Clinic for plastic surgery, Belgrade, Serbia

EYELID SURGERY

BLEPHAROPLASTY

Eyelid surgery

Our results show that denting of medial canthus and appearance of lower orbital ridge is the first sign of orbital region ageing.


In his doctoral dissertation that was the result of 10-year-long research, Dr. Milan Jovanovic has proven that first signs of ageing in orbital region are characterized by: dents and bulges, and then later by skin flabbiness.


By analysis of the upper orbital region (upper eyelids) he has proven that there are two types of ageing, and by analysis of the lower orbital region (lower eyelids) he has determined that there are 14 types of ageing. None of the classifications of the orbital region age signs includes different types of ageing. So we consider that Dr. Milan Jovanovic's classification is very original and clear to understand orbit ageing as well as to setting the indication and choosing surgical and nonsurgical treatments in orbital region rejuvenation.


By analyzing his results Dr. Milan Jovanovic prefers his concept of orbital region rejuvenation that has to include and determine the following:


  1. type of ageing
  2. it must not be based only on tradicional 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

If the patient has excess skin on eyelids (that appears after dents and bulges appear), the excess skin needs to be removed.


Eyelid lift (Blepharoplasty) is used as a standalone procedure or combined with facelift aiming to rejuvenate the face.


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


COSMETIC EYELID SURGERY CANDIDATES

In practice it is not unusual to see a considerable number of patients (of both genders) between 27 and 40 years of age that turn to mentioned surgical intervention.


INDICATIONS

The most common indications for plepharoplasty are: excess skin that hangs on eyelids, wrinkles around eyes, clusters of fat pouches, reduced field of view as a result of skin lowering on eyelids or skin pigmentation.


PREOPERATIVE PREPARATION

Preoperative preparation for eyelid correction is the same as for face lift, and includes anamnestic data, as well as examination of the patient and his general condition.


Before eyelids surgery an anatomical evaluation of your eyelids must be done, which will include evaluation of the skin, muscles, fatty tissue, height of the supratarsal fold, eyebrow height, orbital ridge, eye protrusion and preexisting eyelid ptosis (drooping).


EYELID SURGERY TECHNIQUE

Eyelid surgery is done in local anesthesia, and can also be done in combination with neuroleptanalgesia.


Course of the surgery is removal of excess skin from upper and lower eyelid (or just from the upper or from the lower), removal and premodeling of fat pouches. Plepharoplasty requires very precise and meticulous measuring and planning. One millimeter too much or too little removed can lead to bad results or complications.


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


Eyelid surgery lasts about one to two hours. After the surgery bags or special eyeglasses with eyes are placed on the eyes, in order to reduce swelling. Sutures are removed 4 to 5 days after the surgery.


COMPLICATIONS

Complications in blepharoplasty are rare, and if they occur they are most commonly swellings with bruising (which usually disappear within couple of days), infections, ectropion or visible scars.


POSTOPERATIVE TREATMENT

A couple of days after the eyelid surgery, patients can fully resume their earlier activities. It is necessary to use anti-scar creams.



EYELID SURGERY COST

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