Lower Blepharoplasty

Blepharoplasty, or eyelid surgery, can enhance your appearance and your self-confidence by eliminating droopy or sagging eyelids. As people age, the eyelid stretches, muscles weaken, and fat accumulates around the eyes, causing “bags” or excess skin to become prominent.

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Generally, patients for this procedure are 35 years or older. However, if sagging eyelids run in your family, it may be advisable to have eyelid surgery at a younger age.

Fullness or “sad eyes” can be treated with a Blepharoplasty or Eyelid Lift procedure. It can be performed upon either the upper eyelids or lower eyelids or all four eyelids in the same surgical setting. Frequently, patients will have their brows elevated (Brow or Forehead Lift) and may also have a facelift (Rhytidectomy) during the same surgery.

Blepharoplasty involves removing excess skin and recontouring the fatty tissue, which causes bags under the eyes. Incisions are placed in the natural skin folds to camouflage scars. Occasionally, eyelids can be treated with internal incisions, so there is no external scar.

Very fine lines around eyelids, “crow’s feet”, are not usually improved with a Blepharoplasty surgery. However, the “sad” look may be improved with realistic expectations.

Initial Consultation 
At the initial consultation the doctor and the patient will have many decisions to make based on the patient’s health,expectations,and condition of breast tissue.The doctor will discuss the patient’s medical history and examine her breasts. The patient and the doctor will need to discuss the following :

  • Implant size/volume
  • Implant shape
  • Implant texture
  • Implant placement
  • Incision site

Surgeons will outline for their patients what behaviours are appropriate and necessary before Surgery.Here are some preoperative tips for them to follow :

  • Stop taking any aspirin, ibuprofen, vitamins and herbs at least two weeks before surgery.

Pre Operative Assessment for Size and Placement of the Implant 

  • Size and Placement .The size and placement of the implant we choose will depend on many factors, such as your original cup size, your desired cup size, and your physique including chest muscle
  • If you have only a small amount of breast tissue and want to enhance the tissue much as possible, it is recommended that a large implant is placed below the muscle in order to prevent the feeling or appearance of the implant. There is also less chance of capsular contracture.
  • If you have large chest muscles as a result of exercising, the implant should be placed above the muscles in order to allow for comfortable movement and a natural look.
  • For patients with mild to moderate breast sagging, larger implants placed over the muscle is recommended. The larger the implant, the greater and more favourable the augmentation.
  • The implant can be inserted into the body through four different incision sites.Two leave scars on the breast, while the other two leave scars away from the breast .Because the implant is inserted empty, all of the incisions are small, generally measuring 1-2 inches.

Once the incision has been created, the surgeon lifts the breast tissue and skin to create a pocket. It is within this “pocket” that the breast implant will be placed and centered beneath the nipple and areola. Depending on the patient’s anatomy, the size of the implant, the surgeon’s technique, etc., the implants will be placed either directly behind the breast tissue or underneath the muscles of the chest wall (sub-muscular).

Breast augmentation surgery usually requires one to two hours to complete. Following the insertion and placement of the breast implants, sutures are used to close the surgical incisions. The surgeons will wrap the chest region with a elastic bandage to provide support and to assist with healing. Occasionally, tubes may be used for a brief time following the breast augmentation surgery to drain the surgical site.

Breast augmentation surgery stretches the breast tissue and, therefore, can be painful especially in those breast augmentation cases where the implants have been placed under the chest muscle. Typically, the greatest amount of pain is experienced within the first forty-eight hours following breast augmentation surgery. The level of pain typically reduces day-by-day and may be effectively treated by various pain medications.

Information 
AnesthesiaGeneral.
Surgery Length1-2 hours
Side EffectsTemporary soreness, swelling, change in nipple sensation, bruising. Breast sensitive to stimulation for a few weeks.
Recovery PeriodBack to work : a few days. Physical contact with breasts : 3 to 4 weeks. Fading of scars : several months to a year or more.
Stay in Hospital1 day
Stay in Thailand7 – 10 day

Postoperative Breast Augmentation Instructions

Position: During the first week post breast augmentation surgery, attempt to sleep on your back instead of on your side. We want your breast implants to stay in a perfect position during the initial healing process. This is not a “life and death” issue, however. If you cannot sleep on your back, sleep in another comfortable position.

Activity: Avoid heavy lifting and straining for two weeks minimum. You may however do normal activities at any time if they cause no pain or discomfort. Let your body tell you what you can do or not do.

Dressings: The bra acts as a “dressing,” holding the breasts and implants in perfect position. Try to keep the bra “even.” If the bra feels too tight or hurts, switch immediately to any bra that feels comfortable. A bra that is too tight can cause ulceration of the skin – YOU MUST NOT LET THIS HAPPEN! We want you to wear a bra at all times for 2 weeks. After 2 weeks, you may sleep without the bra. You should not go braless during the day for 4-6 weeks after breast enlargement surgery. It is probably more comfortable not to wear an underwire bra.

Showering and bathing: You may shower the day after breast augmentation surgery. If you prefer to bathe, do not allow the incision lines to soak for more than a few minutes in the bath water. Leave the adhesive strips (steri-strips) on your skin. (Do take your bra off while you bathe.)

  • All dressings and bandages are removed on the third day following the operation. Afterwards, the patient is free to bathe as usual.
  • The patient is requested to gently move the implants upward, downward, and inward in order to decrease the chances of capsule contracture.
  • Only gentle massaging is recommended. Overly aggressive manipulation of the implant or strong squeezing can possibly cause an inflammation, thus producing an adverse effect on the capsules.
  • During the first month following surgery, you should exercise your implants three to four times per for fifteen to twenty minutes. After that, if breast contour improve satisfactorily, you will need to exercise only once or twice daily.

Potential Surgery Risks and Complications vary from patient to patient depending on a range of factors and the extent of surgical work required. Regardless of how remote, the potential risks are listed below are possible. Your own research is essential especially if you are considering surgery. Following pre and post surgical care and instructions will also reduce your risks. See the following potential risks and complications include and not limited to:

Medical:

  • Temporary pain, swelling, bruising, infection, scarring, fluid build up (seroma), bleeding and haematoma, numbness, Keloid scarring, reaction to anaesthesia and medications
  • Change in nipple sensation (hypersensitive or under sensitive)
  • Poor healing or Necrosis (common with smokers)
  • Implant Rupture

Aesthetic:

  • Implant folding, rotation, rippling, bottoming out, asymmetry (symmetry is never guaranteed, double bubble (especially women with “tuberous breasts”), Capsular contracture, Implant rejection
  • Stretch marks (abrupt expansion of the tissues)