There has been a serious change in our approach to eyelids in recent years. It has been noticed that the surgical techniques that have been performed for the last 30 years as a standard have many inadequacies and problems. It is argued that attempts such as “removing the fat bags” are now unnecessary. Our expectations went beyond just creating “bagless” eyelids and we prefer to evaluate the face as a whole.
Signs of aging affecting the eye area:
Eyelids are where aging manifests itself the most and attracts the most attention. Wrinkling of the skin is almost inevitable in the advancing age in the eyelids, which are both very mobile and very thin skinned by their nature. All the sagging and loosening that starts around them also affect the eyelids.
1. The forehead goes down with age. Along with the forehead, the eyebrows begin to fall over the upper eyelids. Eyelids, which do not have the strength to carry such a load, slide down.
2. There is a membrane that surrounds the eyeball and separates the fat bags that support it from the lower eyelids. This is an elastic membrane and acts as a barrier. With advancing age, this membrane loosens and becomes unable to carry the weight of the fat bags. Thus, the oils carry outward and we see them as “eye bags”.
3. The skin of the eyelids is the thinnest in the body. It is also adhered to the very mobile muscles underneath. Therefore, with every eye movement, the skin of the eye becomes a little more wrinkled and sagging. Side wrinkles called “crowbars” around the eyes are an example of this.
4. A deep groove appears on the upper border of the cheeks in custody. This is due to the drooping of the cheeks.
In standard eyelid surgeries, the eyelid skin, thin muscle layer under the skin and fat filling the eye bags are removed. Although this is a very common surgery, it is often disappointing to patients. The reason for this is that some of the main problems I mentioned above do not belong to the operated tissues, but to other neighboring structures such as cheeks and forehead. For example, most of the clumps on the upper eyelids come from drooping eyebrows.
What is the ideal treatment?
The ideal is to approach the eyelids as part of the face. Step-by-step fixes:
1. First of all, if there is a deep pit under your eye that goes down to your cheek, this pit must be filled. Standard lower eyelid surgeries do not solve this problem, it may even deepen it. This pit should be removed by spreading the fats forming the under-eye bags downwards and lifting the cheeks up. In this way, an uninterrupted flat surface extending from the cheekbones to the lower eyelids should be formed. This is an indispensable rule to look young and fresh.
2. If you have a serious sagging on your cheeks, this must be corrected. For this, it is possible to use endoscopic techniques and to lift the cheeks or to raise the middle face during lower eyelid surgery.
3. For the upper eyelid, the forehead must be evaluated. If your forehead and eyebrows are piled up on your eyes, they should be corrected first, and the eyebrows should be placed in the correct position with temporal lifting. Then, if there is still sagging in the upper eyelid, this should be treated. Crow’s feet also appear from sagging in the temple area and are largely eliminated by temple stretching.
After the above-mentioned problems are resolved in both eyelids, it will be sufficient to remove only muscle and skin excesses.