DROOPING EYELID AND AESTHETIC SURGERY: WHAT'S NEW?

This is one of the most common requests in cosmetic surgery of the face. Performed by a qualified and experienced (maxillofacial surgery or plastic surgery, reconstructive and aesthetic), the drooping eyelid surgery gives stunning results of a natural, illuminating a look and blurring wearily standing? Explanations of Professor Armand Paranque.

How aging upper eyelid?

Professor Armand Paranque: Around 40 years, the lid top gets heavier, with more or less gradual appearance of excess skin, the classic "hat". The wrinkles of the crow's feet will gradually mark and a pocket of fat is formed in the inner portion of the eyelid (near the nose). This situation gets progressively worse over the years. The cap of excess skin that can abut against the lashes. The look is becoming heavier and loses its original luster, especially since the fall eyebrow (especially its outer end or tail of the eyebrow), increasing the excess skin and giving a sad and "weeping". All these anomalies appears worse because of the effects of gravity and external aggressions (UV, tobacco, pollution?), But also repeated actions of the orbicularis muscle of the eye.

What are the techniques of cosmetic surgery if possible eyelids drooping?

Professor Armand Paranque: The wrinkles of the crow's feet can be improved by resurfacing techniques (pulsed light - laser non-ablative fractional Erbium or CO2) and injections of botulinum toxin (relaxation of the orbicularis muscle) and hyaluronic acid ( filling and rehydration of the dermis). The fall of the tail of the eyebrow can be improved within certain limits by the botulinum toxin. Its goal is to make the action of the frontalis muscle (eyebrow lifter) predominant over that of the depressor muscle (orbicularis of the eye). In contrast, a net surplus skin eyelid is a superior surgical light: the palpébroplastie or upper blepharoplasty.

What happens at a higher palpébroplastie?

Professor Armand Paranque: It is preceded by a careful examination of the eye region (eyelids and orbit). Any indication of order cons-eye must be removed and expert advice will be sought in doubt. The procedure often takes place under local anesthesia, sometimes with light sedation. The amount of skin to remove must be evaluated to perfection. Better to withdraw too little (editing easier) too. The scar is hidden in the fold of the eyelid superior very quickly invisible. The skin is resected (cut with a scalpel). A gesture is almost always performed on the underlying orbicularis muscle, contributing to type of resection in particular to an ascending movement of the tail of the eyebrow. The pocket of internal fat is treated conventionally by resection and careful bipolar coagulation. The suture is made using a thin wire, removed to the 5th postoperative day. When the fall of the eyebrow is severe, a lifting of the eyebrow (zigzag incision in the tail of the eyebrow) can be achieved at the same time, more rarely a facelift or a temporal brow lift.

What usually follows an upper palpébroplastie?

Professor Armand Paranque: They are not painful. If the bruise ("blue") is possible despite all the precautions taken by the surgeon during the intervention (coagulation smallest vessels), swelling is almost systematic. It is fought by applying ice and adopting a sleeping position head slightly elevated. The swelling is maximum between the 2nd and 3rd postoperative days. The social activity can be resumed to the 8th day on average. This is a procedure performed in a surgical facility perfectly secure, as outpatients (first morning out in the afternoon). The dressing is removed before returning home. Rate: between 2,600 and 3,600 euros.

What are the recent developments of this surgery?

Professor Armand Paranque: It tends towards more natural and customization.Thus, for example, an eyelid "full" will be preserved, care should be taken to alleviate subtly retaining the sense of mystery that gives the look. The gestures made shall in no case (except case and requires very specific) change the shape of the eyes. Well done, they give an air of relaxed and make the light radiance.Surgery today includes gestures lighter, more conservative vis-à-vis the fat pockets and skin. This procedure is also recommended from the onset of excess skin, making it even more discreet scars and source of a more natural result.Finally, the combination of injections (botulinum toxin at low doses, hyaluronic acid) is very common, comprehensive and sustainable outcomes of surgery. * Professor Armand Paranque, maxillofacial surgeon, Associate Professor of Val de Grace, Head of Department at the National Institution des Invalides.