We provide professional support in Eyelid surgery (lower lid).
Dermatochalasis most often affects the upper
eyelid. Bagging on the lids and sagging skin can narrow the visual field
and cause aesthetic concerns. In most patients, excess skin and fat
herniation are together. In some patients, ptosis may also accompany this
condition. Significant skin laxity and sagging cause complaints of
heaviness around the eyes, eyebrows, forehead pain, eyelashes in the visual
axis, and consequently a decrease in the upper visual field.
Bags around the eyes and excess skin are removed with an
eyelid aesthetic operation called “blepharoplasty”.
The most important step in surgical success and
minimizing possible problems in blepharoplasty is to perform a detailed
examination of the eye and especially the lids. Before the operation, the
patient should be examined with a biomicroscope and it should be determined
whether there is any other eye disease. This surgery may not be suitable
for patients with ocular surface diseases and dry eye symptoms. The
patient’s systemic diseases and medications should be evaluated. It should
be learned whether the patient uses blood thinners (anticoagulant) drugs,
including aspirin, and the drug should be discontinued with the approval of the
doctor who started the treatment 2 weeks before the surgery.
The patient should be evaluated psychologically along
with other diseases. Before the operation, the expectations of the patient
should be known and discussed, the personality structure of the patient should
be investigated, and if there are unrealistic expectations, they should be
determined and explained. Each patient should be photographed from the
front and the side before and after the surgery. The type of anesthesia
(local or general) is determined together with the patient. Local
anesthesia is usually preferred in this operation, but if the patient expresses
that he cannot be comfortable, general anesthesia can be applied. The
operation takes an average of 30-45 minutes for the upper lids and 45-60
minutes for the lower lids, but this time may vary from patient to patient.
Excess skin on the eyelid (lower or upper lid) is marked.
If local anesthesia is used, the eyelids are
anesthetized, and in general anesthesia, the patient is put to sleep.
An incision is made in the fold of the upper eyelid and
under the eyelashes in the lower eyelid.
Excess sagging skin tissue is removed, if any, the fat
tissue that causes bagging is removed.
Bleeding is controlled and the incision is sutured.
The incision is covered with thin strips of tape, and the
entire eye is not closed.
Ice compress is applied for the first 24 hours after the
surgery. During this period, bleeding may occur in the form of
leakage. It is natural to have bruising and swelling for the first week.
Do not touch the eyes with water for 1 week. Adhered
tapes can be taken on the 2nd and 3rd day. During this period, antibiotic
ointment is applied over the tapes 4 times a day. After the bands are
removed, the ointment is continued to be applied directly on the wound site
until the end of the 1st week. Artificial tears are instilled into the eye
4 times a day for 1 month.
The stitches on the eyelids are removed in the 1st week.
Controls are made on the 1st day, 1st week, 1st month.
With normal aging, age-related changes are seen in the
eyelids as well as in all areas of the skin. At the age of twenties, lines
called crow’s feet begin to appear around the eyes due to the contraction of
the muscle (orbicularis oculi) that closes the eyelids. At the age of 40,
sagging and bagging begin on the skin that loosens with the effect of
gravity. These aging changes are called “dermatochalasis”.
A droopy upper eyelid is called ptosis. Lid droop
can be seen at any age. The treatment is surgery.
The inward turning of the eyelids is called entropion. Entropion
usually occurs in the lower eyelid. Very rarely, it can also be on the
upper lid. Although entropion is mostly caused by aging-related lid
relaxation, it can also be due to scars called scars or congenital. The
treatment is surgery.
The outward turning of the eyelids is called ectropion. Ectropion
happens on the lower eyelid. Although Ectropion is mostly caused by
age-related valve loosening, the treatment of scars (cicatricial), facial nerve
palsy, and lower eyelid Ectropion is surgical.
The ends of the sebaceous glands on the eyelids are the pores at the bottom of the
eyelashes. Swelling and inflammation occur in the
sebaceous gland behind as a result of the clogging of these pores due to
lubrication, make-up and infection. When this turns into a cyst over time,
it is called a chalazion. At the initial stage, antibiotic drops are used
to prevent infection. Warm dressing is applied. The warm dressing can
make the inflammatory tissue organized and the pores at the bottom of the
eyelashes expand and drain out. But if it is not treated on time and
adequately, the body surrounds the inflammatory tissue with a cyst over
time. This may need to be drained surgically and the cyst removed.
Xanthelasma is a fat-cholesterol plaque that is usually seen in women. It occurs in the
inner parts of the lower and upper eyelids. High cholesterol should be
suspected in xanthelasma seen at a young age. The treatment is surgery. In
this type of valve surgery, there is no scar after the operation, as the skin
is thin and very bloody.
Masses that develop on their lids can be benign or
malignant. The treatment of such masses is often surgical. The
removed mass should be sent for pathology examination.
Inward turning of the eyelashes is called “trichiasis”. It
can be seen in long-lasting infections and valve diseases. Inward
eyelashes cause stinging and discomfort as well as an unaesthetic appearance. These
eyelashes rub against the cornea and damage the cornea. They can reduce
vision by causing permanent scars on the cornea. Treatment; Inverted
eyelashes are plucked with tweezers, Inverted eyelash roots are burned with
cautery, Inverted eyelash roots are frozen with a device called “cryo”.
The tear fluid, which moistens the eye, moves towards the
nose through small canals in the inner part of the eye. The disease occurs
as a result of obstruction of this duct, mostly in the lower part of the
lacrimal sac. Tear duct obstruction is most commonly seen in infants in
the first year, middle-aged and later women, individuals with curved nasal
structures, and as a result of long-term nasal infections and allergies. Since
the tear cannot pass into the nose, it flows from the eyelid to the cheek. Lacrimal
duct obstruction also causes frequent eye infections. Symptoms of Tear
Duct Obstruction and Infection; Excessive watering, Frequent burrs in the
eye, Inflammation of the eye by pressing on the root of the nose, Swelling in
the root of the nose. Treatment of Tear Duct Obstruction in Infants; Massage
is applied for the first year. Massage is applied from the root of the
nose in the form of a downward stroke. 3-4 times a day, It is
necessary to do this massage movement for 5 minutes. Antibiotic eye drops
are used for burring in the eye. Treatment of Tear Duct Obstruction in
Adults; Laser or surgery.
Graves’ disease is an immune system disorder that causes excessive
secretion of thyroid hormone, leading
to hyperthyroidism. Although the exact cause of Graves’ disease is not
known, smoking can increase the risk. As a result of the disease, the eye
grows forward and the eyelid opens. It can be dangerous for the
eyes. Although the basic treatment is thyroid gland treatment, some
treatment procedures can be followed for damage to the eye.