How is dermatochalasis different from ptosis?
These are different conditions, and the extent of the operation depends on their distinction. With dermatochalasis, the edge of the eyelid is positioned normally, and the view is obscured by a drooping fold of skin. With ptosis, the very edge of the upper eyelid droops due to weakness of the levator palpebral muscle or its tendon. Often both conditions are combined, and then removing the skin alone will not give a good result. The doctor measures the distance from the edge of the eyelid to the light reflex and assesses the strength of the muscle by raising the patient's eyebrows and observing the edge of the eyelid.
- Dermatochalasis - excess skin, the edge of the eyelid is in place
- Ptosis - drooping of the very edge of the upper eyelid
- A combination of both conditions is possible
- Lowering the eyebrow increases sagging
- Sudden ptosis requires neurological examination
Why does it appear
The main factor is the natural aging of tissue: collagen and elastin are destroyed, the skin stretches, and fat packets shift forward. Heredity plays a significant role, so heavy eyelids are often visible in several generations of the family and appear early. The process is accelerated by ultraviolet radiation, smoking, the habit of rubbing the eyes, chronic swelling due to diseases of the kidneys, heart and thyroid gland, allergic reactions and prolonged inflammation of the edges of the eyelids. Sometimes it is the drooping of the eyebrows that causes sagging, not the skin of the eyelid itself.
- Age-related loss of skin elasticity
- Hereditary features of the structure of the eyelids
- Ultraviolet radiation and smoking
- Chronic edema and allergies
- Blepharitis and constant eye rubbing
- Drooping eyebrows and forehead
Symptoms and when it bothers you
Usually a person is worried about his appearance: a crease falls on the eyelashes, the look seems tired, and the upper eyelid cannot be painted. Functional complaints appear when the skin covers the upper part of the visual field: it becomes more difficult to read signs and drive a car, you have to constantly raise your eyebrows and throw back your head, and in the evening your forehead ache. Due to the overhang, the skin rubs against the eyelashes, and irritation or weeping develops in the fold. All these signs are a reason to discuss surgery with your doctor.
- A fold of skin rests on the eyelashes
- Feeling of heaviness in the eyelids in the evening
- Habit of raising eyebrows and wrinkling forehead
- Narrowing of the upper part of the visual field
- Skin irritation in the crease of the eyelid
- Headache in the forehead area
Examination before correction
The ophthalmologist measures the position of the eyelid margin and the height of the crease, assesses the strength of the levator muscle, and the position of the eyebrow. For functional complaints, computer perimetry is performed with a raised and lowered eyelid: it objectively shows how much of the field of view is covered by the skin. Be sure to check the tear film, because after blepharoplasty, eye dryness may increase. Photographs are taken from several angles to plan cuts and compare the results. In case of edema, the functioning of the thyroid gland, kidneys and heart is clarified.
- Measuring the position of the eyelid edge and crease
- Assessing the function of the levator palpebral muscle
- Computer perimetry
- Tests for dry eyes
- Photo recording before surgery
- Examination for severe edema
How to correct
Creams, massages and hardware procedures can slightly improve the quality of the skin, but they do not remove excess tissue. The main method is blepharoplasty: the surgeon removes a strip of skin,, if necessary, part of the orbicularis muscle and protruding fatty hernias, and hides the suture in the natural crease of the eyelid. The operation is usually performed under local anesthesia and takes about an hour. If there is ptosis at the same time, the muscle tendon is strengthened, and if the eyebrows droop, their elevation is discussed. The stitches are removed after a few days, bruising and swelling disappear within 1–2 weeks.
- Upper eyelid blepharoplasty
- Removal of fatty hernias when they protrude
- Simultaneous correction of ptosis
- Raising the eyebrow when lowering it
- Local anesthesia, outpatient setting
- Cold, rest and sun protection after surgery
