The eyes determine face expressiveness. Every person has natural features which can be emphasized and improved to highlight your natural beauty. Effective results are achieved thanks to simple techniques, without going into the operating theatre.

In Japan and China, Asian Blepharoplasty to obtain a western look has been reported to be one of the most common aesthetic procedures. The increase of the economic level of these countries increases the interest to improve the personal image and therefore the demand of aesthetic treatments.

Anatomically, there are a number of differences in the upper eyelids of Eastern Asians compared with Caucasians. Eastern eyes are almond-shape and do not have a crease in the upper-lid. The upper-lid falls like a ‘curtain’. Blepharoplasty removes the skin or fat excess in some cases and creates a crease so that the eye keeps clearer.

This procedure is made with local anaesthesia and it is so successful that the patient can go home with his/her eyes uncovered.

On the other hand, Blepharoplasty can be made the other way round, namely, for western featured people who want to achieve an Asian almond-shape look.

Lids are very sensitive and it is very important that the patient explains what he/she wants exactly. The best results are achieved with a perfect relation doctor-patient.

The study gathers considerations, casuistry, applied techniques and results obtained on 300 Blepharoplasty cases made in eyelids of patients with Dermatochalasis or lower bags.

Dr José González Vidal explains why Blepharoplasty can be necessary for the upper eyelid:

“Amongst other reasons, eyebrows can affect the upper eyelids. So the ‘ptosis’ or drooping eyebrow can also produce drooping upper eyelid. It may look excess skin, but the problem is in the eyebrow and not in the eyelid. This way the eyelid closes right and problems like eye dryness are avoided. Each person has a different look. Therefore it is necessary to study what we expect to get.”

Regarding Lower Eyelid Blepharoplasty, Dr José González Vidal emphasises that the most common problem is fat build-up, which is usual until 40 or 50 years old.

“There are three fat packets to be considered. Lack of skin firmness in this congenital area, due to the age. It causes upper fat herniation and therefore the bags or rings around the eyes.”

Both Upper and Lower Eyelid Blepharoplasty are techniques with a high level of satisfaction amongst their patients. The choice of the most proper technique for each case and the perfect communication and understanding between surgeon and patient are very important factors.

Process:

• - Anaesthetic drops
• – A protective contact lens is placed.
• – Local anaesthetic is infiltrated.
• – Fat removal or transposition.
• – No stitches.
• – An ice mask is placed.
• – Antibiotic eye drops.

“Personalised studies for our patients in order to obtain the best results with the most simple techniques.”

New technologies give us an innovative tool that has become indispensable to us and is available to our patients and public: audiovisual information in the Internet. With this aim we have chosen an agile and easy-to-navigate system to include a new section of Videos in our web page.

On Rejuvenate Without Surgery, we begin another approximation stage for the Internet user with a clear aim: explaining the last medical advances in aesthetics by the means of IMAGES. These advances allow the obtaining of effective results without going in the theatre room with simple techniques.

We open this section with three topics of our speciality and in great demand in aesthetic medicine:
Blepharoplasty: a very asked procedure by men and women around 30 and 45 years old. It is used to correct the ‘falling eyelids’ and to remove the bags around the eyes.

Rings under the eyes: those dark spots under the eyes. They vary in size and tone, when we get tired, nervous, we do not sleep tight… The semicircle that they form in the lower eyelid makes the look lifeless.

Anti-aging: new anti-aging non-invasive techniques to keep the skin youth and improve naturally with the passing of the time.

The selection of demonstrative videos are part of the series ‘The Secrets of the Young Look’, an informative space where you can find everything explained with an accessible language but also scientific rigor: the different techniques of treatment without surgery for the first signs of eye and face aging. We can stop the signs of aging and keep a natural and healthy face with just small touch-ups.

We know by experience that in Aesthetic matters the main thing is the patient’s satisfaction. If there is a good relation doctor-patient and the patient knows exactly what he/she will obtain, the results of these small non-surgical touch-ups and the patient’s satisfaction can be superb.

How can we improve them without surgery:

• – With a Reducer Serum in the rings and bags area. This way we can reduce the bags and give the eyelid more muscle tone, so the wrinkles and flaccidity improve too. The Serum is applied twice a day in the area and does not produce any kind of irritation.

The results are immediately visible from the first day on, with an instant effect: at the moment a visible improvement is produced in the bags and rings under the eyes.
There is another alternative if we do not want to be depending on the constant application of products.

• - Infiltration of vitamins

It involves a little superficial infiltration of a mixture consisted of: Vitamins (A, B, C…), Minerals (Calcium, Potassium…), Nucleic Acid (Adenosine…), Reducer Agents (Absorbic Acid), Hyaluronic Acid, Amino Acids (Taurine, Tyrosine…), Co-Enzymes…
With this infiltration, we reduce the dark colour of the bags under the eyes as we remove the melanin sediments. These infiltrations of vitamins stimulate the collagen and regenerate the skin elements achieving very natural results.

Other applications

Besides reducing the bags under the eyes, the infiltrations of vitamins outdo the lifting, provided that the technique is correctly applied. A complete facial rejuvenating session gives luminosity to the face and harmony to the expression and the face outline.
A complete treatment lasts around 20 minutes. Once finished, the patient can start his/her normal activity. No allergy tests are necessary.

A good appearance and enjoying good health has become a social imposition and this is proved by market research in new aesthetic trends of European men: more than half of the Spanish male population recognizes having wrinkles, still they are fewer than the rest of the European men (63%).

These researches are focused on hygiene habits and other aesthetic aspects of men from Spain, Italy, France, Germany and Great Britain.

Researches provide interesting information: 35% of the Spanish male population is worried about rings and bags under their eyes. This concern is greater than the one they have about wrinkles, probably because a 27% of the Spanish men suffer from these kinds of problems around their eyes.

This is a natural concern given that 27% of the Spanish men suffer from these problems around their eyes; however this figure is not the highest in Europe. German men show a greater obsession about rings and bags under their eyes.

When the general standard of economy and culture in a country increases, cosmetic surgery becomes a necessity. A nice appearance is important in jobs involving direct contact with clients.

Normally business men are the ones most interested in showing a healthy and nice appearance. They are not only trying to look younger, but also to have a young look in their eyes and therefore a special attention to the eye contour is needed.

Non-surgical techniques

With plastic and cosmetic ocular surgery you can get spectacular results and in very few minutes. Non-surgical touch-ups, injections and other kinds of periocular rejuvenation procedures as blepharoplasty (removing bags under the eyes), periocular lifting or correcting sagging eyelids are all performed in women and men between 25 and 80 years old.

We always emphasize that it is easier and safer to keep young by small and harmless corrections than to try to rejuvenate 30 years in one go.

It is important to know the specific treatments for each kind of problem. There is not a particular age at which they start to appear but there are particular solutions to correct them.

We use non-surgical techniques to return youth and brightness to your eyes.

Which is the treatment?

We inject microinjections under the skin to reoxygenate tissues and stimulate the dermis in order to produce new collagen fibres and elastin. By this procedure we get a skin with elasticity and without wrinkles.

Which substance do we inject?

The newest substance we use nowadays is the hyaluronic acid. This substance is present normally in the human organism and therefore it is totally biocompatible. This substance is responsible for nourishing and reconstructing the necessary collagen to have an invigorated skin and it also revitalizes the cell cycle and restores brightness and smoothness to the face skin.

How do we inject it?

• - We use microinjections.
• - No anaesthetic is necessary because the procedure is not painful. Tolerance tests are also not necessary because the substance cannot cause side effects or swelling.

Recovery

The first and immediate effect is the smoothing and tightening of the skin and the face contour. Next consequence is a lasting chemical effect which keeps on revitalizing the skin tissue. The treatment is usually repeated every two years.

Thanks to the so waited authorization from the Ministry of Health to use the botulinum toxin for cosmetics purposes, botox is still nowadays one of the most demanded techniques to remove face wrinkles. It is used to relax frown lines, smooth the forehead, elevate the eyebrow and remove those annoying crow’s feet. However, the year 2007 can be considered the Blepharoplasty Year.

The number of women and men who choose antiage techniques is increasing. They want to remove tiredness signs and to rejuvenate the look in their eyes. Blepharoplasty or eyelid repair is one of the most demanded techniques (46%), it is the most demanded by men (30%) and women (70%). As regards of the age, it has decreased from the age of 49 in the year 2000 to the age of 46 in the 2006.

After the results obtained in about 300 Blepharoplasty operations with patients having dermatochalasis (an eyelid condition) or lower eye bags, it is confirmed that the main aesthetic problem around the eyes for women and men is the eye bags presence.

At the SEPOO Congress hold in Barcelona, we introduced a new option to the lower eyelid blepharoplasty procedure as an alternative method to the traditional one which basically consists in removing Fat and sometimes also excess Skin from the Lower Eyelid.

This classic concept of removing as much Fat as possible has changed. In order to achieve better and lasting results, instead of removing the fat we should rearrange it or even incorporate it again. This new PROPOSAL consists in treating these two problems separately. On the one hand, we have the excess fat which pushes the orbital septum, the orbicularis muscle and the skin forwards and on the other the possible skin ageing.

Both upper and lower eyelid blepharoplasty are techniques which achieve high satisfaction among the patients. They are carried out with local anaesthesia, without pain, under observation of an anaesthetist and without hospitalization.

Oculoplastic surgery deals with every kind of problems around the eyes, in the eyelids, brows, etc. not only medical diseases (as eyelids disorders), but also cosmetic problems. The skin in this area is smoother and the water evaporation is twice more important. Furthermore, the quantity of elastin and collagen fibres is much lower.

The result is that the epidermis surrounding the eye wrinkles quicker and what’s more, the expression wrinkles appear spontaneously at the outer angle of the eyes no matter the age.
Besides the wrinkles, this area shows more problems:

• - The bags appearing when the tissues relax.
• - The rings around the eyes appearing as soon as any minimum organic disorder takes place.

Palpebral bags
The bags formed under the eyes consist of little fat lumps which relax the skin tissues. The age and tiredness increase this effect, and so the tissues relaxation and therefore the bags become bigger. With rest, the bags attenuate, however, when the years pass by, every time it is more difficult to hide them.

The rings and bags under the eyes are the aesthetic problems which appear usually in a percentage of 70% of the population over 25/30 years old.

People having these kinds of problems can rejuvenate the look of their eyes by oculoplastic techniques. The procedure is carried out with local anaesthesia and without hospitalization. It is a very easy operation made by an expert surgeon and the results are really satisfactory. Eyelids are very delicate and that is why it is advisable that the professional is an ophthalmic surgeon specialized in this kind of surgery (oculoplastic surgeon).

In our Centre we carry out eye operations with laser surgery and plastic and cosmetic eye surgery to correct rings and bags under the eyes and sagging eyelids. We always advise:

• - to choose a proper technique. Usually a small operation or correction at the proper place can produce spectacular results.
• - not to treat the eyelids separately. It is very important to achieve a smooth contour around the eyelids along with the rest of the face; that is the main characteristic of a young face.
• - to make a customized study to every patient in order to achieve the best results with the easiest technique.

The skin of the upper eyelid loses firmness and becomes loose with the time and that is why some skin creases appear covering the eyelashes. The eyelid loses the youthful look. We achieve to remove the excess skin and fat with minimal incisions at the creases of the upper eyelid. We place internal self-absorbing stitches so that the first days after the operation only a little scar hidden by the upper eyelid crease can be noticed.

For women: the goal sought is an upper and curved crease and a wide-open eyelid.

For men: the goal sought is a straighter and lower crease and a less open eyelid.

Easy post-operation: the internal self-absorbing stitches will dissolve on their own after few days, therefore it is not necessary to remove them in a week after as it is usually done in other operations. All of this favours a comfortable and easy recovery.

Pictures of upper eyelid surgery:

Beneath the lower eyelid there are three fat pockets. The fat functions like a sponge which retains liquids. The result is that any kind of situation involving liquids retaining like for instance the women’s menstruation or the lack or excess of sleep, produces the retaining of liquids and therefore swelling and redness of the bags. Most of the times, the swelling remains also without liquids retaining.

The ideal shape of a lower eyelid is slightly convex and the area joining the eyelid with the cheekbone is smooth, showing a continuous curvature.

Someone having the so called “bags” has a bulging eyelid. By removing the fat, the skin of the eyelid which was convex curves itself inwards, by this procedure we achieve not only to remove the bags but also a firm skin at the lower eyelid and everything WITHOUT CUTTING THE SKIN. We remove the fat by making a microscopic incision through the conjunctive inside the eyelid. This wound at the conjunctive heals itself in 24 hours.

Next day a minor swelling and redness appear at the lower eyelid. Normally there are no bruises.

Pictures of lower eyelid surgery:

To correct this problem we make a small incision at the upper eyelid in order to insert an absorbable plate which elevates the eyebrow (Brow Lifting), achieving an ideal position of the eyebrow.

For women: the classic ideal eyebrow is arched and upper than the men’s one.

For men: the classic ideal eyebrow is straighter and lower than the women’s one and also concave at the outer side.