Eyelid Surgery
Eyelid skin is the thinnest skin on the entire human body, and therefore the first area to wrinkle. Eye contact is the first form of communication between people. Wrinkled and sagging eyelids can reflect a person's inner world. It is often possible to get an idea of a person's mental and physical state by looking at the changes around their eyes. Additionally, symptoms of conditions such as kidney, heart, and thyroid diseases, or alcohol and drug addiction, can also be observed in the eyelids. In psychosomatic approaches, under-eye bags are described as "unshed tears," a reflection of repressed emotions.
Considering all these reasons, achieving a more dynamic, refreshed, and healthy appearance through eyelid surgery is of great importance.
Upper eyelid surgery is one of the smallest yet most effective procedures in aesthetic surgery. Due to its relatively easy application, low risk of complications, and significant effect on facial expression, it is frequently preferred by both women and men. Especially with the increasing importance of a fresh and energetic appearance in modern business life, the interest of male patients in this surgery has also increased in recent years.
Aging and changes around the eyelid encompass four main structures: skin, muscle, the thin layer separating the eyelid from the eye socket, and fat tissue. In surgeries in this area, these four structures are evaluated together, and the treatment plan is devised accordingly. Wrinkles on the outer part of the eye, caused by smiling and squinting, can be reduced with small lifting procedures from the temple area, preserving the natural expression.
The correct assessment of muscle position is of great importance. In approximately 70% of upper eyelid ptosis cases, downward displacement of the eyebrow also plays a role. Surgeries performed without correcting this condition can cause the eyebrows to approach the eyelashes and result in a harsh facial expression.
In upper eyelid surgery, excess skin and muscle tissue are removed in an elliptical shape, taking care not to prevent the eye from closing. The thin membrane in front of the eye socket is opened, and excess fat tissue, especially accumulated in the inner part, is removed. In some patients, ptosis due to weakness of the muscle that lifts the eyelid can also be corrected during the same surgery.
At this point, attention should be paid to Botox applications. The tired look that appears after Botox injections to reduce forehead wrinkles is often due to congenital weakness of the levator muscle, which lifts the eyelid. When this muscle is weak, a person tries to keep their eye open by raising their eyebrows and using their forehead muscles. When this balance is disturbed by Botox, the eyelid may appear lower, and a tired expression may emerge.
Today, in upper eyelid surgeries, the classic "excess skin removal" approach has been replaced by modern "combined treatment" methods. In addition to procedures on the skin, muscle, and fat tissue, internal fixation techniques can be applied to prevent tissues from sliding down. Eyebrow lifting can be performed through the same incision line, and muscles that cause frowning can be weakened.
In lower eyelid surgeries, classical methods have largely changed. Today, only skin and fat removal is rarely performed. Before surgery, the skin, muscle, fat bags, periorbital area, and midface should be evaluated in detail.
The most common concern for patients is the eye remaining open after surgery or too much of the white of the eye being visible. This condition, called "scleral show," usually occurs due to excessive skin removal and insufficient muscle support. For this reason, in modern approaches, fat is preserved and redistributed instead of being removed. Fat pockets are opened and spread to soften the harsh transitions under the eyes.
If necessary, the lower eyelid muscle is tightened and supported. In some patients, the midface region can even be lifted with the same procedure to achieve a more balanced appearance.
All these developments show how much the approach in aesthetic eyelid surgery has changed.
Upper eyelid surgery can be performed at any age and generally provides a positive aesthetic contribution. In older ages, vision field constriction due to sagging can also be corrected with this surgery. Lower eyelid surgery, however, is usually planned in conjunction with upper eyelid surgery, not as a standalone procedure.
One of the most important points to consider here is the preservation of the overall harmony of the face. A successful intervention performed only on the eye area can create an artificial appearance if it is not harmonious with other parts of the face. Therefore, some patients may later request additional procedures such as facelifts.
In conclusion, aesthetic eyelid surgery, like all other aesthetic procedures, has evolved over time, adopting a more holistic approach that aims for natural results. Today's goal is to achieve the most natural and effective result with minimally invasive methods and personalized planning.