Consultant plastic surgeon Mr Gary Ross describes how he combines these techniques to provide individualised results. The eyes are one of our most striking facial features and rejuvenation of the eyes in the form of blepharoplasty helps to provide a more youthful look with minimal downtime. Upper blepharoplasty is a common procedure where the skin of the upper eye is removed, placing the scar in a natural crease line. It is one of the commonest aesthetic procedures and results in minimal downtime with minimal risks and complications. It can often be performed under local anaesthetic. Sometimes small amounts of fat need to removed and occasionally fat needs to be added in the form of autologous fat transfer. The ageing process leads to weakening of the muscles of the eye and drooping of the contents and this is particularly important in the lower eyelid. Lower eyelid blepharoplasty is often performed in combination with upper blepharoplasty. In lower eyelid blepharoplasty, the contents of the orbital septum need to be tightened and patients often need treatment of eye bags and hollowing, which result from ageing of the lower lid and sagging of the mid-face.
This lid-cheek junction and mid-face sagging often is not addressed by a standard blepharoplasty technique but by using the same minimal scars as a lower blepharoplasty the mid-face can be lifted so that the sagging tissue of the mid-face can be repositioned into the lid-cheek junction, disguising the hollowing and rejuvenating not just the eyes, but also the midface. It is well known that the ligaments of the mid-face relax as we age, with thinning of the tissues and sagging of the soft tissue. The aims of mid-face rejuvenation are to reposition this sagging tissue. Previously, facelifting techniques would be required to lift the mid-face through separate scars and although in certain patients this still remains the best option – especially in patients with drooping of the jowls and lower face – the mid-face can often be addressed adequately through this minimal scar technique. The mid-facelift in combination with blepharoplasty can tighten the sagging lower eyelid and the mid-face through a minimal incision with a net effect that minimal tissue needs to be removed and the tissue is simply repositioned into a higher position. Sometimes additional tissue in the form of autologous fat needs to be added. The recovery following this surgery is a lot quicker than standard facelifting techniques.