This surgery is technically known as lower blepharoplasty. Commonest age of presentation is between 35 to 45 years in a Caucasian and 45 to 55 in an oriental. By the time the individual decides on a consultation with a plastic surgeon it is likely they have tried a variety of non invasive or non surgical option. Most of these do not remedy the problem.
Consultation
- The first objective during a consultation is to asses the presenting problem. These may range from lower lid fat bulges (eye bags), fine lines (wrinkles) deep expression lines (crows feet & muscle expression lines) dark eyelid skin colour (dark eye circle) and growths on the skin such as milia (blocked oil glands), syringomas (sweat gland swelling) xanthalasma (fat deposit on the skin) etc . A detail history of what has been done before is also important . Some may have a family history of eye bags.
- Botox injection given on the lower eyelid may lead to weakening of the muscles and fat herniation (eye bags) become more prominent.
Examination
- Examination of the lower eyelid area to assess the presenting problem and which structure or anatomical layer it arises from. Is it excessive eyelid skin, excessive muscle or lack of muscle activity, or fat herniating (bulging) out? Which layers does the problem involve ? In addition the eyelid muscle tone, eye lashes position and tear duct position & function will have to be assessed. This is especially if there has been previous surgery done and the problem still not rectified.
- The eyelid skin colour and past scars and healing response are also important.
- Next is the aging process around the eyes. Are the eyebrows drooping , symetrical or asymetrical? Are there forehead frown lines present?
- During the consultation these questions will be answered and assessment must correlate with what can be surgically done to improve the situation.