[ Sagging eye ]
To correct a sagging eye, when considering blepharoplasty as a primary procedure, we must keep in mind the important relationships among the forehead, eyebrows, and upper eyelids. Many times, peoples are referred for “crowded” upper eyelids. Often, the culprit is actually the eyebrow. This may be corrected with forehead surgery or sub-brow lifting instead of a simple classical blepharoplasty with wide skin excision.
Endoscopic forehead lift can provide eyebrow lift while minimizing postoperative scarring and tissue disruption. The goal is not only to elevate the brow but also to decrease forehead rhytides (wrinkles or skin folds).
Sagging eye can be easily improved by Sub-brow lifting. Sub-brow lifting does not elevate the eybrow itself though, skin redundancy in the upper eyelid can be reduced without interrupting the skin crease and natural double eyelid folds.
Aging double eyelid fold might be reinforced with simple non-incisional buried stitch method or incisional double eyelid procedure along the natural skin crease without skin excision.
Indications
- Reduced double eyelid folds
- Sagging eye correction only without double eyelid fold
- Eyelash inversion due to the sagging skin
- Outside sagging double eyelid fold
Sagging eye Correction
Endontine forehead lift |
The sagging eyebrow and forehead are lifted upward in their original position and fixed with Absorable endotine prosthesis. |
Endotine |
Endotine implants are made from a substance called polylactic acid, which is produced from plant materials to create a bio-plastic substance that dissolves naturally and is absorbed by the body. |
Sub-brow lift |
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Just belw the eyebrow, thick upper part of eyelid skin can be reduced without skin crease interrution |
Fixed to the periosteum |
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Sagging eye can be easily improved by Sub-brow lifting. Sub-brow lifting does not elevate the eybrow itself though, skin redundancy in the upper eyelid can be reduced without interrupting the skin crease and natural double eyelid folds. However, just below the eyebrow nearly unnoticeable scar remains and lifting is slightly upward and outward direction not in true vertical direction.
Aging double eyelid fold might be reinforced with simple non-incisional buried stitch method or incisional double eyelid procedure along the natural skin crease without skin excision.
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Upper blepharoplasty |
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Redundant skin excision along the previous designed line |
Sagging fat removed adequately |
Fixing double eyelid line naturally |
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For a senior over than 70’s, too much redundant skin should be excised along the double eyelid line. Previously used forehead lifting or Sub-brow lifting is insufficent to uncover all the droopings.
However, this procedure is not appropriate to correct early sagging eyelids because wide skin excision might disrupt the natural skin crease and provoke peri-excisional wrinkles. At that ages, we recommend endotine forehead-brow lift or sub-brow lift with non incisional or non-excisional double eyelid procedure
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Why Upper blepharoplasty should be avoided?
The skin near the eyelash is very thin and has natural skin crease parallel to the skin folding line. Three skin layers are folded along the double eyelid. By upper blepharoplasty, this thin skin near the double fold should be excised to remove the redundancy. At that time, two important disadvanatages happen
One.
Thin beautiful skin is excised and the double eyelid skin fold is folded with thicker upper skin in three layers. The upper eyelid thickness become prominent and makes bigger shadow over the eye itself. It makes facial impression strong.
Two.
Fine skin creases along the double eyelid folidng line is disrupted inevitably by wide fusiform excision. Newly formed scar along the excision line is not exactly parallel to the natural crease. Multiple fine wrinkles might form newly by unwanted interaction of the scar tissue and existing fine skin crease.
So, to preserve the natural thin skin crease near the natural double eyelid line, the eyelid surgery should avoid the skin excision and allow only incision. Instead, forehead brow lift or sub-brow lift is preferred.