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The eyelids are the eye frames and the first aging signs usually appear in them. The skin excess and fat pockets become more evident, especially in the morning, when waking up. In addition, the patient may present an unreal tired appearance. The redundant upper eyelids, besides anti-aesthetic, also cause, in some cases, damages to vision. The blepharoplasty is very frequently associated with other procedures such as facial lifting, wrinkle filling and eyebrow lifting. Within the Plastic Surgery field, it is one of the most common procedures. When is surgery recommended? Usually after 35 years old or when there is a family trait. In this case, surgery may be indicated earlier. Risks and Complications: The surgery, when properly conducted, does not present risks or major complications. However, patients with pathologies, such as thyroid diseases, dry eye with insufficient tear production, hypertension, heart diseases or diabetes should first have these conditions well controlled and stabilized. Problems may occur in post-operative, however, with prompt remission, such as: blurred vision, swelling in the corner of the eyes and whitish small cysts at the place of the sutures, which are easily removable. Thousands of blepharoplasty procedures are performed successfully every year. However, although rare, there may be some complications inherent to any surgical procedure such as hematomas, scarring and infection. ANESTHESIA: Local anesthesia associated to sedation. The Surgical Technique After anesthesia, incisions are made in the upper natural furrows and under the lower eyelid lashes. The fat pockets are removed, as well as skin excess and sagging muscles. In the end, suture is made with fine threads. In some cases the incision called transconjunctival is used, which reaches the pockets directly with no incision on the skin. This technique is reserved for patients with little sagging skin and protuberant pockets in the lower eyelids. PRE-OPERATIVE CARE: Do not makeup on the day of hospitalization. Bring to the Clinic only personal use objects, and do not forget the sunglasses. For smokers, abstinence is recommended before and after surgery. Substances present in the smoke cause vasoconstriction and hinder the tissue healing. The surgery patients should be assisted by a companion to go back to their homes. POST-OPERATIVE: Soon after surgery a dressing with lubricating eye ointment is made. Normally there is an uncomfortable feeling, which may be controlled with ordinary painkillers. Otherwise, the patient should contact the surgical team immediately. Use gauze compress soaked in iced saline solution on the eyes, especially in the first 12 hours after surgery to reduce the swelling as much as possible. Keep your head raised, sitting or using several pillows to lie down, and avoiding sleeping on side posture or facing downwards for a week after surgery. The first dressing is usually made after 72 hours, removing the sutures very carefully, with no discomfort to the patient. The edema (swelling) varies from person to person, but it usually reaches a peak on the 2nd post-operative day and ends around the 7th day. Ecchymosis (bruises) disappears on average after two weeks, and makeup may be used to camouflage them appropriately. There may also be cases of eye dryness , little tearing and increased sensitivity to light. Therefore, avoid unnecessary visual efforts, exposure to wind, dust, sunlight or excessive heat, and always wear sunglasses when going out, protecting the face with a hat or cap, and sunblock. Reading and TV watching are authorized after the second day, but sparingly. Eye drops and lubricating ointments are used in the first two weeks. Patients using contact lenses may usually wear them again after two weeks. The return to gym and other physical efforts should be gradual. Try to avoid movements to lower and raise the head quickly, or lifting weights for 30 days. Other lighter activities may be authorized after two weeks. To speed the recovery up, massages may be indicated, using the lymphatic drainage technique, starting it 7 to 10 days after surgery. RESULTS: A firmer lid will be noticed, with the disappearance of sagging. Most patients report a pleasant feeling that the eyes are more open and rejuvenated. The scars, virtually invisible, may remain slightly red for a period of 2 to 6 months, becoming clearer over time. In the lower eyelids, the disappearance of the bulging caused by eyelid pockets is noticed more visibly, in this area. The result is a more youthful, rested and relaxed look.

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