Who operates on drooping eyelids?

Why choose an oculoplastic surgeon to operate on drooping eyelids?

An oculoplastic surgeon is a surgeon trained in ophthalmology, which allows them to practise this highly specialised art with, no pun intended, a double eye: the aesthetic approach and the ophthalmological approach.

This complementary view is all the more interesting given that the main complications of eye surgery are ophthalmological in nature.
Most are linked to excessive eyelid resection, resulting in incomplete eyelid closure, or lagophthalmos.
Nocturnal lagophthalmos then leads to dry eye syndrome, which can cause chronic keratitis or even corneal ulcers.

Thanks to their knowledge of eyelid physiopathology, oculoplastic surgeons are more alert to these potential complications than anyone else: they can anticipate them perfectly and adapt their surgical procedure accordingly.

Before practising as an eye surgeon for the past 30 years, Dr Hayot was head of an ophthalmology department: his medical knowledge, together with his surgical expertise, allows him to take better care of ageing eyes.

Why is a microsurgeon essential for blepharoplasty?

A successful eyelid lift is surgery of excellence and precision, requiring training and extensive experience in microsurgery.
The surgeon uses an operating microscope or magnifying loupes to perform a highly precise, meticulous procedure, down to the last millimetre.

This is important for at least two reasons.

The first reason is that a botched blepharoplasty is always difficult to repair. Only an experienced oculoplastic surgeon can do so.
The slightest imperfection in the surgical technique is immediately apparent, the most frequent error being scleral show, which exposes the white of the sclera more visibly. The surgical technique must therefore be perfect.

The second reason is that an imperfect technique can alter the contours of the eyes, durably betrayinga patient’s identity. Yet surgery for drooping eyelids rests on a fundamental principle: rejuvenating the eyes while preserving their soul. This can only be achieved by respecting the anatomical contours of the eyelid, hence the importance of extremely precise eyelid surgery.

Why does an eyelid lift require real expertise?

But as is often the case in surgery, good technique and good equipment are not enough: what makes the difference is the choice of the right surgical procedure.
Expertise allows a more precise, more subtle diagnosis, based on a complete analysis of the causes of ageing eyes and drooping eyelids.

In many cases, the general aesthetic surgeon will perform a subtraction blepharoplasty, removing the excess eyelid skin by simple resection, under local or general anaesthesia.
Unless the resection is too extensive, the eyes are rejuvenated to some degree, but often insufficiently. Why?
The apparent excess of skin has often not been analysed rigorously: is it skin that, having lost its tone and elasticity, can no longer retract? Or is it an apparent fold of skin caused by the loss of the underlying volumes, giving the appearance of an emptying sack?

The skin of the eyelids is very thin and subject both to mechanical stress (1000 blinks a minute) and to physical aggression: UV, wind, cold.
That is why it ages so quickly, with frequent loss of the fatty tissue above and below the eyes.

If this fat loss is under-diagnosed, subtraction blepharoplasty can give catastrophic results: by tightening the skin over lost volume, the eyes are hollowed out a little more, which ultimately darkens and alters them.

Successful surgery for drooping eyelids caused by fat loss, on the other hand, requires addition blepharoplasty, using micro-lipofilling to restore the lost fat. This injection of fat taken from the patient carries a very limited risk of rejection and is completely natural.

All the expertise of good eyelid surgery therefore lies in restoring volume through microlipostructure, before resecting any excess skin.
This micro-lipofilling technique is still considered innovative in eye surgery by many, although it has been tried and tested for years in facelifts. You can be sure of a natural result, with rejuvenated eyes that regain all the curves and expressiveness of youth, without ever altering their identity.