Volumetric sculpting of the eyes
Blepharoplasty (eyelid surgery) represents one of the most delicate cosmetic and functional procedures involving the face. Designed to restore a more youthful appearance in an area that conveys so many emotions, subtle changes, when executed correctly, can be transformative. As an oculofacial plastic surgeon, Dr Papageorgiou has a unique understanding of the eyelid anatomy and physiology. Blepharoplasty requires a customizable approach, meticulous surgical skills and the ability to identify and balance all the variables involved in the aging process: skin elasticity loss, muscle tone, fat prolapse and bone structure, are critical in restoring the aging anatomy of the eyelid.
Recent advances have emphasized the need of a conservative approach (augmenting blepharoplasty) with the aim being to preserve the function and redistribute the eyelid tissues (fat and muscle layers) rather than subtracting them as has been the practice in recent years. Unlike traditional techniques, which alter volume proportions, replacing and augmenting what is lost is the key element in enhancing a natural and more functional outcome for the patient.
Upper eyelid blepharoplasty has evolved into a sophisticated multilayered surgery extending beyond ‘skin excess excision’ that can leave patients with an undesired tightness or even restricted movement and expression.
Using a comprehensive three-dimensional approach, Dr Papageorgiou utilizes several surgical techniques to achieve a natural and predictive outcome. During this delicate one-hour procedure an incision is made along the natural crease of the eyelid, allowing the surgeon to manipulate the skin, muscle and fat layers to achieve a natural result. In selected cases re-enforcement of the weakened levator muscle (the muscle that lifts the eyelid) is essential
In the lower eyelid, the procedure involves transferring the prolapsing fat pads across the bony orbital rim through hidden incisions (transconjuctival approach). This approach can have a powerful rejuvenative effect as it redistributes volume, smoothens the contours of the region and improves aging hollowness. The traditional approach that most surgeons adopt (transcutaneous incision) is a subtractive form of surgery that can lead to functional and aesthetic complications such as eyelid malposition, dry eye and rounded eyelid corner.
In this perspective a combined approach (bilamellar surgery) that addresses lower eyelid fat through a hidden transconjuctival incision and excess skin through a conservative skin incision, represents the foundation of Dr Papageorgiou’s surgical approach to the lower eyelid. This incorporates preserving the integrity of the orbital septum (a structural component of the eyelid) and the function of the orbicularis muscle.