical incision and making sure that there are no remaining fatty cysts in the wound area, the doctor resorts to cauterizing the wound using a hot tip iron. The use of monopolar electric irons can lead to significant pain in the eyelid area, especially when under simple local anesthesia.
The cauterization process using this tool causes pain in the eye, at a distance of 1 cm inside the eye. Therefore, it is preferable to use a tool to stop bleeding and make sure that no blood or fluids come out of the eyelid area first before resorting to using the cautery tool. To avoid the patient feeling pain during the cautery stage, the doctor injects the eyelid again with local anesthesia. It is preferable that the anesthesia be doubled in this case so that the patient can resist the pain resulting from the cautery.
Wound closure stage after completion of the operation
After completing the process of cauterizing the wound and making sure that the bleeding has stopped completely. The doctor leaves the eyelid area open for a few minutes to detect any occasional bleeding or excess mucous secretions. If the doctor notices any of these secretions, they must be cleaned and removed completely before the final stage and wound closure. It is preferable to use a 0-6 scale Brolini tool to close the wound in the upper eyelid, and the surgical sutures often leave no trace after the operation.
It is normal for the stitches to completely disappear within 3-4 days after the operation, but if they do not disappear on their own after this period, the doctor resorts to removing them manually using simple surgical tools. Also, the incidence of traces resulting from stitches, such as suture channels or stains, is very small. The middle area above the eyelid, from which the amount of fat is removed, is considered the easiest area in terms of surgical sutures. As for the high tension area, it is the parts near the end of the side of the eye, as it is visible and more delicate.
The crease of the eyelid covers the surgical sutures to a large extent, which does not cause concern to the patient in the midsection. And the skill of the surgeon in closing the wound is the basis in this step because how to deal with the skin after the operation is considered one of the cosmetic matters that are supposed to be available in a plastic surgeon. The surgeon begins by closing the high tension lateral parts of the wound first and then proceeds to the middle area, which is the innermost area that has been previously cauterized. Sometimes some surgeons close the middle area using traditional surgical sutures and using surgical tape on both sides of the wound. These adhesives are considered among the highly accurate surgical tools, as they can close the wound without leaving any trace after the operation, but they require skill and accuracy during use. Surgical adhesives also require continuous daily change for 5 days after the operation until the surgeon makes sure that the wound is closed and healed.
At the end of this delicate cosmetic procedure, the doctor will look at the center of the eyelid and note any additional shrinkage or wrinkling of the skin. If any of these remarkable things are observed in the eyelid, the doctor removes the excess skin with a precise surgical scalpel, taking into account that no bleeding occurs that would affect the stitches and adhesive. Any growths in the middle of the eyelid in the form of prominent triangles are removed so as not to leave a noticeable distortion when closing the eye. This final operation aims to leave the incision in the center of the eyelid flat without any protrusion. If the surgeon notices any gaps or open areas in the wound after completing the surgery, he or she can make small additional stitches to close these gaps.
Finally, wound closure is a high-precision plastic surgery technique that depends largely on the skill and experience of the surgeon. Therefore, choosing a professional surgeon with surgical capacity and high skill is indispensable in any plastic surgery.